@phdthesis{drph-gan-shiz-yee-2024, title = {Assessment of Implementation and Enforcement of Smoke-Free Laws and Policies Among Malaysian Smokers: A Mixed Method Approach}, author = {Gan Shiz Yee }, year = {2024}, date = {2024-12-18}, urldate = {2024-12-18}, abstract = {Smoking has remained prevalent and plateaued for decades in Malaysia. Smoke-free laws (SFL) and policies could deter smoking by strengthening anti-smoking norms, impacting cessation behaviour due to decreased social acceptability of smoking in public spaces. With socioeconomic status (SES) affecting smoking risk factors, disparities in health outcomes post-SFL implementation are likely. Furthermore, regional and international assessments show Malaysia’s poor performance due to ineffective smoking bans and enforcement. Local studies revealed inadequate SFL implementation and enforcement, leading to high secondhand smoke (SHS) exposure. Understanding these challenges and opportunities is crucial for improving policy implementation and enforcement to enhance public health outcomes. This study examined the association between SFL and quit intention among Malaysian smokers, exploring the mediating role of smoking social norms and SFL support while considering SES as a moderator. Challenges and opportunities in implementing and enforcement of SFL and policies were also explored. This study employed a convergent parallel mixed-methods approach, incorporating secondary data analysis of the International Tobacco Control Malaysia Survey 2020 and semi-structured individual in-depth interviews (IDI) with local tobacco control experts. Quantitative cross-sectional survey data was managed and analysed using Stata version 17.0 and Smart-PLS 4.0.9.2, employing descriptive analysis and the Partial Least Squares Structural Equation Modeling method. Semi-structured IDI between May and December 2022, with purposive sampling of selected participants, provided insight into implementing and enforcing SFL. Framework method and NVivo 1.6.1 software were used to analyse the qualitative data. Triangulation of findings provided a comprehensive evaluation of SFL through SWOT analysis. Smoking prevalence was highest in night-time entertainment venues (85.4%), non-air-conditioned eateries (46.7%), and indoor workplaces (36.3%). Fewer smokers (14.2%) observed smoking at air-conditioned eateries. While most smokers report comprehensive smoke-free rules in public places, including eateries (both non-air-conditioned at 78.2% and air-conditioned at 74.9%) and indoor workplaces (69.2%), fewer observe such regulations in night-time entertainment venues (24.4%). Support for comprehensive SFL in public venues was substantial among smokers, particularly in non-air-conditioned eateries (66.7%), workplaces (65.5%), and night-time entertainment venues (49.9%). Although SFL has minimal direct impact on quit intentions, its influence on smokers’ decisions to quit, mediated by perceived societal norms against smoking, is significant. Lower SES smokers may be more responsive to societal attitudes against smoking concerning quitting intentions. Effective implementation and enforcement of SFL face challenges such as tobacco industry interference, stakeholder attitudes, social norms, resource scarcity, and political and organizational barriers. However, community-led initiatives, multi-faceted advocacy, synergistic collaborative efforts, and proactive enforcement offer opportunities for improvement, requiring commitment and leadership from local champions and authorities. This study suggests that SFL could protect non-smokers from SHS and encourage anti-smoking norms, aiding adult cessation efforts. This is particularly important for smokers who find smoking socially unacceptable in public and those actively attempting to quit, especially within lower SES groups. Expert’s insights regarding the challenges and opportunities of SFL implementation and enforcement strategies strengthen the justification for promoting smoke-free environments across governance levels. They are pivotal in refining these strategies, particularly at the grassroots level, and in fostering further local initiatives.}, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @phdthesis{drph-Patrick-Peng-Wee-Yao-2024, title = {Impact of Psychosocial Work Factors and Voice Disorders Mediated by Psychological Distress Among Secondary School Teachers}, author = {Patrick Peng Wee Yao}, year = {2024}, date = {2024-12-18}, urldate = {2024-12-18}, school = {Universiti Malaya}, abstract = {Voice disorders are relatively common and can cause adverse effects, including reduced quality of life, increased absenteeism from work, and increased economic costs to the country. Teaching is a profession that uses voice as a primary tool, which puts a heavy demand on the teacher’s voice. Teachers have a higher rate of current voice problems than the general population. This study aimed to assess the prevalence, lifetime prevalence and association between psychosocial work factors and voice disorders and the mediation effect of psychological distress among secondary school teachers. This study was conducted in two phases. Phase 1 utilised secondary data from the CLUSTer study to examine the prevalence, lifetime prevalence, and association of work psychosocial factors with voice disorders mediated by psychological distress among secondary school teachers. Partial Least Square Structural Equation Modelling was used to build and analyse the proposed mediation model. Phase 2 involved external validation of the}, note = {Doctor of Public Health Thesis}, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @phdthesis{phd-huifang-zhang-2024, title = {The Mediating Role of Perceived Organisational Support and Professional Benefit On The Relationship Between Burnout and Turnover Intention: A Study Among Chinese Nurses}, author = {Huifang Zhang}, year = {2024}, date = {2024-11-29}, abstract = {Nurse shortage is a global problem, and high turnover further exacerbated it, which induced the healthcare industry faces a critical challenge, particularly acute in China. Existing research indicates that burnout is closely linked to turnover intention. However, few studies have studied the additive and reciprocal effects of several factors on the development of turnover intention. There is a need for a comprehensive study to explore the direct and indirect relationships between burnout and turnover intentions, with a focus on identifying mediating factors and understanding the internal impact mechanisms. This study attempted to investigate the current state of burnout, perceived organisational support, perceived professional benefit, and turnover intention; and to determine the interrelationships between the four areas.; This study examine the mediating roles of perceived organisational support and professional benefit in the link between burnout and turnover intention among nurses in China. Data were collected using a purposive sampling method from May 2023 to August 2023. A total of 1,058 nurses in Beijing completed the online questionnaires. The study employed a cross-sectional survey design. The instruments used in the study were the Maslach Burnout Inventory (MBI-GS), Turnover Intention Scale, Perceived Organisational Support Scale, and Perceived Professional Benefit Scale. Pearson correlation analysis explored associations between four variables. Multivariate regression analysis was used to assess the main factors influencing turnover intention. Structural equation modelling with AMOS 24.00 was used to assess the mediating effects. Relationship analysis showed that burnout was significantly and negatively associated with both perceived organisational support (r=-0.223, p\<0.001) and perceived professional benefit (r=-0.172, p\<0.001). Turnover intention was also negatively associated with perceived organisational support (r=-0.232, p\<0.001) and perceived professional benefit (r=-0.150, p\<0.001). Burnout had a significant positive correlation with turnover intention (r=0.182, p\<0.001). Among the sub-dimensions of perceived organisational support, affective perceived organisational support, superior support, and colleague support were significant predictors of turnover intention, while job security and work value were significant predictors too. Perceived organisational support and perceived professional benefit concurrently mediated the relationship between burnout and turnover intention, with a mediation effect of 0.167, accounting for 42.89% of the total effect (0.394). The mediation effect of perceived organisational support was 0.131, representing 34.75% of the total effect, while the mediation effect of perceived professional benefit was 0.056, accounting for 14.93% of the total effect. The findings suggest that burnout influences turnover intention through perceived organisational support and perceived professional benefit. Improving these supports can buffer the relationship between burnout and turnover intention. Medical institutions and nursing managers should focus on enhancing organisational support and professional benefits to mitigate burnout\'s effect on turnover intention. It is recommended to prioritise adequate organisational support, especially strengthening supervisor support, and creating a supportive leadership environment.}, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @phdthesis{nokey, title = {Development of A Health Education Intervention and Its Effectiveness in Improving MMR Vaccination Confidence, Attitude and Uptake Among Parents Attending Public Health Clinics in Kuala Lumpur}, author = {Aida binti Mohd Azlan}, year = {2024}, date = {2024-11-11}, abstract = {Introduction: Despite the progress made in Malaysia\'s vaccination programmes, measles continues to persist. Parental confidence in measles vaccines plays a pivotal role in ensuring successful immunisation. However, there is currently limited research on effective interventions to measure outcomes related to parental trust in MMR (measles, mumps, rubella) vaccination programmes in Malaysia. Hence, this study aims to determine the effectiveness of Parent\'s Health Education as an intervention to improve MMR vaccination confidence among parents in Malaysian urban settings. Methods: The research was conducted in three phases based on the Logical Framework Approach from June 2022 to March 2024. The phases include systematically developing and validating a Parental Health Education (PaHE-Measles) consisting of MMR brochures and framing messages for measles (MMR) vaccination. The Heuristics Framework\'s guiding principles were used to develop PaHE-Measles. The Emory Vaccine Confidence Index and MMR Attitude Measurement Instruments were adapted, translated, and validated to suit the Malaysian populace. Lastly, the effectiveness of Parent Health Education Intervention was delivered and assessed in a quasi-experimental study design with a control group in Government Maternal Child Health clinics in Kepong, Kuala Lumpur. Participants in the intervention group received PaHE-Measles to reinforce behavioural change. Participants in the control group received standard care from primary healthcare providers in the clinics. The pre- and post-intervention questionnaires were administered to determine parental MMR vaccination confidence. Ultimately, the uptake of the MMR vaccine at 9 and 12 months of age in children of follow-up parents was determined. The primary outcome was the proportion of parental vaccine confidence in MMR vaccination. The secondary outcome included the between-group mean difference for change in parental vaccine confidence and the uptake of MMR vaccine at 9 and 12 months of age. Participants\' demographic characteristics and baseline values were compared using an independent t-test for normality-distributed variables and continuous data. Conversely, the Mann-Whitney test was used for non-normality-distributed variables, and a Chi-square test was used for the categorical data. Repeated measures of ANCOVA were used to measure the difference in MMR vaccination confidence score between the two groups. The proportion of children who received their MMR vaccinations on-time was compared at 9 and 12 months of age in children of follow-up parents. Results: The newly developed PaHE-Measles intervention exhibits strong content validity and clarity. The intervention significantly improved parental confidence in measles vaccination, as evidenced by the increase in trust (F(1, 247.8) = 53.34, p\<0.001, np² = 0.14) and improved attitudes (F(1, 119.1) = 32.91, p\<0.01, np² = 0.09) compared to the control group. Both the intervention and control groups adhered to the MMR vaccination schedule; however, substantial delays (15.8%) and defaults (2.4%) were reported in the control group. Conclusion: This study provides evidence that a newly developed PaHE-Measles using combined educational brochures and framing messages via text can be implemented in a healthcare setting and improves parental vaccine confidence in measles vaccination. Further studies are required to determine whether similar outcomes could be achieved in communities with different health settings, socioeconomic backgrounds, and geographical areas.}, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @phdthesis{drph-Mohd-Khairul-Anwar-2024, title = {Site-Specific Prevalence of Human Papillomavirus Infection in Malaysian Men}, author = {Mohd Khairul Anwar Shafii}, year = {2024}, date = {2024-11-11}, abstract = {Human papillomavirus (HPV) infection is among one of the common infections among the female population and is closely associated with cervical cancer. It has gained attention since the introduction of prophylactic HPV vaccines. However, the epidemiology of HPV infection among the male population in the Asian context remains largely unknown. The worldwide report on the prevalence of HPV infection among men varies depending on the target population and method of sampling. This study aims to determine the knowledge, and site-specific prevalence of anogenital HPV infection, and its associated factors among sexually active men in an urban middle-income Asian setting. The acceptance of self sampling in HPV infection detection was also examined. A cross-sectional study was conducted among 498 healthy males from three health clinics in Klang Valley, an urban conglomerate in Malaysia, a middle-income Asian country. Study sites were chosen to represent the diverse sociodemographic background of the Malaysian population. A 43-item questionnaire was used to assess the knowledge and awareness on HPV. Genital and anal samples were collected for detection of HPV DNA based on specific sites, i.e., penile (shaft, penile glans, corona sulcus, scrotum) and anal. It was found that knowledge on HPV were poor among the males in this study. Overall, 21% (86 out of 410) were positive for penile HPV and 13.5% (50 out of 370) were positive for anal HPV infection. HPV18 was found to be the most oncogenic type in both sites, whereas HPV6 was prevalent in terms of the non-oncogenic types. Penile HPV infection was higher among non-smokers, alcohol consumers and those with a high number of lifetime sexual partners. However, there were no significant predictors of anal HPV infection. It was also noted that participants who were younger and of higher income preferred self-sampling as compared to physician-acquired sampling. The prevalence of HPV infection among sexually active Malaysian men in the urban setting seem to be notably higher than their female counterparts. Overall, our findings appear to suggest that vaccinating men against HPV infection may confer benefits in the middle-income Asian settings.}, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @phdthesis{drph-Tengku-Nuraihan-Zafirah-2024, title = {Effectiveness of an Improved Leprosy Lakar Training on Knowledge and Skills Among Healthcare Workers in Primary Healthcare in Pahang Malaysia}, author = {Tengku Nuraihan Zafirah Tengku Zainal Abidin}, year = {2024}, date = {2024-10-16}, abstract = {Introduction: Despite the progress made in Malaysia\'s vaccination programmes, measles continues to persist. Parental confidence in measles vaccines plays a pivotal role in ensuring successful immunisation. However, there is currently limited research on effective interventions to measure outcomes related to parental trust in MMR (measles, mumps, rubella) vaccination programmes in Malaysia. Hence, this study aims to determine the effectiveness of Parent\'s Health Education as an intervention to improve MMR vaccination confidence among parents in Malaysian urban settings. Methods: The research was conducted in three phases based on the Logical Framework Approach from June 2022 to March 2024. The phases include systematically developing and validating a Parental Health Education (PaHE-Measles) consisting of MMR brochures and framing messages for measles (MMR) vaccination. The Heuristics Framework\'s guiding principles were used to develop PaHE-Measles. The Emory Vaccine Confidence Index and MMR Attitude Measurement Instruments were adapted, translated, and validated to suit the Malaysian populace. Lastly, the effectiveness of Parent Health Education Intervention was delivered and assessed in a quasi-experimental study design with a control group in Government Maternal Child Health clinics in Kepong, Kuala Lumpur. Participants in the intervention group received PaHE-Measles to reinforce behavioural change. Participants in the control group received standard care from primary healthcare providers in the clinics. The pre- and post-intervention questionnaires were administered to determine parental MMR vaccination confidence. Ultimately, the uptake of the MMR vaccine at 9 and 12 months of age in children of follow-up parents was determined. The primary outcome was the proportion of parental vaccine confidence in MMR vaccination. The secondary outcome included the between-group mean difference for change in parental vaccine confidence and the uptake of MMR vaccine at 9 and 12 months of age. Participants\' demographic characteristics and baseline values were compared using an independent t-test for normality-distributed variables and continuous data. Conversely, the Mann-Whitney test was used for non-normality-distributed variables, and a Chi-square test was used for the categorical data. Repeated measures of ANCOVA were used to measure the difference in MMR vaccination confidence score between the two groups. The proportion of children who received their MMR vaccinations on-time was compared at 9 and 12 months of age in children of follow-up parents. Results: The newly developed PaHE-Measles intervention exhibits strong content validity and clarity. The intervention significantly improved parental confidence in measles vaccination, as evidenced by the increase in trust (F(1, 247.8) = 53.34, p \< 0.001, \c{c}\~{n}² = 0.14) and improved attitudes (F(1, 119.1) = 32.91, p \< 0.01, \c{c}\~{n}² = 0.09) compared to the control group. Both the intervention and control groups adhered to the MMR vaccination schedule; however, substantial delays (15.8%) and defaults (2.4%) were reported in the control group. Conclusion: This study provides evidence that a newly developed PaHE-Measles using combined educational brochures and framing messages via text can be implemented in a healthcare setting and improves parental vaccine confidence in measles vaccination. Further studies are required to determine whether similar outcomes could be achieved in communities with different health settings, socioeconomic backgrounds, and geographical areas.}, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @phdthesis{drph-Munazieraa-Ab-Aziz-2024, title = {Prevalence and Determinants of Anaemia Among Orang Asli Adolescents in Peninsular Malaysia}, author = {Munazieraa Ab Aziz}, year = {2024}, date = {2024-10-11}, urldate = {2024-10-11}, abstract = {Anaemia is a significant public health issue that affects people of all ages globally. According to the 2019 National Health and Morbidity Survey, 20.5% of Malaysian adolescents suffer from anaemia. Among Orang Asli adolescents, the situation is even more severe, with up to 50% affected by anaemia. This study aims to understand the burden of anaemia among the indigenous group in Malaysia and identify the factors associated with anaemia among Orang Asli adolescents in Peninsular Malaysia. The study comprises a systematic review and a cross-sectional study. First, a systematic review was conducted to analyse the literature on the burden and causes of anaemia among Orang Asli in Malaysia. Second, a cross-sectional study was carried out among 404 Orang Asli adolescents in two states, namely Pahang and Perak. The participants were selected using systematic random sampling of the settlements. Adolescents aged 10 to 19 years in the respective settlements were invited to participate and underwent interview-administered questionnaires, 24-hour dietary recalls, anthropometric measurements, and comprehensive blood and stool samples. Anaemia status was defined according to specific WHO guidelines for age and gender. Multiple logistic regression analysis was performed to identify the factors associated with anaemia among Orang Asli adolescents. The systematic review revealed a high prevalence of anaemia among Orang Asli (68.4%), with research primarily focusing on iron-deficiency anaemia and soil-transmitted helminth infections. Other factors contributing to anaemia included malaria, female gender, young age, mothers with low education levels, and low household incomes. Interestingly, no studies were found associating Orang Asli with hereditary anaemia. The cross-sectional study showed that 31.0% of Orang Asli adolescents were affected by anaemia, with 45.5% suffering from moderate to severe anaemia. Anaemia was associated with factors such as chewing betel (aOR=4.080, 95% CI=2.008, 8.285; p=\<0.001), having a working father (aOR=3.183, 95% CI=1.607, 6.303; p=0.001), soil transmitted helminth infections (aOR=2.446, 95% CI=1.302, 4.595; p=0.005), hemoglobinopathies (aOR=2.341, 95% CI=1.114, 4.917; p=0.025), living in rural areas (aOR=3.494, 95% CI=1.044, 11.694; p=0.042), being female (aOR=2.195, 95% CI=1.022, 4.711; p=0.044), and using river water (aOR=3.255, 95% CI=1.023, 10.360; p=0.046). Protective factors for anaemia included having a home toilet, taking iron-folate supplementation, weight gain, and using a gravity-feed system for water sources. In conclusion, this study identified various risk factors associated with anaemia among Orang Asli adolescents, highlighting the complex interplay between socioeconomic determinants, environmental factors, and health outcomes among these marginalised populations. The study suggests that existing strategies should be reviewed and strengthened to address the specific needs of Orang Asli adolescents, requiring collaborative efforts involving government agencies, NGOs, healthcare professionals, educators, and community leaders for meaningful change.}, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @phdthesis{drph-Noor-Azwani-Raduan-2024, title = {Prevalence and Factors Associated with Internet Addiction Among Adolescents in Penang: A Cross Sectional Study}, author = {Noor Azwani Raduan}, year = {2024}, date = {2024-10-07}, abstract = {In today’s society, the internet has become a necessity rather than a privilege. The increasing number of internet users, particularly among children and adolescents, raises concerns about preventing addiction in this young generation. Internet addiction can have negative effects on the physical, mental, and social health of adolescents. This study aims to investigate the factors associated with internet addiction and examine how family, friends, and school connections relate to adolescent internet addiction. A cross-sectional study was conducted from January 2020 to March 2020 involving 2,048 students in secondary schools across all five districts in Penang, Malaysia. Data from the study was collected using self-administered questionnaires. The level of connectedness that adolescents felt towards their family, friends, and school was evaluated using a validated bilingual version of The Hemingway Measure of Adolescent Connectedness. Furthermore, internet addiction among adolescents was assessed using a validated Malay version of the Internet Addiction Test. Of all the participants in the study, 53% belonged to the early adolescence group while the remainder were part of middle adolescence group. On average, study participants were 14.95 years (SD: 1.02). A majority identified as Malay (83.5%), followed by Indian (9.9%), Chinese (5.8%), and others making up for only 0.8%. Overall findings indicate that approximately 66% of adolescents exhibited symptoms indicating internet addiction. In terms of social connectedness, the majority of adolescents were highly connected with their mother (80.2%), father (67.1%), siblings (68.8%), friends (62.4%), teachers (64.4%) as well as school (58.0%). However, only 48.2% demonstrated high connectedness with peers in school. Factors associated with internet addiction among adolescents include older adolescents (OR = 1.276, 95% CI: 1.142, 1.426), schooling in Seberang Perai Selatan district (OR= 2.215, 95% CI: 1.444, 3,400), comes from high-income families (OR = 1.681, 95% CI: 1.144, 2.468), have history of smoking (OR= 2.128, 95% CI = 1.385 - 3.270), have personal gadgets at the age of 7 to 12 years (OR = 2.143, 95% CI:1.522, 3.016) and before 7 years (OR= 3.581, 95% CI: 1.633, 7.851) and spend more than 3 hours daily online (OR = 2.785, 95% CI: 2.224, 3.487). Indians were found to be a protective factor for internet addiction among adolescents (OR = 0.553, 95% CI: 0.387, 0.790). In terms of social connectedness, low connectedness with fathers (OR = 1.329, 95% CI: 1.052, 1.678), school (OR = 1.489, 95% CI: 1.177, 1.885) and peers in school (OR = 1.415, 95% CI: 1.123, 1.783) as well as high connectedness with friends (OR = 1.321, 95% CI = 1.055 - 1.654) were associated with internet addiction among adolescents. This study suggests that it is important to enhance public awareness and implement early screening measures for internet addiction. Additionally, emphasising the role of fathers in adolescents’ lives and providing a safe and supportive environment in schools may help reduce internet addiction among this population.}, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @phdthesis{nokey, title = {Effectiveness Of Fatigue Intervention Program (FIP) In Reducing Work Fatigue Among Royal Malaysian Air Force Personnel: A Quasi Experimental Study}, author = {Kamesh Rajendran}, year = {2024}, date = {2024-10-07}, abstract = {Introduction: The Royal Malaysian Air Force (RMAF) is entrusted with defending Malaysian airspace. The RMAF personnel have been experiencing work fatigue, posing risks to their health, productivity, and safety. Work fatigue is extreme tiredness and reduced functional capacity that is experienced during and at the end of the workday. Furthermore, work fatigue also affects the sleep quality of the personnel. Factors contributing to this work fatigue include high workload, extended hours, shift duties, and inadequate rest. Recognising the absence of any work fatigue intervention studies in Malaysia for air force personnel, this study aimed to develop and evaluate a Fatigue Intervention Program (FIP) for its effectiveness in reducing fatigue and improving sleep quality among RMAF personnel. Method: The study was conducted in two phases. Phase One involved the development of the FIP through literature review and expert evaluation, including a pilot test. Phase Two, the implementation and evaluation phase, employed a quasi-experimental design. It involved ground and air crew members from two air force bases in East and West Malaysia, serving as the intervention and control groups respectively. The intervention group included 74 participants, while the control had 76. Work fatigue (primary outcome) and sleep quality (secondary outcome) was evaluated using Multidimensional Fatigue Inventory (MFI) and Pittsburgh Sleep Quality Index (PSQI) questionnaires respectively. Assessments were carried out at baseline, post-intervention, and at one-month and threemonth follow-ups. Data analysis utilized percentages, frequencies, mean, General Estimating Equation (GEE), and Cohen d effect size. Results: The study found significant demographic differences between the groups in ethnicity, marital status, house type, and commuting distance (p=\<0.05). Baseline data showed comparable levels of work fatigue and sleep quality in both groups (p\>0.05). The intervention group exhibited a significant reduction in all MFI domains (p\<0.05) with Cohen d effect sizes ranging from 0.80 to 1.12 at post three months. Similarly, significant improvements were seen in most PSQI domains, at post three months with Cohen d effect sizes from 0.35 to 1.14, except for the sleep efficiency domain. Conclusion: The study showed that the FIP was effective in reducing work fatigue and improving sleep quality among the air force personnel. We recommend its integration into healthy workplace policy targeting work fatigue among Malaysian air force personnel. }, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @phdthesis{nokey, title = {The Association of Household Food Insecurity and Child Feeding Practices with Childhood Undernutrition Among Residents of Low-Cost Public Housing in Klang Valley}, author = {Lye Chuan Way}, year = {2024}, date = {2024-10-01}, abstract = {This study aims to investigate the relationship of household food insecurity (HFIS) and child feeding practices towards children undernutrition among the low-income urban dwellers in Klang Valley. Firstly, a systematic review that examined household food insecurity among the undernourished under-five children was conducted. Four databases were searched from 1st January 2012 to 1st April 2022, for relevant articles. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) reporting criteria was used. Secondly, a cross-sectional survey with simple random sampling was conducted among households with at least one child aged 6 to 59 months living in the low-cost area. Data was collected from November 2022 to July 2023. Data collected includes Household Food Insecurity Access Scale (HFIAS) questionnaire to understand about household food insecurity and Comprehensive Feeding Practices Questionnaire (CFPQ) to examine child feeding practices among the low-income urban dwellers. Data analysis was done using STATA. The systematic review included thirty-six studies (out of the 2779 abstracts screened). The HFIAS was the commonest tool used to measure HFIS. HFIS has been found to be significantly associated with undernutrition, particularly stunting and underweight. Meanwhile the cross-sectional study revealed that among the 290 households, 57.1% of the households experienced food insecurity. The prevalence of childhood undernutrition was 36.4% stunted, 20.6% underweight and 15.7% wasted, respectively. The multivariate analysis revealed household income below poverty line was a significant factor of HFIS, adjusted odds ratio (aOR) 2.09 (95%CI: 1.19\textendash3.68, p\<0.01). For childhood stunting, maternal education of primary level aOR 8.96 (95%CI: 1.41\textendash56.75, p\<0.05), and household size aOR 0.39 (95%CI: 0.21\textendash0.72, p\<0.01) were found to be significant factors. The multivariate analysis for both underweight and wasting did not yield any significant results. The two child feeding practices that are protective against stunting were (1) monitoring child’s feeding aOR 0.42 (95%CI: 0.21\textendash0.84, p\<0.05), and (2) not being involved in child feeding aOR 0.22 (95%CI: 0.05\textendash0.85, p\<0.05). Whereas the practices that were found to be statistically significant for stunting were (1) not using food as a reward for child behaviour aOR 3.00 (95%CI: 1.35\textendash6.85, p\<0.01), (2) parents who allowed the child control of his/her eating behaviours and parent\textendashchild feeding interactions aOR 2.91 (95%CI: 1.08\textendash8.03, p\<0.05) and (3) parents who does not provide clear explanations to encourage the consumption of healthy foods aOR 4.27 (95%CI: 1.21\textendash16.34, p\<0.05). Meanwhile for underweight, parents who make healthy foods available in the home were less likely to have underweight children aOR 0.38 (95%CI: 0.14\textendash0.95, p\<0.05). Whereas for wasting, mothers who received secondary education were less likely to have wasted children aOR 0.33 (95%CI: 0.12\textendash0.87, p\<0.05). The low-income urban dwellers experience high burdens of both household food insecurity and child undernutrition. While socioeconomic, behavioural, and individual factors likely influence the severity of these issues, a comprehensive plan of action which encompass of various stakeholders is needed. Such collaboration is underscoring the need for comprehensive interventions that address both the upstream root causes (poverty, food access) and the downstream consequences (feeding practices) of undernutrition. }, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @phdthesis{drph-Yap-Jun-Fai-2024, title = {A Cohort Study of Cardiovascular Disease Incidence, Its Predictors, Effects on Workplace Productivity and Monetary Loss Among School Teachers in Peninsular Malaysia}, author = {Yap Jun Fai}, year = {2024}, date = {2024-09-30}, urldate = {2024-09-30}, abstract = {Cardiovascular disease (CVD) can affect work productivity in the working populations. Despite this, there is scarcity of longitudinal studies addressing the cardiovascular health burden among school teachers in Malaysia. This study aimed to determine the incidence rate of CVD, identify predictors, assess the effect of incident CVD and monetary loss on workplace productivity among school teachers in Peninsular Malaysia. Baseline data (sociodemographic characteristics, six lifestyle factors and clinical factors) were obtained from a cohort of school teachers without pre-existing CVD. In Phase One, three computerised registries - National CVD-Acute Coronary Syndrome (ACS) Database, National Stroke Registry and National Hospital Admission Database were accessed to confirm incident CVD cases among teachers. Cumulative incidence and crude incidence rates were calculated. Adjusted hazard ratios (aHR) with 95% confidence interval (CI) were estimated using multivariable Cox regression model to identify predictors of incident CVD. In Phase Two, a nested case-control design (1: 4 ratio) was employed. Short version of the Malay-validated World Health Organization-Health and Work Performance Questionnaire (WHO-HPQ) was used to estimate the workplace productivity effect among teachers with incident CVD (cases) before 31st December 2021. Similar questionnaire was distributed to teachers of a single state in Peninsular Malaysia without incident CVD (controls). Absenteeism, presenteeism and annual monetary loss were computed based on the scoring rules in WHO-HPQ. Analysis of covariance was performed with covariate adjustment using propensity score. Bootstrapping method was applied to better estimate marginal mean differences (with standard errors and appropriate effect sizes). A total of 14,046 eligible school teachers were followed up. There were 209 incident cases (195.7 CVD cases per 100,000 person-years) over a median follow-up of 7.71 years. The incidence rate for males was higher than that for females, with 538.8 versus 117.3 cases per 100,000 person-years, respectively. Being married (aHR = 0.50, 95% CI: 0.26, 0.96) was associated with a lower risk of CVD. Being male (aHR = 3.05, 95% CI: 2.07, 4.49), aged . 50 years old (aHR = 3.94, 95% CI: 1.45, 10.74), Malay (aHR = 2.32, 95% CI: 1.04, 5.19), Indian or others (aHR = 3.22, 95% CI: 1.25, 8.27), having laboratory-confirmed diabetes mellitus (aHR = 2.67, 95% CI: 1.70, 4.21), self-reported hypertension (aHR = 2.42, 95% CI: 1.60, 3.67), high low-density lipoprotein cholesterol (aHR = 3.53, 95% CI: 1.98, 6.31) or high triglyceride (aHR = 2.01, 95% CI: 1.38, 2.93) were predictors for incident CVD among these school teachers. Marginal mean scores of absolute presenteeism among 48 cases (76.30) were lower (p = 0.001, eta squared = 0.075) than 192 controls (85.97). Marginal mean annual cost of presenteeism (MYR 21,237.52) was higher (p = 0.001, eta squared = 0.082) in cases, as opposed to controls (MYR 12,089.74). In conclusion, incidence rate of CVD was relatively high, especially among male school teachers in Peninsular Malaysia. Targeted screening at-risk teachers for modifiable predictors such as diabetes mellitus, hypertension or dyslipidemia and implementing supportive work strategies in school settings may be useful in increasing absolute presenteeism or decreasing its annual cost associated with incident CVD.}, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @phdthesis{drph-Mohd-Zahiruddin-2024, title = {The Development and Effectiveness of a Psychoeducational Video in Improving Depression Literacy Among University Students}, author = {Mohd Zahiruddin Mohd Khairi}, year = {2024}, date = {2024-09-30}, urldate = {2024-09-30}, abstract = {Depression is an important public health issue that affects many university students worldwide. It causes a wide range of physiological impairments, resulting in high mortality and morbidity rates. Regardless of the severity of the situation, a lack of knowledge about depression prevents university students from seeking help. Videos are an effective method to disseminate information because their visual content increases engagement, improves the learning experience, and aligns with university students’ preferred way of accessing information. However, research into developing psychoeducational videos to improve depression literacy among university students in Malaysia is limited. Hence, this study was conducted to address this research gap. The study’s conceptual framework was based on the theoretical framework of mental health literacy, guidelines for video production, and the principles of psychoeducation. It was carried out in four phases from October 2022 to November 2023. The first phase involved translating and validating the Depression Literacy Questionnaire (D-Lit) into Malay, following the guidelines of Wild et al. Item number five was dropped due to cultural considerations related to its relevance in the Malaysian context. Thus, the Malay D-Lit consisted of 21 questions, one less than the original version. Subsequently, structural equation modelling was conducted among 584 participants, resulting in a total of 17 items and six factors. It had strong internal consistency (Cronbach alpha = 0.704) and test-retest reliability (ICC = 0.702). Phase two comprised a need assessment study involving 717 end-users. A self-developed questionnaire was used to determine their preferences for the video’s development. 87.3% of the participants preferred videos ranging from five to seven minutes, and 95% preferred subtitles in English and Malay. On the other hand, phase three involved using Diefenbach et al.’s video production technique to develop the psychoeducational video based on the results of the needs assessment survey. This technique included preproduction, production, and postproduction processes. A panel of nine experts and 30 end-users then validated the video. The final phase involved conducting a quasi-experimental study with a total of 161 bachelor of chemical engineering students to determine the effectiveness of the psychoeducational video. Assessments were carried out using the translated Malay version of D-Lit from phase one of the study. Participants in the intervention group were shown the psychoeducational video, whereas those assigned to the control group received a single session of mental health talk, which excluded any information on depression. An analysis of covariance was used to evaluate the effectiveness of the intervention. The results indicated that the level of D-Lit was similar at baseline in both the control and intervention groups, with mean scores of 7.74 and 7.63, respectively. The post-test findings revealed a statistically significant increase in D-Lit of 10.63 in the intervention group, compared to 8.44 in the control group. In conclusion, the psychoeducational video has proven to be a valid tool for improving students\' understanding of depression. Thus, it can be utilised to promote mental health and wellbeing, which aligns with the National Strategic Plan for Mental Health and helps to achieve Sustainable Development Goal No. 3. }, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @phdthesis{drph-Hazwa-Harith-2024, title = {A Study on the Development and Effectiveness of EduMind for Monitoring Mental Health Status Among Youths}, author = {Hazwa Harith}, year = {2024}, date = {2024-09-12}, abstract = {The global surge in mental health issues, particularly among the youth, is evident. Despite the proliferation of digital mental health services, their adoption remains limited, hindered by various barriers. Persistent gaps and constraints underscore the ongoing need for continuous advancements in technology to better cater to the targeted demographic. Given the pivotal role that mental well-being plays in shaping the future of public health status and society in general, it becomes imperative to confront these challenges. To address this issue, a digital mental health intervention is necessary. The objective of this research is to develop an evidence-based digital mental health interventional module and to test its effectiveness in improving the mental health status among youths through a four-phase approach. This module development began with the initial phase of a needs assessment (phase 1) to identify the limitations of an existing digital mental health intervention. This phase was followed by a wide exploration of evidence-based and commonly practiced psychotherapies to be included in the newly developed online intervention module through a process of a scoping review (phase 2). The information gathered was then refined and embedded into a prototype web application for the subsequent validation process (phase 3) by experts. The evidence based digital mental health interventional module proposed by this study were introduction, activity and mood tracking, motivation, thoughts and feelings, advanced thoughts, and feelings, as well as stress and acute anxiety management. These modules integrated principles from psychoeducation, cognitive-behavioral therapy (CBT), dialectical-behavioral therapy (DBT), mindfulness and grounding techniques. The application underwent iterative refinement, and the validation process obtained a content validation index (CVI) of 0.96 based on expert feedback. Following the finalization of content and the web application, its effectiveness was evaluated through a quasi-experimental study (phase 4) involving an intervention group and a waitlist control group. The mean differences between baseline and post-intervention measurements of mental health status, as assessed by the DASS-21 questionnaire, were compared. The study revealed significant improvements in mental health status between groups, with moderate effect sizes for stress (ƞp2 = 0.57, p \< 0.001) and depression (ƞp2 = 0.71, p \< 0.001), and a small effect size for anxiety (ƞp2 = 0.27, p \< 0.001). This study utilized a comprehensive module development framework and demonstrated the effectiveness of the expert-guided mental health intervention module. The findings contribute to the advancement of technology-assisted health services, facilitating greater uptake among the population. The validated content hold potential for adaptation across various platforms to cater to diverse target populations. Furthermore, the study suggests potential integration with the National Strategic Plan for Mental Health 2020-2025 and the National Mental Health Policy, proposing the web application as a potential compulsory student screening tool administered by universities. The information gathered by this application could inform future research directions, propelling technological-assisted mental health services to new heights. }, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @phdthesis{phd-Teh-Chien-Huey-2024, title = {Sociodemographic Patterns in Non-Communicable Disease (NCD) Risk Factors and Their Impact on Mortality Risk in Malaysia, 1996-2015}, author = {Teh Chien Huey}, year = {2024}, date = {2024-08-22}, abstract = {The age, period and cohort (APC) associations of behavioural and biological NCD risk factors are essential in unveiling underlying population-level changes over time for informed decision-making in health-related policies and interventions. However, there has not been an APC study in Malaysia. Therefore, the present study aimed to determine the trajectories of five behavioural (number of cigarettes smoked per day, total AUDIT score, total METs-min/week, total sitting hours and total serving of fruit/vegetable per day) and six biological (BMI, waist circumference, total cholesterol, blood glucose, systolic and diastolic blood pressure) NCD risk factors across age, period and cohort (APC) and examine the differences in such trajectories by sex and ethnicity. Subsequently, the mediating roles of these NCD risk factors in the associations between sex and ethnicity with all-cause mortality were also determined. We pooled data from four National Health and Morbidity Surveys (NHMS) conducted in 1996, 2006, 2011, and 2015. The extended Hierarchical APC (HAPC) analysis modelled the APC trajectories using the mixed command in STATA 14.0. Then, the mediation roles of these NCD risk factors were explored using causal mediation analysis in STATA 14.0 via the med4way command. The APC analysis demonstrated that Malaysian adults were getting less healthy as they aged (positive age effect), and younger cohorts replaced older cohorts (positive cohort effect). Generally, the trajectories of behavioural risk factors across age and birth cohorts did not vary by sex. On the other hand, postmenopausal women and women of more recent cohorts had more pronounced increasing biological NCD risk factor trajectories. Despite increasing sedentarism and low fruit/vegetable intake trajectories, the Chinese had the least pronounced increasing trajectories of biological NCD risk factors over age and cohort than other ethnicities. Mediation analysis revealed that current smoking, physical inactivity and sedentarism are significant mediators that explain about 10%, 2% and 0.5% of the male-excess mortality risk. Furthermore, current smoking alone accounted for almost 20% of the Malay-excess all-cause mortality risk (compared to Chinese). Abdominal obesity accounted for about 9% of male-excess mortality risk. In conclusion, the present study identified important underlying population-level changes in behavioural and biological NCD risk factor trajectories across the life course and birth cohorts, and most of these changes varied by sex and ethnicity. Future studies should consider the sex- and ethnic-specific age and cohort effects in health data surveillance, formulation of health policies and preventive health measures to tackle the rising prevalence of behavioural and biological NCD risk factors in Malaysia, with a particular emphasis on smoking and abdominal obesity. random effect, inter-cohort differences, mediation}, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @phdthesis{drph-Rowena-John-2024, title = {Knowledge, Barriers and Utilization of Adolescents Sexual Reproductive Health Services among Malaysian Youth - A mixed methods study}, author = {Rowena John}, year = {2024}, date = {2024-01-18}, urldate = {2024-01-18}, school = {Universiti Malaya}, abstract = {Despite the availability of SRH (sexual reproductive health) services, it is uncertain whether youths are aware of and utilise SRH services. This study aims to identify factors and barriers that affect the utilisation of SRH services among youths in Malaysia. A sequential mixed-method study design comprising two different phases were used in this study. Phase one was the quantitative phase, followed by phase two qualitative phase. A web-based cross-sectional study was conducted from March 2022 to June 2022 using a self-administered pre-tested questionnaire. Variables used in the questionnaire were identified by applying the Andersen Behavioral Model of Health Service Utilisation. Logistic regression was used to identify factors associated with SRH utilisation. Complementary to the quantitative analyses, the qualitative phase was conducted via in-depth interviews among 18 youths. Methodological triangulation was applied to analyse the evidence from quantitative findings to support the themes that emerge in the qualitative study. A total of 617 youths aged 18-24 participated in the quantitative phase. Of these, 65% (n = 403) of participants were unaware of the availability of the services, and only 20.4% (n =126) of youths had ever visited SRH services in their entire life. Findings from the logistic regression analyses indicated that predisposing factors such as age, marital status, high-risk behavior such as vaping, and exposure to information from friends, family, and LPPKN (Lembaga Penduduk Dan Pembangunan Keluarga Negara) are significantly associated with SRH utilisation. (p\<0.05). Older age group (20-24 years old) utilises SRH services more than the younger age group ( 18-19 years old)(AOR=0.605,95%CI=0.38,0.96), married youths (AOR=0.218,95% CI=0.09,0.50) and vaping (AOR = 2.05,95% CI=1.14,3.66) was associated with SRH utilisation. Exposure of SRH information from LPPKN is associated with SRH utilisation (AOR = 0.48,95%CI =0.29,0.78), exposure of SRH information from friends is associated with SRH utilisation ( AOR =0.611,95% CI 0.38,0.98), exposure of SRH information from family is associated with SRH utilisation (AOR=2.086,95% CI=1.28,3.38) .Enabling factor associated with SRH utilisation is the availability of services, described as self-buy medicine in pharmacy and the comfortability of services. (p\<0.05) (AOR=1.57,95%CI = 0.36,0.90) Youths more comfortable with SRH services are twice as likely to utilise SRH services. (AOR=1.92,95%CI =1.23,2.99). Need factor that is associated with SRH utilisation are youths who are diagnosed with SRH diseases who are 5 times likely to utilise SRH services. (AOR 5.16,95%CI=2.17,12.2). The qualitative findings further confirmed the results by exploring the barriers preventing youths from accessing SRH services. This includes cognitive accessibility, defined as lack of sexual knowledge and awareness of SRH services; psychosocial accessibility, defined as feelings of shyness and shame caused by cultural attitudes; geographical accessibility, referring to the availability of SRH services; affordability, referring to cost and quality of SRH services in health care settings. These findings were further confirmed by methodological triangulation. Awareness of utilisation of (SRH) services among youths in Malaysia is still generally poor. Recommendations to improve access by young people include a multi-component strategy involving multiple stakeholders in providing these SRH services.}, note = {Doctor of Public Health Thesis}, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @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 January and April 2014 a mail survey was conducted using physicians in Malaysia known to provide either one or both HPV vaccine (Gardasil and Cervarix) immunisation services. A total of 357 completed questionnaires were received (response rate 22.5%). Of these, 335 physicians see adolescent boys aged 11 to 18 years old in their practice. Only 26.3% (n = 88) recommended the HPV vaccine to these boys. A total of 46.6% (n = 41) have successfully given the HPV vaccine to adolescent boys. A lack of proper guidelines from the health authorities regarding the recommendation of HPV vaccine to the boys (37.2%) and a lack of awareness of the availability of the vaccine for boys (32.8%) were the most commonly cited reasons for non-recommendation. Impact statement Recommending the HPV vaccine for adolescent boys remains a challenge for physicians. Our study provides evidence of challenges and barriers faced by Malaysian physicians who recommend the HPV vaccines (Gardasil and Cervarix) in their practices. In this study, physicians reported HPV vaccine uptake by adolescent boys was very poor. A lack of proper guidelines from the health authorities regarding the recommendation of HPV vaccine to boys and a lack of awareness of the availability of the vaccine for boys were the most commonly cited reasons for non-recommendation. Physicians viewed that support and encouragement from the health authorities are needed to promote the recommendation of the HPV vaccine to adolescent boys. Physicians were also of the opinion that the lay public should be educated about the availability of the HPV vaccine for boys, and its benefits, safety and efficacy, and the high susceptibility of boys to getting HPV infections. The findings provide insights that could be helpful to policymakers or high-level decision-makers of the potential strategies to enhance HPV uptake among adolescent boys.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15557b, title = {Attitudes towards Zika screening and vaccination acceptability among pregnant women in Malaysia}, author = {L P Wong and H Alias and J Hassan and S AbuBakar}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28886944}, doi = {10.1016/j.vaccine.2017.08.074}, issn = {1873-2518 (Electronic) 0264-410X (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Vaccine}, volume = {35}, number = {43}, pages = {5912-5917}, abstract = {The aim of this study was to examine the willingness of pregnant women to have prenatal screening for the Zika virus (ZIKV). Secondly, the study also assessed the acceptability of a hypothetical Zika vaccination and its association with the health belief model (HBM) constructs. A cross-sectional study was conducted from 4th October to 11th November 2016, among pregnant women who attended antenatal care at the University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. The majority (81.8%) was willing to be tested for ZIKV and 78% felt that their spouse would be willing to be tested for ZIKV. A total of 94% expressed a willingness to receive a Zika vaccination if available. The participants expressed high perceived benefits of a ZIKV vaccination. Although many have a high perception of the severity of ZIKV, the proportion with a strong perception of their susceptibility to ZIKV was low. In the multivariate analysis of all the HBM constructs, cue-to-action, namely physician recommendation (odds ratio [OR]=2.288; 95% confidence interval [CI] 1.093-4.793) and recommendation from friends or relatives (OR=4.030; 95% CI 1.694-9.587), were significantly associated with a willingness to be vaccinated against ZIKV. The favourable response to a Zika vaccination implies that more research attention has to be given to develop a vaccine against ZIKV. Should the vaccine be available in the future, publicity and healthcare providers would play a vital role in ensuring vaccine uptake among pregnant women.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15606b, title = {Differences in Perceived Severity of Zika Virus Infection and Dengue Fever and its Influence on Mosquito Control Practices in Malaysia}, author = {L P Wong and H Alias and N Aghamohammadi and I C Sam and S AbuBakar}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28238029}, doi = {10.1007/s10900-017-0326-7}, issn = {1573-3610 (Electronic) 0094-5145 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {J Community Health}, volume = {42}, number = {5}, pages = {854-864}, abstract = {The aims of this study were to explore the differences in (1) the perception of severity towards ZIKV infection and dengue fever, and (2) mosquito control practices before and after the ZIKV outbreak were declared a Public Health Emergency of International Concern (PHEIC). Data were collected between Feb to May 2016 using a computer-assisted telephone interviewing system. The median scale score for perceived severity of ZIKV was 3 (interquartile range [IQR] 1-5) versus 4 (IQR 3-5) for dengue (P \< 0.001). The scores for mosquito control practices before and after ZIKV was declared a PHEIC were similar, at 4 (IQR 3-5). Multivariate analysis revealed that participants with a higher score for perception of severity of ZIKV were more likely to report greater mosquito control practices after the declaration of the PHEIC (OR 1.822 [95% CI 1.107-2.998]). The emerging ZIKV pandemic requires concerted efforts to enhance mosquito control practices among the Malaysian public. Efforts to improve public mosquito control practices should focus on enhancing the perception of the severity of ZIKV.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15593b, title = {Erratum: Wong, L.P., et al. The Self-Regulation Model of Illness: Comparison between Zika and Dengue and Its Application to Predict Mosquito Prevention Behaviours in Malaysia, a Dengue-Endemic Country Int. J. Environ. Res. Public Health 2016, 13, 1210}, author = {L P Wong and H Alias and N Aghamohammadi and I C Sam and S Abu Bakar}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28422053}, doi = {10.3390/ijerph14040433}, issn = {1660-4601 (Electronic) 1660-4601 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Int J Environ Res Public Health}, volume = {14}, number = {4}, abstract = {n/a.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15579b, title = {E-Cigarette Users' Attitudes on the Banning of Sales of Nicotine E-Liquid, Its Implication on E-Cigarette Use Behaviours and Alternative Sources of Nicotine E-Liquid}, author = {L P Wong and H Alias and N Agha Mohammadi and A Ghadimi and V C W Hoe}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28589268}, doi = {10.1007/s10900-017-0374-z}, issn = {1573-3610 (Electronic) 0094-5145 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {J Community Health}, volume = {42}, number = {6}, pages = {1225-1232}, abstract = {The banning of sales of nicotine e-liquid in e-cigarette shops has been implemented in several states in Malaysia. The distribution of nicotine e-liquid can only be allowed by licensed pharmacies or registered medical practitioners. This study aimed to evaluate e-cigarette users' responses to the control policy in a cross-sectional survey of 851 e-cigarette users by utilizing a self-report questionnaire that assessed (1) attitudes on regulation policy of e-cigarette banning; (2) e-cigarette use behaviors; and (3) sources of e-liquid after the regulation policy has been implemented. Participants from the state of Selangor where the banning policy was implemented were surveyed. The majority (95.8%) opposed the banning and believed e-cigarettes should be sold to anyone aged 18 years or above as with tobacco cigarettes, only a minority believed that nicotine e-liquid should only be available for sale over the counter in pharmacy stores (14.6%) and in clinics with a doctor's prescription (11.8%). The majority (44.2%) reported that they would continue their e-cigarette use as before the banning policy, while 20% plan to completely stop e-cigarette usage without replacing it with any alternatives. The vast majority (87.9%) was still able to obtained nicotine e-liquid from e-cigarette shops in spite of the ban and the second most common source was from online purchase (63.1%). The sales of nicotine e-liquid from black-market were evidenced as many reported obtaining zero nicotine e-liquid from the black market (54.4%). Self- or home-made (30.8%) nicotine e-liquid was also reported. Majority of respondents that self-made e-liquid were from the average monthly income group (below MYR3000). Obtaining nicotine from the pharmacy was least preferred (21.4%). Provision of professional advice to nicotine e-liquid users along with the ban may lessen the likelihood of users switching to tobacco cigarettes or other nicotine alternatives. Banning of sales of nicotine e-liquid in e-cigarette shops resulted in a boom in the black market supplying nicotine e-liquid and, self- or home-made nicotine e-liquid. Enforcing regulations and monitoring black market sales is warranted. Efforts to educate e-cigarette users of the danger of sourcing nicotine e-liquid from the black market and self- or home-made nicotine e-liquid are essential.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15537b, 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}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29168911}, doi = {10.1111/jpc.13789}, issn = {1440-1754 (Electronic) 1034-4810 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {J Paediatr Child Health}, abstract = {AIM: Adenotonsillectomy is performed in children with recurrent tonsillitis or obstructive sleep apnoea. Children at risk of post-operative respiratory complications are recommended to be monitored in paediatric intensive care unit (PICU). The aim of the study is to review the risk factors for post-operative complications and admissions to PICU. METHODS: A review of medical records of children who underwent adenotonsillectomy between January 2011 and December 2014 was performed. Association between demographic variables and post-operative complications were examined using chi-square and Mann-Whitney tests. RESULTS: A total of 214 children were identified, and of these, 19 (8.8%) experienced post-operative complications. Six children (2.8%) had respiratory complications: hypoxaemia in four and laryngospasm requiring reintubation in a further two. Both of the latter patients were extubated upon arrival to PICU and required no escalation of therapy. A total of 13 (6.1%) children had non-respiratory complications: 8 (3.7%) had infection and 5 (2.3%) had haemorrhage. A total of 26 (12.1%) children were electively admitted to PICU and mean stay was 19.5 (SD +/- 13) h. No association between demographic characteristics, comorbid conditions or polysomnographic parameters and post-operative complications were noted. A total of 194 (90.7%) children stayed only one night in hospital (median 1 day, range 1-5 days). CONCLUSION: The previously identified risk factors and criteria for PICU admission need revision, and new recommendations are necessary.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15554b, title = {Psychometric Properties of the Malay Version of the Dutch Eating Behaviour Questionnaire (DEBQ) in a Sample of Malaysian Adults Attending a Health Care Facility}, author = {K Subramaniam and W Y Low and K Chinna and K F Chin and S Krishnaswamy}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28951691}, doi = {10.21315/mjms2017.24.4.8}, issn = {1394-195X (Print) 1394-195X (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Malays J Med Sci}, volume = {24}, number = {4}, pages = {64-73}, abstract = {OBJECTIVE: This study aims to investigate the psychometric properties of the Malay version of the Dutch Eating Behaviour Questionnaire (DEBQ) among Malaysian adults. METHOD: The Malay version of the DEBQ instrument was administered to 398 outpatients (269 women and 129 men) at the University of Malaya Medical Centre (UMMC). Confirmatory Factor Analysis (CFA) was conducted to study the construct validity of the instrument. Composite reliability coefficient, Raykov's rho, was used to determine the internal consistency. RESULTS: The proposed three-factor structure for the DEBQ instrument was appropriate, although three items (Items 21, 14 and 27) showed problematic loadings with inappropriate model fit and were removed. The modified version had an appropriate model fit chi(2)/df = 2.129}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15542b, title = {Correction to: The effectiveness of a life style modification and peer support home blood pressure monitoring in control of hypertension: protocol for a cluster randomized controlled trial}, author = {T T Su and H A Majid and A M Nahar and N A Azizan and F M Hairi and N Thangiah and M Dahlui and A Bulgiba and L J Murray}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29110641}, doi = {10.1186/s12889-017-4862-y}, issn = {1471-2458 (Electronic) 1471-2458 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {BMC Public Health}, volume = {17}, number = {1}, pages = {864}, abstract = {After publication of the article [1], it has been brought to our attention that the methodology outlined in the original article was not able to be fully carried out. The article planned a two armed randomized control trial. However, due to a lower response than expected and one housing complex dropping out from the study, the method was changed to pre- and post-intervention with no control group. All other methods were conducted as outlined in the original article.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15533b, 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}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29209834}, doi = {10.1007/s00520-017-3987-y}, issn = {1433-7339 (Electronic) 0941-4355 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Support Care Cancer}, abstract = {PURPOSE: This study aimed, firstly, to assess the determinants of return to work (RTW), secondly, to explore the amount of annual wage loss, and finally, to discover the determinants of wage loss among breast cancer (BC) survivors. METHODS: A cross-sectional study design was used in this research. The data was collected via interview using a validated questionnaire. Logistic regression models were developed to discover the significant determinants of RTW and of wage loss among BC survivors. RESULTS: A total of 256 BC survivors were included in this study. The analysis showed that there was a 21% loss of or reduction in mean income within 1 year after diagnosis. The significant predictors of RTW are being a government employee, having reduced wages or wage loss, and if the case had been diagnosed 1 year or more ago. Being a private sector employee and having a late stage of cancer was a barrier to RTW. The main risk factors for reduced wages or wage loss were belonging to the age group of 40-59 years, being of Chinese or Indian ethnicity, having low educational status, and not returning to work. However, belonging to the higher monthly income group (earning \> RM 2000) is a protective factor against the risk of reduced wages or wage loss. CONCLUSIONS: Non-RTW and wage loss after diagnosis of BC may result in the survivors experiencing a significant financial burden. Assessment of these patients is becoming more crucial because more women participate in the workforce in Malaysia nowadays and because BC is managed using multiple treatment modalities with their consequences could lead to long absences from work.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15580b, title = {Pre-diagnostic copper and zinc biomarkers and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort}, author = {M Stepien and M Jenab and H Freisling and N P Becker and M Czuban and A Tjonneland and A Olsen and K Overvad and M C Boutron-Ruault and F R Mancini and I Savoye and V Katzke and T Kuhn and H Boeing and K Iqbal and A Trichopoulou and C Bamia and P Orfanos and D Palli and S Sieri and R Tumino and A Naccarati and S Panico and H B A Bueno-de-Mesquita and P H Peeters and E Weiderpass and S Merino and P Jakszyn and M J Sanchez and M Dorronsoro and J M Huerta and A Barricarte and S Boden and B Guelpen and N Wareham and K T Khaw and K E Bradbury and A J Cross and L Schomburg and D J Hughes}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28575311}, doi = {10.1093/carcin/bgx051}, issn = {1460-2180 (Electronic) 0143-3334 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Carcinogenesis}, volume = {38}, number = {7}, pages = {699-707}, abstract = {Adequate intake of copper and zinc, two essential micronutrients, are important for antioxidant functions. Their imbalance may have implications for development of diseases like colorectal cancer (CRC), where oxidative stress is thought to be etiologically involved. As evidence from prospective epidemiologic studies is lacking, we conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort to investigate the association between circulating levels of copper and zinc, and their calculated ratio, with risk of CRC development. Copper and zinc levels were measured by reflection X-ray fluorescence spectrometer in 966 cases and 966 matched controls. Multivariable adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using conditional logistic regression and are presented for the fifth versus first quintile. Higher circulating concentration of copper was associated with a raised CRC risk (OR = 1.50; 95% CI: 1.06, 2.13; P-trend = 0.02) whereas an inverse association with cancer risk was observed for higher zinc levels (OR = 0.65; 95% CI: 0.43, 0.97; P-trend = 0.07). Consequently, the ratio of copper/zinc was positively associated with CRC (OR = 1.70; 95% CI: 1.20, 2.40; P-trend = 0.0005). In subgroup analyses by follow-up time, the associations remained statistically significant only in those diagnosed within 2 years of blood collection. In conclusion, these data suggest that copper or copper levels in relation to zinc (copper to zinc ratio) become imbalanced in the process of CRC development. Mechanistic studies into the underlying mechanisms of regulation and action are required to further examine a possible role for higher copper and copper/zinc ratio levels in CRC development and progression.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15612b, title = {Circulating copper and zinc levels and risk of hepatobiliary cancers in Europeans}, author = {M Stepien and D J Hughes and S Hybsier and C Bamia and A Tjonneland and K Overvad and A Affret and M His and M C Boutron-Ruault and V Katzke and T Kuhn and K Aleksandrova and A Trichopoulou and P Lagiou and P Orfanos and D Palli and S Sieri and R Tumino and F Ricceri and S Panico and H B Bueno-de-Mesquita and P H Peeters and E Weiderpass and C Lasheras and C Bonet Bonet and E Molina-Portillo and M Dorronsoro and J M Huerta and A Barricarte and B Ohlsson and K Sjoberg and M Werner and D Shungin and N Wareham and K T Khaw and R C Travis and H Freisling and A J Cross and L Schomburg and M Jenab}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28152549}, doi = {10.1038/bjc.2017.1}, issn = {1532-1827 (Electronic) 0007-0920 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Br J Cancer}, volume = {116}, number = {5}, pages = {688-696}, abstract = {BACKGROUND: Copper and zinc are essential micronutrients and cofactors of many enzymatic reactions that may be involved in liver-cancer development. We aimed to assess pre-diagnostic circulating levels of copper, zinc and their ratio (Cu/Zn) in relation to hepatocellular carcinoma (HCC), intrahepatic bile duct (IHBD) and gall bladder and biliary tract (GBTC) cancers. METHODS: A nested case-control study was conducted within the European Prospective Investigation into Cancer and Nutrition cohort. Serum zinc and copper levels were measured in baseline blood samples by total reflection X-ray fluorescence in cancer cases (HCC n=106, IHDB n=34, GBTC n=96) and their matched controls (1:1). The Cu/Zn ratio, an indicator of the balance between the micronutrients, was computed. Multivariable adjusted odds ratios and 95% confidence intervals (OR; 95% CI) were used to estimate cancer risk. RESULTS: For HCC, the highest vs lowest tertile showed a strong inverse association for zinc (OR=0.36; 95% CI: 0.13-0.98}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15604b, title = {Alone and Lonely: A Case Report on Elder Abuse in Malaysia}, author = {R Sooryanarayana and C Wan Yuen and N N Hairi}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28283379}, doi = {10.1016/j.jamda.2017.01.018}, issn = {1538-9375 (Electronic) 1525-8610 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {J Am Med Dir Assoc}, volume = {18}, number = {5}, pages = {447}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15559b, title = {The prevalence and correlates of elder abuse and neglect in a rural community of Negeri Sembilan state: baseline findings from The Malaysian Elder Mistreatment Project (MAESTRO), a population-based survey}, author = {R Sooryanarayana and W Y Choo and N N Hairi and K Chinna and F Hairi and Z M Ali and S N Ahmad and I A Razak and S A Aziz and R Ramli and R Mohamad and Z L Mohammad and D Peramalah and N A Ahmad and T Aris and A Bulgiba}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28864485}, doi = {10.1136/bmjopen-2017-017025}, issn = {2044-6055 (Electronic) 2044-6055 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {BMJ Open}, volume = {7}, number = {8}, pages = {e017025}, abstract = {BACKGROUND: As Malaysia is fast becoming an ageing nation, the health, safety and welfare of elders are major societal concerns. Elder abuse is a phenomenon recognised abroad but less so locally. This paper presents the baseline findings from the Malaysian Elder Mistreatment Project (MAESTRO) study, the first community-based study on elder abuse in Malaysia. DESIGN: Cross-sectional study, analysing baseline findings of a cohort of older adults. SETTING: Kuala Pilah district, Negeri Sembilan state, Malaysia. OBJECTIVES: To determine the prevalence of elder abuse among community dwelling older adults and its associated factors. PARTICIPANTS: A total of 2112 community dwelling older adults aged 60 years and above were recruited employing a multistage sampling using the national census. PRIMARY AND SECONDARY OUTCOME MEASURES: Elder abuse, measured using a validated instrument derived from previous literature and the modified Conflict Tactic Scales, similar to the Irish national prevalence survey on elder abuse with modification to local context. Factors associated with abuse and profiles of respondents were also examined. RESULTS: The prevalence of overall abuse was reported to be 4.5% in the past 12 months. Psychological abuse was most common, followed by financial, physical, neglect and sexual abuse. Two or more occurrences of abusive acts were common, while clustering of various types of abuse was experienced by one-third of abused elders. Being male (adjusted OR (aOR) 2.15, 95% CI 1.23 to 3.78), being at risk of social isolation (aOR 1.96, 95% CI 1.07 to 3.58), a prior history of abuse (aOR 3.28, 95% CI 1.40 to 7.68) and depressive symptomatology (aOR 7.83, 95% CI 2.88 to 21.27) were independently associated with overall abuse. CONCLUSION: Elder abuse occurred among one in every 20 elders. The findings on elder abuse indicate the need to enhance elder protection in Malaysia, with both screening of and interventions for elder abuse.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15540b, 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}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29124356}, doi = {10.1007/s00268-017-4319-6}, issn = {1432-2323 (Electronic) 0364-2313 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {World J Surg}, abstract = {BACKGROUND: The rate of contralateral risk-reducing mastectomy (CRRM) is increasing in the West with controversial evidence of improved survival in early breast cancer patients. Although uptake of CRRM in Asia appears low, the trends may rise, and there is currently an urgent need to provide evidence for informed decision-making in clinical practice. This study aims to determine the risk of contralateral breast cancer (CBC) and its associated factors in an Asian setting. METHOD: A total of 2937 newly diagnosed patients with stage I and stage II breast cancer in University Malaya Medical Centre between Jan 1993 to Dec 2012 were included in the study. Multinomial logistic regression analysis allowing death to compete with CBC as a study outcome was used; patients with unilateral breast cancer who were alive were taken as reference. A stepwise backward regression analysis including age at diagnosis, ethnicity, family history of breast cancer, TNM stage, hormonal receptor status, HER2 status, chemotherapy, radiotherapy, and hormone therapy was conducted. RESULTS: Fifty women developed CBC, over a median follow-up of 6 years. The 5- and 10-year cumulative risk of contralateral breast cancer was 1.0% (95% CI 0.6-1.4%) and 2.8% (95% CI 2.0-3.6%), respectively. Young age at diagnosis of first cancer, positive family history, and stage I disease were independent predictors of CBC. DISCUSSION: The current study suggests that the risk of CBC is very low in a Southeast Asian setting. Any recommendations or practice of CRRM should be reviewed with caution and patients must be counseled appropriately.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15802b, title = {Sedation scoring and managing abilities of intensive care nurses post educational intervention}, author = {V Ramoo and K L Abdullah and P S Tan and L P Wong and Y P Chua and L Y Tang}, url = {https://www.ncbi.nlm.nih.gov/pubmed/25913373}, doi = {10.1111/nicc.12180}, issn = {1478-5153 (Electronic) 1362-1017 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Nurs Crit Care}, volume = {22}, number = {3}, pages = {141-149}, abstract = {BACKGROUND: Inappropriate sedation assessment can jeopardize patient comfort and safety. Therefore, nurses' abilities in assessing and managing sedation are vital for effective care of mechanically ventilated patients. AIMS AND OBJECTIVES: This study assessed nurses' sedation scoring and management abilities as primary outcomes following educational interventions. Nurses' perceived self-confidence and barriers to effective sedation management were assessed as secondary outcomes. DESIGN: A post-test-only quasi-experimental design was used. Data were collected at 3 and 9 months post-intervention. METHODS: A total of 66 nurses from a 14-bed intensive care unit of a Malaysian teaching hospital participated. The educational interventions included theoretical sessions, hands-on sedation assessment practice using the Richmond Agitation Sedation Scale, and a brief sedation assessment tool. Nurses' sedation scoring and management abilities and perceived self-confidence level were assessed at both time points using self-administered questionnaires with case scenarios. Sedation assessment and management barriers were assessed once at 9 months post-intervention. RESULTS: Median scores for overall accurate sedation scoring (9 months: 4.00; 3 months: 2.00}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15576b, title = {The associations between VDR BsmI polymorphisms and risk of vitamin D deficiency, obesity and insulin resistance in adolescents residing in a tropical country}, author = {R Rahmadhani and N L Zaharan and Z Mohamed and F M Moy and M Y Jalaludin}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28617856}, doi = {10.1371/journal.pone.0178695}, issn = {1932-6203 (Electronic) 1932-6203 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {PLoS One}, volume = {12}, number = {6}, pages = {e0178695}, abstract = {BACKGROUND: The vitamin D receptor (VDR) gene is expressed abundantly in different tissues; including adipocytes and pancreatic beta cells. The rs1544410 or BsmI single nucleotide polymorphism (SNP) in the intronic region of the VDR gene has been previously associated with vitamin D levels, obesity and insulin resistance. AIMS: This study was aimed to examine the association between BsmI polymorphism and risk of vitamin D deficiency, obesity and insulin resistance in adolescents living in a tropical country. METHODS: Thirteen-year-old adolescents were recruited via multistage sampling from twenty-three randomly selected schools across the city of Kuala Lumpur, Malaysia (n = 941). Anthropometric measurements were obtained. Obesity was defined as body mass index higher than the 95th percentile of the WHO chart. Levels of fasting serum vitamin D (25-hydroxyvitamin D (25(OH)D)), glucose and insulin were measured. HOMA-IR was calculated as an indicator for insulin resistance. Genotyping was performed using the Sequenom MassARRAY platform (n = 807). The associations between BsmI and vitamin D, anthropometric parameters and HOMA-IR were examined using analysis of covariance and logistic regression. RESULT: Those with AA genotype of BsmI had significantly lower levels of 25(OH)D (p = 0.001) compared to other genotypes. No significant differences was found across genotypes for obesity parameters. The AA genotype was associated with higher risk of vitamin D deficiency (p = 0.03) and insulin resistance (p = 0.03) compared to GG. The A allele was significantly associated with increased risk of vitamin D deficiency compared to G allele (adjusted odds ratio (OR) = 1.63 (95% Confidence Interval (CI) 1.03-2.59}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15621b, title = {Outdoor air pollution and risk for kidney parenchyma cancer in 14 European cohorts}, author = {O Raaschou-Nielsen and 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 M Aasvang 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 H B Bueno-de-Mesquita and M Plusquin and T J Key and A Jaensch and G Nagel and B Foger 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 I Tamayo and P Amiano and M Dorronsoro and R Sokhi and I Kooter and K Hoogh and R Beelen and M Eeftens and R Vermeulen and P Vineis and B Brunekreef and G Hoek}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28006861}, doi = {10.1002/ijc.30587}, issn = {1097-0215 (Electronic) 0020-7136 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Int J Cancer}, volume = {140}, number = {7}, pages = {1528-1537}, abstract = {Several studies have indicated weakly increased risk for kidney cancer among occupational groups exposed to gasoline vapors, engine exhaust, polycyclic aromatic hydrocarbons and other air pollutants, although not consistently. It was the aim to investigate possible associations between outdoor air pollution at the residence and the incidence of kidney parenchyma cancer in the general population. We used data from 14 European cohorts from the ESCAPE study. We geocoded and assessed air pollution concentrations at baseline addresses by land-use regression models for particulate matter (PM10 , PM2.5 , PMcoarse , PM2.5 absorbance (soot)) and nitrogen oxides (NO2 , NOx ), and collected data on traffic. We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random effects models for meta-analyses to calculate summary hazard ratios (HRs). The 289,002 cohort members contributed 4,111,908 person-years at risk. During follow-up (mean 14.2 years) 697 incident cancers of the kidney parenchyma were diagnosed. The meta-analyses showed higher HRs in association with higher PM concentration, e.g. HR = 1.57 (95%CI: 0.81-3.01) per 5 mug/m(3) PM2.5 and HR = 1.36 (95%CI: 0.84-2.19) per 10(-5) m(-1) PM2.5 absorbance, albeit never statistically significant. The HRs in association with nitrogen oxides and traffic density on the nearest street were slightly above one. Sensitivity analyses among participants who did not change residence during follow-up showed stronger associations, but none were statistically significant. Our study provides suggestive evidence that exposure to outdoor PM at the residence may be associated with higher risk for kidney parenchyma cancer; the results should be interpreted cautiously as associations may be due to chance.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15561b, title = {DNA methylation and exposure to ambient air pollution in two prospective cohorts}, author = {M Plusquin and F Guida and S Polidoro and R Vermeulen and O Raaschou-Nielsen and G Campanella and G Hoek and S A Kyrtopoulos and P Georgiadis and A Naccarati and C Sacerdote and V Krogh and H Bas Bueno-de-Mesquita and W M Monique Verschuren and S Sayols-Baixeras and T Panni and A Peters and Dgaj Hebels and J Kleinjans and P Vineis and M Chadeau-Hyam}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28843141}, doi = {10.1016/j.envint.2017.08.006}, issn = {1873-6750 (Electronic) 0160-4120 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Environ Int}, volume = {108}, pages = {127-136}, abstract = {Long-term exposure to air pollution has been associated with several adverse health effects including cardiovascular, respiratory diseases and cancers. However, underlying molecular alterations remain to be further investigated. The aim of this study is to investigate the effects of long-term exposure to air pollutants on (a) average DNA methylation at functional regions and, (b) individual differentially methylated CpG sites. An assumption is that omic measurements, including the methylome, are more sensitive to low doses than hard health outcomes. This study included blood-derived DNA methylation (Illumina-HM450 methylation) for 454 Italian and 159 Dutch participants from the European Prospective Investigation into Cancer and Nutrition (EPIC). Long-term air pollution exposure levels, including NO2, NOx, PM2.5, PMcoarse, PM10, PM2.5 absorbance (soot) were estimated using models developed within the ESCAPE project, and back-extrapolated to the time of sampling when possible. We meta-analysed the associations between the air pollutants and global DNA methylation, methylation in functional regions and epigenome-wide methylation. CpG sites found differentially methylated with air pollution were further investigated for functional interpretation in an independent population (EnviroGenoMarkers project), where (N=613) participants had both methylation and gene expression data available. Exposure to NO2 was associated with a significant global somatic hypomethylation (p-value=0.014). Hypomethylation of CpG island's shores and shelves and gene bodies was significantly associated with higher exposures to NO2 and NOx. Meta-analysing the epigenome-wide findings of the 2 cohorts did not show genome-wide significant associations at single CpG site level. However, several significant CpG were found if the analyses were separated by countries. By regressing gene expression levels against methylation levels of the exposure-related CpG sites, we identified several significant CpG-transcript pairs and highlighted 5 enriched pathways for NO2 and 9 for NOx mainly related to the immune system and its regulation. Our findings support results on global hypomethylation associated with air pollution, and suggest that the shores and shelves of CpG islands and gene bodies are mostly affected by higher exposure to NO2 and NOx. Functional differences in the immune system were suggested by transcriptome analyses.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15595b, title = {Fruit and vegetable intake and prostate cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)}, author = {A Perez-Cornago and R C Travis and P N Appleby and K K Tsilidis and A Tjonneland and A Olsen and K Overvad and V Katzke and T Kuhn and A Trichopoulou and E Peppa and M Kritikou and S Sieri and D Palli and C Sacerdote and R Tumino and H B A Bueno-de-Mesquita and A Agudo and N Larranaga and E Molina-Portillo and E Ardanaz and M D Chirlaque and C Lasheras and P Stattin and M Wennberg and I Drake and J Malm and J A Schmidt and K T Khaw and M Gunter and H Freisling and I Huybrechts and D Aune and A J Cross and E Riboli and T J Key}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28419475}, doi = {10.1002/ijc.30741}, issn = {1097-0215 (Electronic) 0020-7136 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Int J Cancer}, volume = {141}, number = {2}, pages = {287-297}, abstract = {Several dietary factors have been studied in relation to prostate cancer; however, most studies have not reported on subtypes of fruit and vegetables or tumor characteristics, and results obtained so far are inconclusive. This study aimed to examine the prospective association of total and subtypes of fruit and vegetable intake with the incidence of prostate cancer overall, by grade and stage of disease, and prostate cancer death. Lifestyle information for 142,239 men participating in the European Prospective Investigation into Cancer and Nutrition from 8 European countries was collected at baseline. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). After an average follow-up time of 13.9 years, 7,036 prostate cancer cases were identified. Compared with the lowest fifth, those in the highest fifth of total fruit intake had a significantly reduced prostate cancer risk (HR = 0.91; 95% CI = 0.83-0.99; p-trend = 0.01). No associations between fruit subtypes and prostate cancer risk were observed, except for citrus fruits, where a significant trend was found (HR = 0.94; 95% CI = 0.86-1.02; p-trend = 0.01). No associations between total and subtypes of vegetables and prostate cancer risk were observed. We found no evidence of heterogeneity in these associations by tumor grade and stage, with the exception of significant heterogeneity by tumor grade (pheterogeneity \<0.001) for leafy vegetables. No significant associations with prostate cancer death were observed. The main finding of this prospective study was that a higher fruit intake was associated with a small reduction in prostate cancer risk. Whether this association is causal remains unclear.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15629b, title = {Prediagnostic circulating concentrations of plasma insulin-like growth factor-I and risk of lymphoma in the European Prospective Investigation into Cancer and Nutrition}, author = {A Perez-Cornago and P N Appleby and S Tipper and T J Key and N E Allen and A Nieters and R Vermeulen and S Roulland and D Casabonne and R Kaaks and R T Fortner and H Boeing and A Trichopoulou and C La Vecchia and E Klinaki and L Hansen and A Tjonneland and F Bonnet and G Fagherazzi and M C Boutron-Ruault and V Pala and G Masala and C Sacerdote and P H Peeters and H B Bueno-de-Mesquita and E Weiderpass and M Dorronsoro and J R Quiros and A Barricarte and D Gavrila and A Agudo and S Borgquist and A H Rosendahl and B Melin and N Wareham and K T Khaw and M Gunter and E Riboli and P Vineis and R C Travis}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27870006}, doi = {10.1002/ijc.30528}, issn = {1097-0215 (Electronic) 0020-7136 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Int J Cancer}, volume = {140}, number = {5}, pages = {1111-1118}, abstract = {Insulin-like growth factor (IGF)-I has cancer promoting activities. However, the hypothesis that circulating IGF-I concentration is related to risk of lymphoma overall or its subtypes has not been examined prospectively. IGF-I concentration was measured in pre-diagnostic plasma samples from a nested case-control study of 1,072 cases of lymphoid malignancies and 1,072 individually matched controls from the European Prospective Investigation into Cancer and Nutrition. Odds ratios (ORs) and confidence intervals (CIs) for lymphoma were calculated using conditional logistic regression. IGF-I concentration was not associated with overall lymphoma risk (multivariable-adjusted OR for highest versus lowest third = 0.77 [95% CI = 0.57-1.03]}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15570b, title = {Tall height and obesity are associated with an increased risk of aggressive prostate cancer: results from the EPIC cohort study}, author = {A Perez-Cornago and P N Appleby and T Pischon and K K Tsilidis and A Tjonneland and A Olsen and K Overvad and R Kaaks and T Kuhn and H Boeing and A Steffen and A Trichopoulou and P Lagiou and M Kritikou and V Krogh and D Palli and C Sacerdote and R Tumino and H B Bueno-de-Mesquita and A Agudo and N Larranaga and E Molina-Portillo and A Barricarte and M D Chirlaque and J R Quiros and P Stattin and C Haggstrom and N Wareham and K T Khaw and J A Schmidt and M Gunter and H Freisling and D Aune and H Ward and E Riboli and T J Key and R C Travis}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28701188}, doi = {10.1186/s12916-017-0876-7}, issn = {1741-7015 (Electronic) 1741-7015 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {BMC Med}, volume = {15}, number = {1}, pages = {115}, abstract = {BACKGROUND: The relationship between body size and prostate cancer risk, and in particular risk by tumour characteristics, is not clear because most studies have not differentiated between high-grade or advanced stage tumours, but rather have assessed risk with a combined category of aggressive disease. We investigated the association of height and adiposity with incidence of and death from prostate cancer in 141,896 men in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. METHODS: Multivariable-adjusted Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). After an average of 13.9 years of follow-up, there were 7024 incident prostate cancers and 934 prostate cancer deaths. RESULTS: Height was not associated with total prostate cancer risk. Subgroup analyses showed heterogeneity in the association with height by tumour grade (P heterogeneity = 0.002), with a positive association with risk for high-grade but not low-intermediate-grade disease (HR for high-grade disease tallest versus shortest fifth of height, 1.54; 95% CI, 1.18-2.03). Greater height was also associated with a higher risk for prostate cancer death (HR = 1.43, 1.14-1.80). Body mass index (BMI) was significantly inversely associated with total prostate cancer, but there was evidence of heterogeneity by tumour grade (P heterogeneity = 0.01; HR = 0.89, 0.79-0.99 for low-intermediate grade and HR = 1.32, 1.01-1.72 for high-grade prostate cancer) and stage (P heterogeneity = 0.01; HR = 0.86, 0.75-0.99 for localised stage and HR = 1.11, 0.92-1.33 for advanced stage). BMI was positively associated with prostate cancer death (HR = 1.35, 1.09-1.68). The results for waist circumference were generally similar to those for BMI, but the associations were slightly stronger for high-grade (HR = 1.43, 1.07-1.92) and fatal prostate cancer (HR = 1.55, 1.23-1.96). CONCLUSIONS: The findings from this large prospective study show that men who are taller and who have greater adiposity have an elevated risk of high-grade prostate cancer and prostate cancer death.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15549b, title = {Staggering the dose of sugammadex lowers risks for severe emergence cough: a randomized control trial}, author = {S L P and M M Miskan and Z C Y and R A Zaki}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29020936}, doi = {10.1186/s12871-017-0430-3}, issn = {1471-2253 (Electronic) 1471-2253 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {BMC Anesthesiol}, volume = {17}, number = {1}, pages = {137}, abstract = {BACKGROUND: Cough on emergence has been reported as a common adverse reaction with sugammadex reversal. We investigated if staggering the dose of sugammadex will reduce emergence cough in a single-center, randomized, double-blinded study. METHODS: A hundred and twenty ASA 1-3 adults were randomly reversed with 1 mg/kg sugammadex prior to extubation followed by another 1 mg/kg immediately after extubation (staggered group), single dose of 2 mg/kg sugammadex (single bolus group) or neostigmine 0.02 mg/kg with glycopyrrolate (neostigmine group). RESULTS: We found 70% of patients (n = 28) reversed with single boluses of sugammadex had Grade 3 emergence cough compared to 12.5% (n = 5) in the staggered sugammadex group and 17.5% (n = 7) in the neostigmine group (p \< 0.001). Besides cough, emergence agitation also appeared highest in the single bolus sugammadex group (n = 14, 35%}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15545b, title = {Using best-worst scaling to rank factors affecting vaccination demand in northern Nigeria}, author = {S Ozawa and C Wonodi and O Babalola and T Ismail and J Bridges}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29037575}, doi = {10.1016/j.vaccine.2017.09.079}, issn = {1873-2518 (Electronic) 0264-410X (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Vaccine}, volume = {35}, number = {47}, pages = {6429-6437}, abstract = {BACKGROUND: Understanding and ranking the reasons for low vaccination uptake among parents in northern Nigeria is critical to implement effective policies to save lives and prevent illnesses. This study applies best-worst scaling (BWS) to rank various factors affecting parents' demand for routine childhood immunization. METHODS: We conducted a household survey in Nahuche, Zamfara State in northern Nigeria. Nearly two hundred parents with children under age five were asked about their views on 16 factors using a BWS technique. These factors focused on known attributes that influence the demand for childhood immunization, which were identified from a literature review and reviewed by a local advisory board. The survey systematically presented parents with subsets of six factors and asked them to choose which they think are the most and least important in decisions to vaccinate children. We used a sequential best-worst analysis with conditional logistic regression to rank factors. RESULTS: The perception that vaccinating a child makes one a good parent was the most important motivation for parents in northern Nigeria to vaccinate children. Statements related to trust and social norms were ranked higher in importance compared to those that highlighted perceived benefits and risks, healthcare service, vaccine information, or opportunity costs. Fathers ranked trust in the media and views of their leaders to be of greatest importance, whereas mothers placed greater importance on social perceptions and norms. Parents of children without routine immunization ranked their trust in local leaders about vaccines higher in considerations, and the media's views lower, compared to parents with children who received routine immunization. CONCLUSIONS: Framing immunization messages in the context of good parenting and hearing these messages from trusted information sources may motivate parental uptake of childhood vaccines. These results are useful to policymakers to prioritize resources in order to increase awareness and demand for childhood immunization.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15530b, 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-Me 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}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29244072}, doi = {10.1093/annonc/mdx761}, issn = {1569-8041 (Electronic) 0923-7534 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Ann Oncol}, abstract = {Background: Smoking has been associated with colorectal cancer (CRC) incidence and mortality in previous studies and might also be associated with prognosis after CRC diagnosis. However, current evidence on smoking in association with CRC prognosis is limited. Patients and methods: For this individual patient data meta-analysis, sociodemographic and smoking behavior information of 12,414 incident CRC patients (median age at diagnosis: 64.3 years), recruited within 14 prospective cohort studies among previously cancer-free adults, was collected at baseline and harmonized across studies. Vital status and causes of death were collected for a mean follow-up time of 5.1 years following cancer diagnosis. Associations of smoking behavior with overall and CRC-specific survival were evaluated using Cox regression and standard meta-analysis methodology. Results: A total of 5,229 participants died, 3,194 from CRC. Cox regression revealed significant associations between former (hazard ratio (HR)=1.12; 95%-confidence interval (CI)=1.04-1.20) and current smoking (HR = 1.29; 95%CI=1.04-1.60) and poorer overall survival compared with never smoking. Compared with current smoking, smoking cessation was associated with improved overall (HR\<10years=0.78; 95%CI=0.69-0.88; HR\>/=10years=0.78; 95%CI=0.63-0.97) and CRC-specific survival (HR\>/=10years=0.76; 95%CI=0.67-0.85). Conclusion: In this large meta-analysis including primary data of incident CRC patients from 14 prospective cohort studies on the association between smoking and CRC prognosis, former and current smoking were associated with poorer CRC prognosis compared with never smoking. Smoking cessation was associated with improved survival when compared with current smokers. Future studies should further quantify the benefits of non-smoking, both for cancer prevention and for improving survival among CRC patients, in particular also in terms of treatment response.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15543b, 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}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29076190}, doi = {10.1111/jocn.14130}, issn = {1365-2702 (Electronic) 0962-1067 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {J Clin Nurs}, abstract = {AIMS AND OBJECTIVES: To examine nurses' perceptions of barriers to and facilitators of end-of-life care, as well as their association with the quality of end-of-life care. BACKGROUND: Often, dying patients and their families receive their care from general nurses. The quality of end-of-life care in hospital wards is inadequate. METHOD: A self-administered questionnaire was completed by 553 nurses working in a tertiary teaching hospital in Malaysia. RESULTS: The barrier with the highest mean score was "dealing with distressed family members." The facilitator with the highest mean score was "providing a peaceful and dignified bedside scene for the family once the patient has died." With regard to barrier and facilitator categories, the barrier category with the highest total mean score was patient-related barriers and the facilitator category with the highest total mean score concerned facilitators related to healthcare professionals. In the multivariate analysis, age, patient family-related barriers and healthcare professional-related facilitators significantly predict the quality of end-of-life care. CONCLUSION: The results of this study suggest that there is an urgent need to overcome barriers related to the patient and family members that hinder the quality of care provided for dying patients, as well as to enhance and implement the facilitators related to healthcare providers. In addition, there is also a need to enhance the quality of end-of-life care provided by younger nurses through end-of-life care courses and training. RELEVANCE TO CLINICAL PRACTICE: Helping nurses overcome barriers and implement facilitators may lead to enhanced quality of care provided for dying patients.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15711b, title = {Dietary and lifestyle determinants of acrylamide and glycidamide hemoglobin adducts in non-smoking postmenopausal women from the EPIC cohort}, author = {M Obon-Santacana and L Lujan-Barroso and H Freisling and C Cadeau and G Fagherazzi and M C Boutron-Ruault and R Kaaks and R T Fortner and H Boeing and J Ramon Quiros and E Molina-Montes and S Chamosa and J M Castano and E Ardanaz and K T Khaw and N Wareham and T Key and A Trichopoulou and P Lagiou and A Naska and D Palli and S Grioni and R Tumino and P Vineis and M S De Magistris and H B Bueno-de-Mesquita and P H Peeters and M Wennberg and I A Bergdahl and H Vesper and E Riboli and E J Duell}, url = {https://www.ncbi.nlm.nih.gov/pubmed/26850269}, doi = {10.1007/s00394-016-1165-5}, issn = {1436-6215 (Electronic) 1436-6207 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Eur J Nutr}, volume = {56}, number = {3}, pages = {1157-1168}, abstract = {PURPOSE: Acrylamide was classified as 'probably carcinogenic' to humans in 1994 by the International Agency for Research on Cancer. In 2002, public health concern increased when acrylamide was identified in starchy, plant-based foods, processed at high temperatures. The purpose of this study was to identify which food groups and lifestyle variables were determinants of hemoglobin adduct concentrations of acrylamide (HbAA) and glycidamide (HbGA) in 801 non-smoking postmenopausal women from eight countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. METHODS: Biomarkers of internal exposure were measured in red blood cells (collected at baseline) by high-performance liquid chromatography/tandem mass spectrometry (HPLC/MS/MS) . In this cross-sectional analysis, four dependent variables were evaluated: HbAA, HbGA, sum of total adducts (HbAA + HbGA), and their ratio (HbGA/HbAA). Simple and multiple regression analyses were used to identify determinants of the four outcome variables. All dependent variables (except HbGA/HbAA) and all independent variables were log-transformed (log2) to improve normality. Median (25th-75th percentile) HbAA and HbGA adduct levels were 41.3 (32.8-53.1) pmol/g Hb and 34.2 (25.4-46.9) pmol/g Hb, respectively. RESULTS: The main food group determinants of HbAA, HbGA, and HbAA + HbGA were biscuits, crackers, and dry cakes. Alcohol intake and body mass index were identified as the principal determinants of HbGA/HbAA. The total percent variation in HbAA, HbGA, HbAA + HbGA, and HbGA/HbAA explained in this study was 30, 26, 29, and 13 %, respectively. CONCLUSIONS: Dietary and lifestyle factors explain a moderate proportion of acrylamide adduct variation in non-smoking postmenopausal women from the EPIC cohort.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15585b, title = {Genetic variation in the ADIPOQ gene, adiponectin concentrations and risk of colorectal cancer: a Mendelian Randomization analysis using data from three large cohort studies}, author = {K Nimptsch and M Song and K Aleksandrova and M Katsoulis and H Freisling and M Jenab and M J Gunter and K K Tsilidis and E Weiderpass and H B Bueno-De-Mesquita and D Q Chong and M K Jensen and C Wu and K Overvad and T Kuhn and M Barrdahl and O Melander and K Jirstrom and P H Peeters and S Sieri and S Panico and A J Cross and E Riboli and B Van Guelpen and R Myte and J M Huerta and M Rodriguez-Barranco and J R Quiros and M Dorronsoro and A Tjonneland and A Olsen and R Travis and M C Boutron-Ruault and F Carbonnel and G Severi and C Bonet and D Palli and J Janke and Y A Lee and H Boeing and E L Giovannucci and S Ogino and C S Fuchs and E Rimm and K Wu and A T Chan and T Pischon}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28550647}, doi = {10.1007/s10654-017-0262-y}, issn = {1573-7284 (Electronic) 0393-2990 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Eur J Epidemiol}, volume = {32}, number = {5}, pages = {419-430}, abstract = {Higher levels of circulating adiponectin have been related to lower risk of colorectal cancer in several prospective cohort studies, but it remains unclear whether this association may be causal. We aimed to improve causal inference in a Mendelian Randomization meta-analysis using nested case-control studies of the European Prospective Investigation into Cancer and Nutrition (EPIC, 623 cases, 623 matched controls), the Health Professionals Follow-up Study (HPFS, 231 cases, 230 controls) and the Nurses' Health Study (NHS, 399 cases, 774 controls) with available data on pre-diagnostic adiponectin concentrations and selected single nucleotide polymorphisms in the ADIPOQ gene. We created an ADIPOQ allele score that explained approximately 3% of the interindividual variation in adiponectin concentrations. The ADIPOQ allele score was not associated with risk of colorectal cancer in logistic regression analyses (pooled OR per score-unit unit 0.97, 95% CI 0.91, 1.04). Genetically determined twofold higher adiponectin was not significantly associated with risk of colorectal cancer using the ADIPOQ allele score as instrumental variable (pooled OR 0.73, 95% CI 0.40, 1.34). In a summary instrumental variable analysis (based on previously published data) with higher statistical power, no association between genetically determined twofold higher adiponectin and risk of colorectal cancer was observed (0.99, 95% CI 0.93, 1.06 in women and 0.94, 95% CI 0.88, 1.01 in men). Thus, our study does not support a causal effect of circulating adiponectin on colorectal cancer risk. Due to the limited genetic determination of adiponectin, larger Mendelian Randomization studies are necessary to clarify whether adiponectin is causally related to lower risk of colorectal cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15577b, title = {Techniques of monitoring blood glucose during pregnancy for women with pre-existing diabetes}, author = {F M Moy and A Ray and B S Buckley and H M West}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28602020}, doi = {10.1002/14651858.CD009613.pub3}, issn = {1469-493X (Electronic) 1361-6137 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Cochrane Database Syst Rev}, volume = {6}, pages = {CD009613}, abstract = {BACKGROUND: Self-monitoring of blood glucose (SMBG) is recommended as a key component of the management plan for diabetes therapy during pregnancy. No existing systematic reviews consider the benefits/effectiveness of various 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. 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: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 November 2016), searched reference lists of retrieved studies and contacted trial authors. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-RCTs comparing techniques of blood glucose monitoring including SMBG, continuous glucose monitoring (CGM) 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 included. 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 at total of 10 trials (538) women (468 women with type 1 diabetes and 70 women with type 2 diabetes). The trials took place in Europe and the USA. Five of the 10 included studies were at moderate risk of bias, four studies were at low to moderate risk of bias, and one study was at high risk of bias. The trials are too small to show differences in important outcomes such as macrosomia, preterm birth, miscarriage or death of baby. Almost all the reported GRADE outcomes were assessed as being very low-quality evidence. This was due to design limitations in the studies, wide confidence intervals, small sample sizes, and few events. In addition, there was high heterogeneity for some outcomes.Various methods of glucose monitoring were compared in the trials. Neither pooled analyses nor individual trial analyses showed any clear advantages of one monitoring technique over another for primary and secondary outcomes. Many important outcomes were not reported.1. Self-monitoring versus standard care (two studies, 43 women): there was no clear difference for caesarean section (risk ratio (RR) 0.78, 95% confidence interval (CI) 0.40 to 1.49; one study, 28 women) or glycaemic control (both very low-quality), and not enough evidence to assess perinatal mortality and neonatal mortality and morbidity composite. Hypertensive disorders of pregnancy, large-for-gestational age, neurosensory disability, and preterm birth were not reported in either study.2. Self-monitoring versus hospitalisation (one study, 100 women): there was no clear difference for hypertensive disorders of pregnancy (pre-eclampsia and hypertension) (RR 4.26, 95% CI 0.52 to 35.16; very low-quality: RR 0.43, 95% CI 0.08 to 2.22; very low-quality). There was no clear difference in caesarean section or preterm birth less than 37 weeks' gestation (both very low quality), and the sample size was too small to assess perinatal mortality (very low-quality). Large-for-gestational age, mortality or morbidity composite, neurosensory disability and preterm birth less than 34 weeks were not reported.3. Pre-prandial versus post-prandial glucose monitoring (one study, 61 women): there was no clear difference between groups for caesarean section (RR 1.45, 95% CI 0.92 to 2.28; very low-quality), large-for-gestational age (RR 1.16, 95% CI 0.73 to 1.85; very low-quality) or glycaemic control (very low-quality). The results for hypertensive disorders of pregnancy: pre-eclampsia and perinatal mortality are not meaningful because these outcomes were too rare to show differences in a small sample (all very low-quality). The study did not report the outcomes mortality or morbidity composite, neurosensory disability or preterm birth.4. Automated telemedicine monitoring versus conventional system (three studies, 84 women): there was no clear difference for caesarean section (RR 0.96, 95% CI 0.62 to 1.48; one study, 32 women; very low-quality), and mortality or morbidity composite in the one study that reported these outcomes. There were no clear differences for glycaemic control (very low-quality). No studies reported hypertensive disorders of pregnancy, large-for-gestational age, perinatal mortality (stillbirth and neonatal mortality), neurosensory disability or preterm birth.5.CGM versus intermittent monitoring (two studies, 225 women): there was no clear difference for pre-eclampsia (RR 1.37, 95% CI 0.52 to 3.59; low-quality), caesarean section (average RR 1.00, 95% CI 0.65 to 1.54; I(2) = 62%; very low-quality) and large-for-gestational age (average RR 0.89, 95% CI 0.41 to 1.92; I(2) = 82%; very low-quality). Glycaemic control indicated by mean maternal HbA1c was lower for women in the continuous monitoring group (mean difference (MD) -0.60 %, 95% CI -0.91 to -0.29; one study, 71 women; moderate-quality). There was not enough evidence to assess perinatal mortality and there were no clear differences for preterm birth less than 37 weeks' gestation (low-quality). Mortality or morbidity composite, neurosensory disability and preterm birth less than 34 weeks were not reported.6. Constant CGM versus intermittent CGM (one study, 25 women): there was no clear difference between groups for caesarean section (RR 0.77, 95% CI 0.33 to 1.79; very low-quality), glycaemic control (mean blood glucose in the 3rd trimester) (MD -0.14 mmol/L, 95% CI -2.00 to 1.72; very low-quality) or preterm birth less than 37 weeks' gestation (RR 1.08, 95% CI 0.08 to 15.46; very low-quality). Other primary (hypertensive disorders of pregnancy, large-for-gestational age, perinatal mortality (stillbirth and neonatal mortality), mortality or morbidity composite, and neurosensory disability) or GRADE outcomes (preterm birth less than 34 weeks' gestation) were not reported. AUTHORS' CONCLUSIONS: This review found no evidence that any glucose monitoring technique is superior to any other technique among pregnant women with pre-existing type 1 or type 2 diabetes. The evidence base for the effectiveness of monitoring techniques is weak and additional evidence from large well-designed randomised trials is required to inform choices of glucose monitoring techniques.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15611b, title = {Mediterranean diet and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition cohort}, author = {E Molina-Montes and M J Sanchez and G Buckland and H B Bueno-de-Mesquita and E Weiderpass and P Amiano and P A Wark and T Kuhn and V Katzke and J M Huerta and E Ardanaz and J R Quiros and A Affret and M His and M C Boutron-Ruault and P H Peeters and W Ye and M Sund and H Boeing and K Iqbal and B Ohlsson and E Sonestedt and A Tjonneland and K E Petersen and R C Travis and G Skeie and C Agnoli and S Panico and D Palli and R Tumino and C Sacerdote and H Freisling and I Huybrechts and K Overvad and A Trichopoulou and C Bamia and E Vasilopoulou and N Wareham and K T Khaw and A J Cross and H A Ward and E Riboli and E J Duell}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28170373}, doi = {10.1038/bjc.2017.14}, issn = {1532-1827 (Electronic) 0007-0920 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Br J Cancer}, volume = {116}, number = {6}, pages = {811-820}, abstract = {BACKGROUND: The Mediterranean diet (MD) has been proposed as a means for cancer prevention, but little evidence has been accrued regarding its potential to prevent pancreatic cancer. We investigated the association between the adherence to the MD and pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. METHODS: Over half a million participants from 10 European countries were followed up for over 11 years, after which 865 newly diagnosed exocrine pancreatic cancer cases were identified. Adherence to the MD was estimated through an adapted score without the alcohol component (arMED) to discount alcohol-related harmful effects. Cox proportional hazards regression models, stratified by age, sex and centre, and adjusted for energy intake, body mass index, smoking status, alcohol intake and diabetes status at recruitment, were used to estimate hazard ratios (HRs) associated with pancreatic cancer and their corresponding 95% confidence intervals (CIs). RESULTS: Adherence to the arMED score was not associated with risk of pancreatic cancer (HR high vs low adherence=0.99; 95% CI: 0.77-1.26, and HR per increments of two units in adherence to arMED=1.00; 95% CI: 0.94-1.06). There was no convincing evidence for heterogeneity by smoking status, body mass index, diabetes or European region. There was also no evidence of significant associations in analyses involving microscopically confirmed cases, plausible reporters of energy intake or other definitions of the MD pattern. CONCLUSIONS: A high adherence to the MD is not associated with pancreatic cancer risk in the EPIC study.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15590b, title = {Complementary and alternative medicine (CAM) use and delays in presentation and diagnosis of breast cancer patients in public hospitals in Malaysia}, author = {N M Mohd Mujar and M Dahlui and N A Emran and I Abdul Hadi and Y Y Wai and S Arulanantham and C C Hooi and N A Mohd Taib}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28448541}, doi = {10.1371/journal.pone.0176394}, issn = {1932-6203 (Electronic) 1932-6203 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {PLoS One}, volume = {12}, number = {4}, pages = {e0176394}, abstract = {Complementary and alternative medicine (CAM) is widely used among the breast cancer patients in Malaysia. Delays in presentation, diagnosis and treatment have been shown to impact the disease prognosis. There is considerable use of CAM amongst breast cancer patients. CAM use has been cited as a cause of delay in diagnosis and treatments in qualitative studies, however there had not been any confirmatory study that confirms its impact on delays. The purpose of this study was to evaluate whether the use of CAM among newly diagnosed breast cancer patients was associated with delays in presentation, diagnosis or treatment of breast cancer. This multi-centre cross-sectional study evaluating the time points of the individual breast cancer patients' journey from first visit, resolution of diagnosis and treatments was conducted in six public hospitals in Malaysia. All newly diagnosed breast cancer patients from 1st January to 31st December 2012 were recruited. Data were collected through medical records review and patient interview by using a structured questionnaire. Complementary and alternative medicine (CAM) was defined as the use of any methods and products not included in conventional allopathic medicine before commencement of treatments. Presentation delay was defined as time taken from symptom discovery to first presentation of more than 3 months. The time points were categorised to diagnosis delay was defined as time taken from first presentation to diagnosis of more than 1 month and treatment delay was defined as time taken from diagnosis to initial treatment of more than 1 month. Multiple logistic regression was used for analysis. A total number of 340 patients participated in this study. The prevalence of CAM use was 46.5% (n = 158). Malay ethnicity (OR 3.32; 95% CI: 1.85, 5.97) and not interpreting symptom as cancerous (OR 1.79; 95% CI: 1.10, 2.92) were significantly associated with CAM use. The use of CAM was associated with delays in presentation (OR 1.65; 95% CI: 1.05, 2.59), diagnosis (OR 2.42; 95% CI: 1.56, 3.77) and treatment of breast cancer (OR 1.74; 95% CI: 1.11, 2.72) on univariate analyses. However, after adjusting with other covariates, CAM use was associated with delays in presentation (OR 1.71; 95% CI: 1.05, 2.78) and diagnosis (OR 2.58; 95% CI: 1.59, 4.17) but not for treatment of breast cancer (OR 1.58; 95% CI: 0.98, 2.55). The prevalence of CAM use among the breast cancer patients was high. Women of Malay ethnicity and not interpreting symptom as cancerous were significantly associated with CAM use. The use of CAM is significantly associated with delay in presentation and resolution of diagnosis. This study suggests further evaluation of access to breast cancer care is needed as poor access may cause the use of CAM. However, since public hospitals in Malaysia are heavily subsidized and readily available to the population, CAM use may impact delays in presentation and diagnosis.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15592b, title = {Vaccine hesitancy among parents in a multi-ethnic country, Malaysia}, author = {F S Mohd Azizi and Y Kew and F M Moy}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28434687}, doi = {10.1016/j.vaccine.2017.04.010}, issn = {1873-2518 (Electronic) 0264-410X (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Vaccine}, volume = {35}, number = {22}, pages = {2955-2961}, abstract = {BACKGROUND: Vaccine hesitancy is a threat in combating vaccine-preventable diseases. It has been studied extensively in the Western countries but not so among Asian countries. OBJECTIVES: To assess the test-retest reliability of the Parent Attitudes about Childhood Vaccines (PACV) questionnaire in Malay language; to determine the prevalence of vaccine hesitancy among parents and its associations with parents' socio-demographic characteristics. METHODS: Forward and backward translation of PACV in Malay language was carried out. The reliability of the Malay-PACV questionnaire was tested among parents with children. The same questionnaire was used to study vaccine hesitancy among parents in a tertiary hospital in Kuala Lumpur. Information pertaining to socio-demographic characteristics, sources of information regarding vaccination and vaccine hesitancy were collected. Associations between vaccine hesitancy with socio-demographic factors were tested using Multivariable Logistic Regression. RESULTS: The Spearman correlation coefficient and Cronbach alpha for total PACV was 0.79 (p\<0.001) and 0.79 respectively. The intra-class correlation coefficients of the subscales ranged from 0.54 to 0.90 demonstrating fair to excellent reliability. A total of 63 (11.6%) parents were noted to be vaccine hesitant. In the univariate analyses, vaccine hesitancy was associated with unemployed parents, parents who were younger, had fewer children and non-Muslim. In the multivariate model, pregnant mothers expecting their first child were four times more likely to be vaccine hesitant compared to those who already had one or more children (aOR: 3.91, 95% CI: 1.74-8.79) and unemployed parents were also more likely to be vaccine hesitant (aOR: 1.97, 95% CI: 1.08-3.59). The internet (65.6%) was the main source of information on vaccination followed by brochures (56.9%). CONCLUSION: The Malay-PACV questionnaire is reliable to be used. The prevalence of vaccine hesitancy among the multi-ethnic Malaysians was comparable with other populations. Pregnant mothers expecting their first child and unemployed parents were found to be more vaccine hesitant.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15628b, title = {Biomarkers of folate and vitamin B12 and breast cancer risk: report from the EPIC cohort}, author = {M Matejcic and J Batlle and C Ricci and C Biessy and F Perrier and I Huybrechts and E Weiderpass and M C Boutron-Ruault and C Cadeau and M His and D G Cox and H Boeing and R T Fortner and R Kaaks and P Lagiou and A Trichopoulou and V Benetou and R Tumino and S Panico and S Sieri and D Palli and F Ricceri and H B Bueno-de-Mesquita and G Skeie and P Amiano and M J Sanchez and M D Chirlaque and A Barricarte and J R Quiros and G Buckland and C H Gils and P H Peeters and T J Key and E Riboli and B Gylling and A Zeleniuch-Jacquotte and M J Gunter and I Romieu and V Chajes}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27905104}, doi = {10.1002/ijc.30536}, issn = {1097-0215 (Electronic) 0020-7136 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Int J Cancer}, volume = {140}, number = {6}, pages = {1246-1259}, abstract = {Epidemiological studies have reported inconsistent findings for the association between B vitamins and breast cancer (BC) risk. We investigated the relationship between biomarkers of folate and vitamin B12 and the risk of BC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Plasma concentrations of folate and vitamin B12 were determined in 2,491 BC cases individually matched to 2,521 controls among women who provided baseline blood samples. Multivariable logistic regression models were used to estimate odds ratios by quartiles of either plasma B vitamin. Subgroup analyses by menopausal status, hormone receptor status of breast tumors (estrogen receptor [ER], progesterone receptor [PR] and human epidermal growth factor receptor 2 [HER2]), alcohol intake and MTHFR polymorphisms (677C \> T and 1298A \> C) were also performed. Plasma levels of folate and vitamin B12 were not significantly associated with the overall risk of BC or by hormone receptor status. A marginally positive association was found between vitamin B12 status and BC risk in women consuming above the median level of alcohol (ORQ4-Q1 = 1.26; 95% CI 1.00-1.58; Ptrend = 0.05). Vitamin B12 status was also positively associated with BC risk in women with plasma folate levels below the median value (ORQ4-Q1 = 1.29; 95% CI 1.02-1.62; Ptrend = 0.03). Overall, folate and vitamin B12 status was not clearly associated with BC risk in this prospective cohort study. However, potential interactions between vitamin B12 and alcohol or folate on the risk of BC deserve further investigation.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15573b, title = {Factors associated with online victimisation among Malaysian adolescents who use social networking sites: a cross-sectional study}, author = {M J Marret and W Y Choo}, doi = {10.1136/bmjopen-2016-014959}, issn = {2044-6055}, year = {2017}, date = {2017-01-01}, journal = {BMJ Open}, volume = {7}, number = {6}, pages = {e014959}, abstract = {OBJECTIVE: To determine the prevalence of online interpersonal victimisation and its association with patterns of social networking site (SNS) use, offline victimisation, offline perpetration and parental conflict among Malaysian adolescents using SNS. METHODS: A cross-sectional study of students from randomly selected public secondary schools in the state of Negeri Sembilan was conducted using an anonymous self-administered questionnaire. The questionnaire examined patterns of SNS use and included measures of online victimisation, online perpetration, offline victimisation and parental conflict. A response rate of 91% from a total of 1634 yielded a sample of 1487 students between 15 years and 16 years of age. RESULTS: Ninety-two per cent of respondents had used at least one SNS. More than half of SNS users (52.2%) reported experiences of online victimisation over the past 12 months. Boys were significantly more likely to experience online harassment compared with girls (52.2% vs 43.3%, p\<0.001). There were no significant gender differences in experiences of unwanted sexual solicitation. Adolescents who engaged in perpetration behaviours online had almost six times higher odds of reporting frequent online victimisation compared with online behaviours involving personal disclosure. There was a significant dose-response relationship between engagement in multiple types of online behaviour and the risk of frequent online victimisation. Both online and offline perpetrations were associated with an increased risk of victimisation. Those who were victimised offline or experienced parental conflict were twice as likely to report online victimisation. CONCLUSION: Interventions to prevent online electronic aggression should target perpetration behaviour both online and offline. Youth should be equipped with skills in communication and decision-making in relationships that can be applied across a spectrum of contexts both online and offline.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15587b, title = {Survival rates and predictors of survival among colorectal cancer patients in a Malaysian tertiary hospital}, author = {B A Magaji and F M Moy and A C Roslani and C W Law}, doi = {10.1186/s12885-017-3336-z}, issn = {1471-2407}, year = {2017}, date = {2017-01-01}, journal = {BMC Cancer}, volume = {17}, number = {1}, pages = {339}, abstract = {BACKGROUND: Colorectal cancer is the third most commonly diagnosed malignancy and the fourth leading cause of cancer-related death globally. It is the second most common cancer among both males and females in Malaysia. The economic burden of colorectal cancer is likely to increase over time owing to its current trend and aging population. Cancer survival analysis is an essential indicator for early detection and improvement in cancer treatment. However, there was a scarcity of studies concerning survival of colorectal cancer patients as well as its predictors. Therefore, we aimed to determine the 1-, 3- and 5-year survival rates, compare survival rates among ethnic groups and determine the predictors of survival among colorectal cancer patients. METHODS: This was an ambidirectional cohort study conducted at the University Malaya Medical Centre (UMMC) in Kuala Lumpur, Malaysia. All Malaysian citizens or permanent residents with histologically confirmed diagnosis of colorectal cancer seen at UMMC from 1 January 2001 to 31 December 2010 were included in the study. Demographic and clinical characteristics were extracted from the medical records. Patients were followed-up until death or censored at the end of the study (31st December 2010). Censored patients' vital status (whether alive or dead) were cross checked with the National Registration Department. Survival analyses at 1-, 3- and 5-year intervals were performed using the Kaplan-Meier method. Log-rank test was used to compare the survival rates, while Cox proportional hazard regression analysis was carried out to determine the predictors of 5-year colorectal cancer survival. RESULTS: Among 1212 patients, the median survival for colorectal, colon and rectal cancers were 42.0, 42.0 and 41.0 months respectively; while the 1-, 3-, and 5-year relative survival rates ranged from 73.8 to 76.0%, 52.1 to 53.7% and 40.4 to 45.4% respectively. The Chinese patients had the lowest 5-year survival compared to Malay and Indian patients. Based on the 814 patients with data on their Duke's staging, independent predictors of poor colorectal cancer (5-year) survival were male sex (Hazard Ratio [HR]: 1.41; 95% CI: 1.12, 1.76), Chinese ethnicity (HR: 1.41; 95% CI: 1.07,1.85), elevated (\>/= 5.1 ng/ml) pre-operative carcino-embryonic antigen (CEA) level (HR: 2.13; 95% CI: 1.60, 2.83), Duke's stage C (HR: 1.68; 95% CI: 1.28, 2.21), Duke's stage D (HR: 4.61; 95% CI: 3.39, 6.28) and emergency surgery (HR: 1.52; 95% CI: 1.07, 2.15). CONCLUSIONS: The survival rates of colorectal cancer among our patients were comparable with those of some Asian countries but lower than those found in more developed countries. Males and patients from the Chinese ethnic group had lower survival rates compared to their counterparts. More advanced staging and late presentation were important predictors of colorectal cancer survival. Health education programs targeting high risk groups and emphasizing the importance of screening and early diagnosis, as well as the recognition of symptoms and risk factors should be implemented. A nationwide colorectal cancer screening program should be designed and implemented to increase early detection and improve survival outcomes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15564b, title = {Genetic Variants Related to Longer Telomere Length are Associated with Increased Risk of Renal Cell Carcinoma}, 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 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.2017.07.015}, issn = {0302-2838}, year = {2017}, date = {2017-01-01}, journal = {Eur Urol}, volume = {72}, number = {5}, pages = {747-754}, abstract = {BACKGROUND: Relative telomere length in peripheral blood leukocytes has been evaluated as a potential biomarker for renal cell carcinoma (RCC) risk in several studies, with conflicting findings. OBJECTIVE: We performed an analysis of genetic variants associated with leukocyte telomere length to assess the relationship between telomere length and RCC risk using Mendelian randomization, an approach unaffected by biases from temporal variability and reverse causation that might have affected earlier investigations. DESIGN, SETTING, AND PARTICIPANTS: Genotypes from nine telomere length-associated variants for 10 784 cases and 20 406 cancer-free controls from six genome-wide association studies (GWAS) of RCC were aggregated into a weighted genetic risk score (GRS) predictive of leukocyte telomere length. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Odds ratios (ORs) relating the GRS and RCC risk were computed in individual GWAS datasets and combined by meta-analysis. RESULTS AND LIMITATIONS: Longer genetically inferred telomere length was associated with an increased risk of RCC (OR=2.07 per predicted kilobase increase, 95% confidence interval [CI]:=1.70-2.53, p\<0.0001). As a sensitivity analysis, we excluded two telomere length variants in linkage disequilibrium (R(2)\>0.5) with GWAS-identified RCC risk variants (rs10936599 and rs9420907) from the telomere length GRS; despite this exclusion, a statistically significant association between the GRS and RCC risk persisted (OR=1.73, 95% CI=1.36-2.21, p\<0.0001). Exploratory analyses for individual histologic subtypes suggested comparable associations with the telomere length GRS for clear cell (N=5573}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15712b, title = {Sugar-sweetened beverage intake and its associations with cardiometabolic risks among adolescents}, author = {D A Loh and F M Moy and N L Zaharan and M Y Jalaludin and Z Mohamed}, doi = {10.1111/ijpo.12108}, issn = {2047-6302}, year = {2017}, date = {2017-01-01}, journal = {Pediatr Obes}, volume = {12}, number = {1}, pages = {e1-e5}, abstract = {BACKGROUND: Investigations on sugar-sweetened beverage (SSB) intake and cardiometabolic risks among Asians are scant. OBJECTIVES: This study aimed to examine associations between SSB intake and cardiometabolic risks among Malaysian adolescents. METHODS: Anthropometric data, blood pressure (BP), fasting blood glucose (FBG), lipid profiles and insulin levels measured involved 873 adolescents (aged 13 years). SSB intake, dietary patterns and physical activity level (PAL) were self-reported. RESULTS: Mean SSB consumption was 177.5 mL day(-1) with significant differences among ethnicities (Malay, Chinese, Indians and Others) (p \< 0.05). SSB intake was deleteriously associated with increased waist circumference, elevated triglycerides, FBG, insulin, insulin resistance and low HDL-cholesterol, independent of PAL, body mass index and dietary patterns. Significant U-shaped and inverse trends were noted between SSB intake and LDL-cholesterol and BP, respectively. CONCLUSION: Sugar-sweetened beverage intake was unfavourably associated with cardiometabolic health outcomes among young adolescents. Concerted efforts towards healthy hydration are imperative to mitigate risk of cardiometabolic events.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15531b, 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 = {2017}, date = {2017-01-01}, journal = {Health Policy Plan}, abstract = {Cost-effectiveness thresholds (CETs) based on the Commission on Macroeconomics and Health (CMH) are extensively used in low- and middle-income countries (LMICs) lacking locally defined CETs. These thresholds were originally intended for global and regional prioritization, and do not reflect local context or affordability at the national level, so their value for informing resource allocation decisions has been questioned. Using these thresholds, rotavirus vaccines are widely regarded as cost-effective interventions in LMICs. However, high vaccine prices remain a barrier towards vaccine introduction. This study aims to evaluate the cost-effectiveness, affordability and threshold price of universal rotavirus vaccination at various CETs in Malaysia. Cost-effectiveness of Rotarix and RotaTeq were evaluated using a multi-cohort model. Pan American Health Organization Revolving Fund's vaccine prices were used as tender price, while the recommended retail price for Malaysia was used as market price. We estimate threshold prices defined as prices at which vaccination becomes cost-effective, at various CETs reflecting economic theories of human capital, societal willingness-to-pay and marginal productivity. A budget impact analysis compared programmatic costs with the healthcare budget. At tender prices, both vaccines were cost-saving. At market prices, cost-effectiveness differed with thresholds used. At market price, using 'CMH thresholds', Rotarix programmes were cost-effective and RotaTeq were not cost-effective from the healthcare provider's perspective, while both vaccines were cost-effective from the societal perspective. Using other CETs, both vaccines were not cost-effective at market price, from the healthcare provider's and societal perspectives. At tender and cost-effective prices, rotavirus vaccination cost approximately 1 and 3% of the public health budget, respectively. Using locally defined thresholds, rotavirus vaccination is cost-effective at vaccine prices in line with international tenders, but not at market prices. Thresholds representing marginal productivity are likely to be lower than those reflecting human capital and individual preference measures, and may be useful in determining affordable vaccine prices.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15623b, title = {Outcome after neoadjuvant chemotherapy in Asian breast cancer patients}, author = {L Y Lim and H Miao and J S Lim and S C Lee and N Bhoo-Pathy and C H Yip and N A Taib and P Chan and E Y Tan and S H Lim and G H Lim and E Woo and Y S Tan and J A Lee and M Wong and P H Tan and K W Ong and F Y Wong and Y S Yap and M Hartman}, doi = {10.1002/cam4.985}, issn = {2045-7634}, year = {2017}, date = {2017-01-01}, journal = {Cancer Med}, volume = {6}, number = {1}, pages = {173-185}, abstract = {We aim to identify clinicopathologic predictors for response to neoadjuvant chemotherapy and to evaluate the prognostic value of pathologic complete response (pCR) on survival in Asia. This study included 915 breast cancer patients who underwent neoadjuvant chemotherapy at five public hospitals in Singapore and Malaysia. pCR following neoadjuvant chemotherapy was defined as 1) no residual invasive tumor cells in the breast (ypT0/is) and 2) no residual invasive tumor cells in the breast and axillary lymph nodes (ypT0/is ypN0). Association between pCR and clinicopathologic characteristics and treatment were evaluated using chi-square test and multivariable logistic regression. Kaplan-Meier analysis and log-rank test, stratified by other prognostic factors, were conducted to compare overall survival between patients who achieved pCR and patients who did not. Overall, 4.4% of nonmetastatic patients received neoadjuvant chemotherapy. The median age of preoperatively treated patients was 50 years. pCR rates were 18.1% (pCR ypT0/is) and 14.4% (pCR ypT0/is ypN0), respectively. pCR rate was the highest among women who had higher grade, smaller size, estrogen receptor negative, human epidermal growth factor receptor 2-positive disease or receiving taxane-based neoadjuvant chemotherapy. Patients who achieved pCR had better overall survival than those who did not. In subgroup analysis, the survival advantage was only significant among women with estrogen receptor-negative tumors. Patients with poor prognostic profile are more likely to achieve pCR and particularly when receiving taxane-containing chemotherapy. pCR is a significant prognostic factor for overall survival especially in estrogen receptor-negative breast cancers.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15672b, title = {Validity and reliability of the Malay version multidimensional scale of perceived social support (MSPSS-M) among teachers}, author = {S C Lee and F M Moy and N N Hairi}, doi = {10.1007/s11136-016-1348-9}, issn = {0962-9343}, year = {2017}, date = {2017-01-01}, journal = {Qual Life Res}, volume = {26}, number = {1}, pages = {221-227}, abstract = {PURPOSE: The multidimensional scale of perceived social support (MSPSS) was developed to measure perceived social support. It has been translated and culturally adapted among natives literate in the Malay language. However, its psychometric properties for teachers who are majority females and married have not been assessed. METHODS: This was a cross-sectional study conducted among the public secondary school teachers in the central region of Peninsular Malaysia from May to July 2013. A total of 150 and 203 teachers were recruited to perform exploratory factor analysis and confirmatory factor analysis (CFA), respectively. Reliability testing was evaluated on 141 teachers via internal consistency and two-week interval test-retest. RESULTS: The 12-item three-factor structure of MSPSS-M was revised to 8-item two-factor structure. The revised MSPSS-M demonstrated excellent fit in CFA with adequate divergent and convergent validity and good factor loadings (0.80-0.90). The revised MSPSS-M also displayed good internal consistency with Cronbach's alpha of 0.91, 0.93 and 0.92 and good test-retest reliability with intraclass correlation of 0.89, 0.88 and 0.88 in the total scale, family and friends factors, respectively. CONCLUSION: The revised 8-item MSPSS-M is a reliable and valid tool for assessment of perceived social support among teachers.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15613b, title = {Metabolic syndrome among non-obese adults in the teaching profession in Melaka, Malaysia}, author = {S C Lee and N N Hairi and F M Moy}, doi = {10.1016/j.je.2016.10.006}, issn = {0917-5040}, year = {2017}, date = {2017-01-01}, journal = {J Epidemiol}, volume = {27}, number = {3}, pages = {130-134}, abstract = {BACKGROUND: Non-obese individuals could have metabolic disorders that are typically associated with elevated body mass index (BMI), placing them at elevated risk for chronic diseases. This study aimed to describe the prevalence and distribution of metabolically obese, non-obese (MONO) individuals in Malaysia. METHODS: We conducted a cross-sectional study involving teachers recruited via multi-stage sampling from the state of Melaka, Malaysia. MONO was defined as individuals with BMI 18.5-29.9 kg/m(2) and metabolic syndrome. Metabolic syndrome was diagnosed based on the Harmonization criteria. Participants completed self-reported questionnaires that assessed alcohol intake, sleep duration, smoking, physical activity, and fruit and vegetable consumption. RESULTS: A total of 1168 teachers were included in the analysis. The prevalence of MONO was 17.7% (95% confidence interval [CI], 15.3-20.4). Prevalence of metabolic syndrome among the normal weight and overweight participants was 8.3% (95% CI, 5.8-11.8) and 29.9% (95% CI, 26.3-33.7), respectively. MONO prevalence was higher among males, Indians, and older participants and inversely associated with sleep duration. Metabolic syndrome was also more prevalent among those with central obesity, regardless of whether they were normal or overweight. The odds of metabolic syndrome increased exponentially from 1.9 (for those with BMI 23.0-24.9 kg/m(2)) to 11.5 (for those with BMI 27.5-29.9 kg/m(2)) compared to those with BMI 18.5-22.9 kg/m(2) after adjustment for confounders. CONCLUSIONS: The prevalence of MONO was high, and participants with BMI \>/=23.0 kg/m(2) had significantly higher odds of metabolic syndrome. Healthcare professionals and physicians should start to screen non-obese individuals for metabolic risk factors to facilitate early targeted intervention.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15558b, title = {Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study}, author = {K Y Lee and W A Wan Ahmad and E V Low and S Y Liau and L Anchah and S Hamzah and H B Liew and R B Mohd Ali and O Ismail and T K Ong and M A Said and M Dahlui}, doi = {10.1371/journal.pone.0184410}, issn = {1932-6203}, year = {2017}, date = {2017-01-01}, journal = {PLoS One}, volume = {12}, number = {9}, pages = {e0184410}, abstract = {INTRODUCTION: The increasing disease burden of coronary artery disease (CAD) calls for sustainable cardiac service. Teaching hospitals and general hospitals in Malaysia are main providers of percutaneous coronary intervention (PCI), a common treatment for CAD. Few studies have analyzed the contemporary data on local cardiac facilities. Service expansion and budget allocation require cost evidence from various providers. We aim to compare the patient characteristics, procedural outcomes, and cost profile between a teaching hospital (TH) and a general hospital (GH). METHODS: This cross-sectional study was conducted from the healthcare providers' perspective from January 1st to June 30th 2014. TH is a university teaching hospital in the capital city, while GH is a state-level general hospital. Both are government-funded cardiac referral centers. Clinical data was extracted from a national cardiac registry. Cost data was collected using mixed method of top-down and bottom-up approaches. Total hospitalization cost per PCI patient was summed up from the costs of ward admission and cardiac catheterization laboratory utilization. Clinical characteristics were compared with chi-square and independent t-test, while hospitalization length and cost were analyzed using Mann-Whitney test. RESULTS: The mean hospitalization cost was RM 12,117 (USD 3,366) at GH and RM 16,289 (USD 4,525) at TH. The higher cost at TH can be attributed to worse patients' comorbidities and cardiac status. In contrast, GH recorded a lower mean length of stay as more patients had same-day discharge, resulting in 29% reduction in mean cost of admission compared to TH. For both hospitals, PCI consumables accounted for the biggest proportion of total cost. CONCLUSIONS: The high PCI consumables cost highlighted the importance of cost-effective purchasing mechanism. Findings on the heterogeneity of the patients, treatment practice and hospitalization cost between TH and GH are vital for formulation of cost-saving strategies to ensure sustainable and equitable cardiac service in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15584b, title = {Cost of elective percutaneous coronary intervention in Malaysia: a multicentre cross-sectional costing study}, author = {K Y Lee and T K Ong and E V Low and S Y Liow and L Anchah and S Hamzah and H B Liew and R M Ali and O Ismail and W A W Ahmad and M A Said and M Dahlui}, doi = {10.1136/bmjopen-2016-014307}, issn = {2044-6055}, year = {2017}, date = {2017-01-01}, journal = {BMJ Open}, volume = {7}, number = {5}, pages = {e014307}, abstract = {OBJECTIVES: Limitations in the quality and access of cost data from low-income and middle-income countries constrain the implementation of economic evaluations. With the increasing prevalence of coronary artery disease in Malaysia, cost information is vital for cardiac service expansion. We aim to calculate the hospitalisation cost of percutaneous coronary intervention (PCI), using a data collection method customised to local setting of limited data availability. DESIGN: This is a cross-sectional costing study from the perspective of healthcare providers, using top-down approach, from January to June 2014. Cost items under each unit of analysis involved in the provision of PCI service were identified, valuated and calculated to produce unit cost estimates. SETTING: Five public cardiac centres participated. All the centres provide full-fledged cardiology services. They are also the tertiary referral centres of their respective regions. PARTICIPANTS: The cost was calculated for elective PCI procedure in each centre. PCI conducted for urgent/emergent indication or for patients with shock and haemodynamic instability were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES: The outcome measures of interest were the unit costs at the two units of analysis, namely cardiac ward admission and cardiac catheterisation utilisation, which made up the total hospitalisation cost. RESULTS: The average hospitalisation cost ranged between RM11 471 (US$3186) and RM14 465 (US$4018). PCI consumables were the dominant cost item at all centres. The centre with daycare establishment recorded the lowest admission cost and total hospitalisation cost. CONCLUSIONS: Comprehensive results from all centres enable comparison at the levels of cost items, unit of analysis and total costs. This generates important information on cost variations between centres, thus providing valuable guidance for service planning. Alternative procurement practices for PCI consumables may deliver cost reduction. For countries with limited data availability, costing method tailored based on country setting can be used for the purpose of economic evaluations. REGISTRATION: Malaysian MOH Medical Research and Ethics Committee (ID: NMRR-13-1403-18234 IIR).}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15603b, title = {A new paradigm for Aedes spp. surveillance using gravid ovipositing sticky trap and NS1 antigen test kit}, author = {S M Lau and T H Chua and W Y Sulaiman and S Joanne and Y A Lim and S D Sekaran and K Chinna and B Venugopalan and I Vythilingam}, doi = {10.1186/s13071-017-2091-y}, issn = {1756-3305}, year = {2017}, date = {2017-01-01}, journal = {Parasit Vectors}, volume = {10}, number = {1}, pages = {151}, abstract = {BACKGROUND: Dengue remains a serious public health problem in Southeast Asia and has increased 37-fold in Malaysia compared to decades ago. New strategies are urgently needed for early detection and control of dengue epidemics. METHODS: We conducted a two year study in a high human density dengue-endemic urban area in Selangor, where Gravid Ovipositing Sticky (GOS) traps were set up to capture adult Aedes spp. mosquitoes. All Aedes mosquitoes were tested using the NS1 dengue antigen test kit. All dengue cases from the study site notified to the State Health Department were recorded. Weekly microclimatic temperature, relative humidity (RH) and rainfall were monitored. RESULTS: Aedes aegypti was the predominant mosquito (95.6%) caught in GOS traps and 23% (43/187 pools of 5 mosquitoes each) were found to be positive for dengue using the NS1 antigen kit. Confirmed cases of dengue were observed with a lag of one week after positive Ae. aegypti were detected. Aedes aegypti density as analysed by distributed lag non-linear models, will increase lag of 2-3 weeks for temperature increase from 28 to 30 degrees C; and lag of three weeks for increased rainfall. CONCLUSION: Proactive strategy is needed for dengue vector surveillance programme. One method would be to use the GOS trap which is simple to setup, cost effective (below USD 1 per trap) and environmental friendly (i.e. use recyclable plastic materials) to capture Ae. aegypti followed by a rapid method of detecting of dengue virus using the NS1 dengue antigen kit. Control measures should be initiated when positive mosquitoes are detected.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15594b, title = {Advanced Stage at Presentation Remains a Major Factor Contributing to Breast Cancer Survival Disparity between Public and Private Hospitals in a Middle-Income Country}, author = {Y C Kong and N Bhoo-Pathy and S Subramaniam and N Bhoo-Pathy and N A Taib and S Jamaris and K Kaur and M H See and G F Ho and C H Yip}, doi = {10.3390/ijerph14040427}, issn = {1660-4601}, year = {2017}, date = {2017-01-01}, journal = {Int J Environ Res Public Health}, volume = {14}, number = {4}, abstract = {Background: Survival disparities in cancer are known to occur between public and private hospitals. We compared breast cancer presentation, treatment and survival between a public academic hospital and a private hospital in a middle-income country. Methods: The demographics, clinical characteristics, treatment and overall survival (OS) of 2767 patients with invasive breast carcinoma diagnosed between 2001 and 2011 in the public hospital were compared with 1199 patients from the private hospital. Results: Compared to patients in the private hospital, patients from the public hospital were older at presentation, and had more advanced cancer stages. They were also more likely to receive mastectomy and chemotherapy but less radiotherapy. The five-year OS in public patients was significantly lower than in private patients (71.6% vs. 86.8%). This difference was largely attributed to discrepancies in stage at diagnosis and, although to a much smaller extent, to demographic differences and treatment disparities. Even following adjustment for these factors, patients in the public hospital remained at increased risk of mortality compared to their counterparts in the private hospital (Hazard Ratio: 1.59; 95% Confidence Interval: 1.36-1.85). Conclusion: Late stage at diagnosis appears to be a major contributing factor explaining the breast cancer survival disparity between public and private patients in this middle-income setting.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15534b, 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 = {2017}, date = {2017-01-01}, journal = {J Med Entomol}, abstract = {Little information is available on human anaplasmosis and ehrlichiosis in Southeast Asia despite increasing reports of the detection of Anaplasma spp. and Ehrlichia spp. in the ticks. We report herein the serological findings against the tick-borne pathogens in a group of animal farm workers (n = 87) and indigenous people (n = 102) in Peninsular Malaysia. IgG antibodies against Ehrlichia chaffeensis were detected from 29.9% and 34.3% of farm workers and indigenous people, respectively, using commercial indirect immunofluorescence assays. Comparatively, only 6.9% of the indigenous people but none of the animal farm workers were seropositive to Anaplasma phagocytophilum. A polymerase chain reaction (PCR) assay targeting the 16S rRNA gene of Anaplasmataceae was used to identify Anaplastamataceae in ticks collected from various locations adjacent to the areas where the serological survey was conducted. In this study, a total of 61.5% of ticks infesting farm animals, 37.5% of ticks infesting peri-domestic animals in rural villages, 27.3% of ticks collected from wildlife animals, and 29.1% of questing ticks collected from forest vegetation were positive for Anaplasmataceae DNA. Sequence analyses of 16S rRNA gene region (238 bp) provide the identification for Anaplasma marginale, Anaplasma bovis, Anaplasma platys, A. phagocytophilum, and Anaplasma spp. closely related to Candidatus Cryptoplasma californiense in ticks. E. chaffeensis DNA was not detected from any ticks, instead, Ehrlichia sp. strain EBm52, Ehrlichia mineirensis and Candidatus Ehrlichia shimanensis are the only Ehrlichia sp. identified from cattle ticks in this study. Further investigation is required to ascertain the occurrence of zoonotic transmission of Ehrlichia and Anaplasma infections in Peninsular Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15536b, title = {Prevalence and sociodemographic correlates of cervicovaginal human papillomavirus (HPV) carriage in a cross-sectional, multiethnic, community-based female Asian population}, author = {S P Khoo and N Bhoo-Pathy and S H Yap and M K Anwar Shafii and N Hairizan Nasir and J Belinson and S Subramaniam and P P Goh and M Zeng and H D Tan and P Gravitt and Y L Woo}, doi = {10.1136/sextrans-2017-053320}, issn = {1368-4973}, year = {2017}, date = {2017-01-01}, journal = {Sex Transm Infect}, abstract = {OBJECTIVES: Cervical cancer is a largely preventable disease, and the strategic implementation of a cervical cancer prevention programme is partly dependent on the impact of human papillomavirus (HPV) infection interpreted within the context of the country's sociodemographic attributes. The objective of this study is to determine the prevalence of cervicovaginal HPV infection among a healthy, community-based, multiethnic Malaysian population. The HPV prevalence was subsequently correlated to the individual's sociodemographics and sexual/reproductive history. Of significance, the observed prevalence captured was in a birth cohort not included in the national school-based HPV vaccination programme. METHODS: This was a cross-sectional study where 1293 healthy women aged between 18 and 60 years were recruited via convenience sampling from five community-based clinics in Selangor, Malaysia. Cervicovaginal self-samples were obtained and DNA was extracted for HPV detection and genotyping. A comprehensive questionnaire was administered to determine the sociodemographics and behavioural patterns of participants. RESULTS: The median age at enrolment was 37 years old (IQR: 30-47). In total, 86/1190 (7.2%) of the samples collected were positive for HPV infection, with the highest HPV prevalence (11.9%) detected in the subgroup of 18-24 years old. The top three most prevalent HPV genotypes were HPV 16, 52 and 58. The independent risk factors associated with higher rates of HPV infection included Indian ethnicity, widowed status and women with partners who are away from home for long periods and/or has another sexual partner. CONCLUSIONS: The overall prevalence of HPV infection in this Malaysian multiethnic population was 7.2%, with 6.5% being high-risk genotypes. The top three most common high-risk HPV types were HPV 16, 52 and 58. This information is important for the planning of primary (HPV vaccination) and secondary (screening) cervical cancer prevention programmes in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15597b, title = {Rickettsial seropositivity in the indigenous community and animal farm workers, and vector surveillance in Peninsular Malaysia}, author = {K L Kho and F X Koh and L I Hasan and L P Wong and M G Kisomi and A Bulgiba and Q N Nizam and S T Tay}, doi = {10.1038/emi.2017.4}, issn = {2222-1751}, year = {2017}, date = {2017-01-01}, journal = {Emerg Microbes Infect}, volume = {6}, number = {4}, pages = {e18}, abstract = {Rickettsioses are emerging zoonotic diseases that are often neglected in many countries in Southeast Asia. Rickettsial agents are transmitted to humans through exposure to infected arthropods. Limited data are available on the exposure of indigenous community and animal farm workers to the aetiological agents and arthropod vectors of rickettsioses in Peninsular Malaysia. Serological analysis of Rickettsia conorii and Rickettsia felis was performed for 102 individuals from the indigenous community at six rural villages and 87 workers from eight animal farms in Peninsular Malaysia in a cross-sectional study. The indigenous community had significantly higher seropositivity rates for R. conorii (P\<0.001) and R. felis (P\<0.001), as compared to blood donors from urban (n=61). Similarly, higher seropositivity rates for R. conorii (P=0.046) and R. felis (P\<0.001) were noted for animal farm workers, as compared to urban blood donors. On the basis of the sequence analysis of gltA, ompA and ompB, various spotted fever group rickettsiae closely related to R. raoultii, R. heilongjiangensis, R. felis-like organisms, R. tamurae, Rickettsia sp. TCM1, R. felis, Rickettsia sp. LON13 and R. hulinensis were identified from tick/flea samples in animal farms, indigenous villages and urban areas. This study describes rickettsial seropositivity of the Malaysian indigenous community and animal farm workers, and provides molecular evidence regarding the presence of rickettsial agents in ticks/fleas infesting domestic animals in Peninsular Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15562b, title = {Single-species versus dual-species probiotic supplementation as an emerging therapeutic strategy for obesity}, author = {G Karimi and R Jamaluddin and N Mohtarrudin and Z Ahmad and H Khazaai and M Parvaneh}, doi = {10.1016/j.numecd.2017.06.020}, issn = {0939-4753}, year = {2017}, date = {2017-01-01}, journal = {Nutr Metab Cardiovasc Dis}, volume = {27}, number = {10}, pages = {910-918}, abstract = {BACKGROUND AND AIM: Recent studies have reported beneficial effects of specific probiotics on obesity. However, the difference in the anti-obesity effects of probiotics as single species and dual species is still uncertain. Therefore, we aimed to compare the efficacy of single and dual species of bacteria on markers of obesity in high-fat diet-induced obese rats. METHODS AND RESULTS: A total of 40 male Sprague-Dawley rats were assigned to one of five groups of varying diets as follows: standard diet, high fat diet (HFD), HFD supplemented with Lactobacillus casei strain Shirota, HFD supplemented with Bifidobacterium longum and HFD supplemented with a mixture of these two bacterial species. After 15 weeks of supplementation, the animals were examined for changes in body weight, body fat, total count of bacteria in fecal, blood serum lipid profile, leptin, adiponectin and inflammatory biomarkers. Histological analysis of the liver and adipose tissue was performed and the hepatic mRNA expression levels of genes related to lipid metabolism were measured. It was found that probiotic supplementation of either B. longum or a mixture of B. longum and LcS bacteria significantly reduced weight and triglycerides in the HFD groups. Supplementation of B. longum bacteria showed better results in terms of modulating leptin level, fat mass, adipocyte size and lipoprotein lipase expression, as well as increasing adiponectin and peroxisome proliferator-activated receptors-gamma expression compared to dual species of bacteria. No significant differences were observed in the total count of fecal bacteria, glucose and inflammatory biomarker levels between supplemented groups. CONCLUSIONS: B. longum supplementation in obesity was more beneficial in metabolic profile changes than the mixture species.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15636b, title = {Adherence to the WCRF/AICR Dietary Recommendations for Cancer Prevention and Risk of Cancer in Elderly from Europe and the United States: A Meta-Analysis within the CHANCES Project}, author = {N Jankovic and A Geelen and R M Winkels and B Mwungura and V Fedirko and M Jenab and A K Illner and H Brenner and J M Ordonez-Mena and J C Kiefte Jong and O H Franco and P Orfanos and A Trichopoulou and P Boffetta and A Agudo and P H Peeters and A Tjonneland and G Hallmans and H B Bueno-de-Mesquita and Y Park and E J Feskens and L C Groot and E Kampman}, doi = {10.1158/1055-9965.Epi-16-0428}, issn = {1055-9965}, year = {2017}, date = {2017-01-01}, journal = {Cancer Epidemiol Biomarkers Prev}, volume = {26}, number = {1}, pages = {136-144}, abstract = {BACKGROUND: It is unknown whether dietary recommendations for cancer prevention are applicable to the elderly. We analyzed WCRF/AICR recommendations in cohorts of European and U.S. adults ages 60 years and above. METHODS: Individual participant data meta-analysis included 362,114 participants (43% women), from seven prospective cohort studies, free from cancer at enrollment. The WCRF/AICR diet score was based on: (i) energy-dense foods and sugary drinks, (ii) plant foods, (iii) red and processed meat, and (iv) alcoholic drinks. Cox proportional hazards regression was used to examine the association between the diet score and cancer risks. Adjusted, cohort-specific HRs were pooled using random-effects meta-analysis. Risk advancement periods (RAP) were calculated to quantify the time period by which the risk of cancer was postponed among those adhering to the recommendations. RESULTS: After a median follow-up of 11 to 15 years across cohorts, 70,877 cancer cases were identified. Each one-point increase in the WCRF/AICR diet score [range, 0 (no) to 4 (complete adherence)] was significantly associated with a lower risk of total cancer [HR, 0.94; 95% confidence interval (CI), 0.92-0.97], cancers of the colorectum (HR, 0.84; 95% CI, 0.80-0.89) and prostate (HR, 0.94; 95% CI, 0.92-0.97), but not breast or lung. Adherence to an additional component of the WCRF/AICR diet score significantly postponed the incidence of cancer at any site by 1.6 years (RAP, -1.6; 95% CI, -4.09 to -2.16). CONCLUSIONS: Adherence to WCRF/AICR dietary recommendations is associated with lower risk of cancer among older adults. IMPACT: Dietary recommendations for cancer prevention are applicable to the elderly. Cancer Epidemiol Biomarkers Prev; 26(1); 136-44. (c)2016 AACR.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15535b, 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 = {2017}, date = {2017-01-01}, journal = {Dig Dis Sci}, abstract = {OBJECTIVE: The role of gastritis in dyspepsia remains controversial. We aimed to examine the efficacy of rebamipide, a gastric mucosal protective agent, in both organic and functional dyspepsia. DESIGN: A systematic review and meta-analysis was performed. The following databases were searched using the keywords ("rebamipide" OR "gastroprotective agent*" OR "mucosta") AND ("dyspepsia" OR "indigestion" OR "gastrointestinal symptoms"): PubMed, Wed of Science, Embase, CINAHL, Cochrane Clinical Trials Register. The primary outcome was dyspepsia or upper GI symptom score improvement. Pooled analysis of the main outcome data were presented as risk ratio (RR) for dichotomous data and standardized mean difference (SMD) for continuous data. RESULTS: From an initial 248 records, 17 randomised controlled trial (RCT) publications involving 2170 subjects (1224 rebamipide, 946 placebo/control) were included in the final analysis. Twelve RCTs were conducted in subjects with organic dyspepsia (peptic ulcer disease, reflux esophagitis or NSAID-induced gastropathy) and five RCTs were conducted in patients with functional dyspepsia (FD). Overall, dyspepsia symptom improvement was significantly better with rebamipide compared to placebo/control drug (RR 0.77, 95% CI = 0.64-0.93; SMD -0.46, 95% CI = -0.83 to -0.09). Significant symptom improvement was observed both in pooled RR and SMD in subjects with organic dyspepsia (RR 0.72, 95% CI = 0.61-0.86; SMD -0.23, 95% CI = -0.4 to -0.07), while symptom improvement in FD was observed in pooled SMD but not RR (SMD -0.62, 95% CI = -1.16 to -0.08; RR 1.01, 95% CI = 0.71-1.45). CONCLUSION: Rebamipide is effective in organic dyspepsia and may improve symptoms in functional dyspepsia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15619b, title = {Triglyceride to HDL-C Ratio is Associated with Insulin Resistance in Overweight and Obese Children}, author = {N A Iwani and M Y Jalaludin and R M Zin and M Z Fuziah and J Y Hong and Y Abqariyah and A H Mokhtar and W M Wan Nazaimoon}, doi = {10.1038/srep40055}, issn = {2045-2322}, year = {2017}, date = {2017-01-01}, journal = {Sci Rep}, volume = {7}, pages = {40055}, abstract = {The purpose of this study was to investigate the usefulness of triglyceride to hdl-c ratio (TG:HDL-C) as an insulin resistance (IR) marker for overweight and obese children. A total of 271 blood samples of obese and overweight children aged 9-16 years were analysed for fasting glucose, lipids and insulin. Children were divided into IR and non-insulin resistance, using homeostasis model assessment (HOMA). The children were then stratified by tertiles of TG: HDL-C ratio. The strength between TG:HDL-C ratio and other parameters of IR were quantified using Pearson correlation coefficient (r). Odds ratio was estimated using multiple logistic regression adjusted for age, gender, pubertal stages and IR potential risk factors. Children with IR had significantly higher TG:HDL-C ratio (2.48) (p = 0.01). TG:HDL-C ratio was significantly correlated with HOMA-IR (r = 0.104, p \< 0.005) and waist circumference (r = 0.134, p \< 0.001). Increasing tertiles of TG:HDL-C ratio showed significant increase in mean insulin level (p = 0.03), HOMA-IR (p = 0.04) and significantly higher number of children with acanthosis nigricans and metabolic syndrome. The odds of having IR was about 2.5 times higher (OR = 2.47; 95% CI 1.23, 4.95; p = 0.01) for those in the highest tertiles of TG:HDL-C ratio. Hence, TG:HDL-C may be a useful tool to identify high risk individuals.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15581b, title = {The Association of Workplace Exposures on Quality of Life in Small and Medium Enterprises Workers: A Cross-Sectional Study in Four ASEAN Countries}, author = {M Isahak and M Y Loh and I H Susilowati and O Kaewboonchoo and K Harncharoen and N Mohd Amin and N P Toai and W Y Low and P Ratanasiripong}, doi = {10.1177/1010539517699060}, issn = {1010-5395}, year = {2017}, date = {2017-01-01}, journal = {Asia Pac J Public Health}, volume = {29}, number = {4}, pages = {315-327}, abstract = {Quality of life is associated with several factors, including personal living styles and working conditions. This article aims to investigate the factors associated with quality of life among small and medium enterprises (SME) workers in 4 countries of the Association of Southeast Asian Nations (ASEAN), namely Malaysia, Indonesia, Thailand, and Vietnam. A total of 2014 workers from food and textile industries were asked to answer a questionnaire about their sociodemographic characteristics, working environment and conditions, and quality of life. Results from showed that lifestyle (ie, alcohol intake and exercising), working characteristics (ie, shift work, working hours, and working days) and workplace conditions were associated with SME workers' quality of life (ie, physical, psychological, social, and environmental domain). Among the 16 types of workplace conditions, "sitting on the chair" and "slippery floor" most affect their quality of life . It is important for these variables to be taken into account in promoting workers' well-being and quality of life.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15620b, title = {Helicobacter pylori infection, chronic corpus atrophic gastritis and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort: A nested case-control study}, author = {J Huang and U Zagai and G Hallmans and O Nyren and L Engstrand and R Stolzenberg-Solomon and E J Duell and K Overvad and V A Katzke and R Kaaks and M Jenab and J Y Park and R Murillo and A Trichopoulou and P Lagiou and C Bamia and K E Bradbury and E Riboli and D Aune and K K Tsilidis and G Capella and A Agudo and V Krogh and D Palli and S Panico and E Weiderpass and A Tjonneland and A Olsen and B Martinez and D Redondo-Sanchez and M D Chirlaque and P Hm Peeters and S Regner and B Lindkvist and A Naccarati and E Ardanaz and N Larranaga and M C Boutron-Ruault and V Rebours and A Barre and H B Bueno-de-Mesquita and W Ye}, doi = {10.1002/ijc.30590}, issn = {0020-7136}, year = {2017}, date = {2017-01-01}, journal = {Int J Cancer}, volume = {140}, number = {8}, pages = {1727-1735}, abstract = {The association between H. pylori infection and pancreatic cancer risk remains controversial. We conducted a nested case-control study with 448 pancreatic cancer cases and their individually matched control subjects, based on the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, to determine whether there was an altered pancreatic cancer risk associated with H. pylori infection and chronic corpus atrophic gastritis. Conditional logistic regression models were applied to calculate odds ratios (ORs) and corresponding 95% confidence intervals (CIs), adjusted for matching factors and other potential confounders. Our results showed that pancreatic cancer risk was neither associated with H. pylori seropositivity (OR = 0.96; 95% CI: 0.70, 1.31) nor CagA seropositivity (OR = 1.07; 95% CI: 0.77, 1.48). We also did not find any excess risk among individuals seropositive for H. pylori but seronegative for CagA, compared with the group seronegative for both antibodies (OR = 0.94; 95% CI: 0.63, 1.38). However, we found that chronic corpus atrophic gastritis was non-significantly associated with an increased pancreatic cancer risk (OR = 1.35; 95% CI: 0.77, 2.37), and although based on small numbers, the excess risk was particularly marked among individuals seronegative for both H. pylori and CagA (OR = 5.66; 95% CI: 1.59, 20.19, p value for interaction \< 0.01). Our findings provided evidence supporting the null association between H. pylori infection and pancreatic cancer risk in western European populations. However, the suggested association between chronic corpus atrophic gastritis and pancreatic cancer risk warrants independent verification in future studies, and, if confirmed, further studies on the underlying mechanisms.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15572b, title = {Hepatitis B and C virus infection and diabetes mellitus: A cohort study}, author = {Y S Hong and Y Chang and S Ryu and M Cainzos-Achirica and M J Kwon and Y Zhang and Y Choi and J Ahn and S Rampal and D Zhao and R Pastor-Barriuso and M Lazo and H Shin and J Cho and E Guallar}, doi = {10.1038/s41598-017-04206-6}, issn = {2045-2322}, year = {2017}, date = {2017-01-01}, journal = {Sci Rep}, volume = {7}, number = {1}, pages = {4606}, abstract = {The role of hepatitis virus infection in glucose homeostasis is uncertain. We examined the associations between hepatitis B virus (HBV) or hepatitis C virus (HCV) infection and the development of diabetes in a cohort (N = 439,708) of asymptomatic participants in health screening examinations. In cross-sectional analyses, the multivariable-adjusted odds ratio for prevalent diabetes comparing hepatitis B surface antigen (HBsAg) (+) to HBsAg (-) participants was 1.17 (95% CI 1.06-1.31; P = 0.003). The corresponding odds ratio comparing hepatitis C antibodies (HCV Ab) (+) to HCV Ab (-) participants was 1.43 (95% CI 1.01-2.02}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15563b, title = {Validation of verbal autopsy: determination of cause of deaths in Malaysia 2013}, author = {S S Ganapathy and K Yi Yi and M A Omar and M F M Anuar and C Jeevananthan and C Rao}, doi = {10.1186/s12889-017-4668-y}, issn = {1471-2458}, year = {2017}, date = {2017-01-01}, journal = {BMC Public Health}, volume = {17}, number = {1}, pages = {653}, abstract = {BACKGROUND: Mortality statistics by age, sex and cause are the foundation of basic health data required for health status assessment, epidemiological research and formation of health policy. Close to half the deaths in Malaysia occur outside a health facility, are not attended by medical personnel, and are given a lay opinion as to the cause of death, leading to poor quality of data from vital registration. Verbal autopsy (VA) is a very useful tool in diagnosing broad causes of deaths for events that occur outside health facilities. This article reports the development of the VA methods and our principal finding from a validation study. METHODS: A cross sectional study on nationally representative sample deaths that occurred in Malaysia during 2013 was used. A VA questionnaire suitable for local use was developed. Trained field interviewers visited the family members of the deceased at their homes and conducted face to face interviews with the next of kin. Completed questionnaires were reviewed by trained physicians who assigned multiple and underlying causes. Reference diagnoses for validation were obtained from review of medical records (MR) available for a sample of the overall study deaths. RESULTS: Corresponding MR diagnosis with matched sample of the VA diagnosis were available in 2172 cases for the validation study. Sensitivity scores were good (\>75%) for transport accidents and certain cancers. Moderate sensitivity (50% - 75%) was obtained for ischaemic heart disease (64%) and cerebrovascular disease (72%). The validation sample for deaths due to major causes such as ischaemic heart disease, pneumonia, breast cancer and transport accidents show low cause-specific mortality fraction (CSMF) changes. The scores obtained for the top 10 leading site-specific cancers ranged from average to good. CONCLUSION: We can conclude that VA is suitable for implementation for deaths outside the health facilities in Malaysia. This would reduce ill-defined mortality causes in vital registration data, and yield more accurate national mortality statistics.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15560b, title = {Erratum to: Validation of verbal autopsy: determination of cause of deaths in Malaysia 2013}, author = {S S Ganapathy and K Yi Yi and M A Omar and M F M Anuar and C Jeevananthan and C Rao}, doi = {10.1186/s12889-017-4687-8}, issn = {1471-2458}, year = {2017}, date = {2017-01-01}, journal = {BMC Public Health}, volume = {17}, number = {1}, pages = {687}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15569b, 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 = {2017}, date = {2017-01-01}, journal = {Eur J Nutr}, abstract = {PURPOSE: There is inconsistent evidence regarding the relationship between higher intake of nuts, being an energy-dense food, and weight gain. We investigated the relationship between nut intake and changes in weight over 5 years. METHODS: This study includes 373,293 men and women, 25-70 years old, recruited between 1992 and 2000 from 10 European countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Habitual intake of nuts including peanuts, together defined as nut intake, was estimated from country-specific validated dietary questionnaires. Body weight was measured at recruitment and self-reported 5 years later. The association between nut intake and body weight change was estimated using multilevel mixed linear regression models with center/country as random effect and nut intake and relevant confounders as fixed effects. The relative risk (RR) of becoming overweight or obese after 5 years was investigated using multivariate Poisson regressions stratified according to baseline body mass index (BMI). RESULTS: On average, study participants gained 2.1 kg (SD 5.0 kg) over 5 years. Compared to non-consumers, subjects in the highest quartile of nut intake had less weight gain over 5 years (-0.07 kg; 95% CI -0.12 to -0.02) (P trend = 0.025) and had 5% lower risk of becoming overweight (RR 0.95; 95% CI 0.92-0.98) or obese (RR 0.95; 95% CI 0.90-0.99) (both P trend \<0.008). CONCLUSIONS: Higher intake of nuts is associated with reduced weight gain and a lower risk of becoming overweight or obese.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15591b, title = {Comparison of general obesity and measures of body fat distribution in older adults in relation to cancer risk: meta-analysis of individual participant data of seven prospective cohorts in Europe}, author = {H Freisling and M Arnold and I Soerjomataram and M G O'Doherty and J M Ordonez-Mena and C Bamia and E Kampman and M Leitzmann and I Romieu and F Kee and K Tsilidis and A Tjonneland and A Trichopoulou and P Boffetta and V Benetou and H B A Bueno-de-Mesquita and J M Huerta and H Brenner and T Wilsgaard and M Jenab}, doi = {10.1038/bjc.2017.106}, issn = {0007-0920}, year = {2017}, date = {2017-01-01}, journal = {Br J Cancer}, volume = {116}, number = {11}, pages = {1486-1497}, abstract = {BACKGROUND: We evaluated the associations of anthropometric indicators of general obesity (body mass index, BMI), an established risk factor of various cancer, and body fat distribution (waist circumference, WC; hip circumference, HC; and waist-to-hip ratio, WHR), which may better reflect metabolic complications of obesity, with total obesity-related and site-specific (colorectal and postmenopausal breast) cancer incidence. METHODS: This is a meta-analysis of seven prospective cohort studies participating in the CHANCES consortium including 18 668 men and 24 751 women with a mean age of 62 and 63 years, respectively. Harmonised individual participant data from all seven cohorts were analysed separately and alternatively for each anthropometric indicator using multivariable Cox proportional hazards models. RESULTS: After a median follow-up period of 12 years, 1656 first-incident obesity-related cancers (defined as postmenopausal female breast, colorectum, lower oesophagus, cardia stomach, liver, gallbladder, pancreas, endometrium, ovary, and kidney) had occurred in men and women. In the meta-analysis of all studies, associations between indicators of adiposity, per s.d. increment, and risk for all obesity-related cancers combined yielded the following summary hazard ratios: 1.11 (95% CI 1.02-1.21) for BMI, 1.13 (95% CI 1.04-1.23) for WC, 1.09 (95% CI 0.98-1.21) for HC, and 1.15 (95% CI 1.00-1.32) for WHR. Increases in risk for colorectal cancer were 16%, 21%, 15%, and 20%, respectively per s.d. of BMI, WC, HC, and WHR. Effect modification by hormone therapy (HT) use was observed for postmenopausal breast cancer (Pinteraction\<0.001), where never HT users showed an approximately 20% increased risk per s.d. of BMI, WC, and HC compared to ever users. CONCLUSIONS: BMI, WC, HC, and WHR show comparable positive associations with obesity-related cancers combined and with colorectal cancer in older adults. For postmenopausal breast cancer we report evidence for effect modification by HT use.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15645b, title = {Associations between lifestyle factors and an unhealthy diet}, author = {H P Fransen and J M A Boer and J W J Beulens and G A Wit and H B Bueno-de-Mesquita and J Hoekstra and A M May and P H M Peeters}, doi = {10.1093/eurpub/ckw190}, issn = {1101-1262}, year = {2017}, date = {2017-01-01}, journal = {Eur J Public Health}, volume = {27}, number = {2}, pages = {274-278}, abstract = {Background: : Unhealthy dietary patterns have been associated with other unhealthy lifestyle factors such as smoking and physical inactivity. Whether these associations are similar in high- and low-educated individuals is currently unknown. Methods: We used information of the EPIC-NL cohort, a prospective cohort of 39 393 men and women, aged 20-70 years at recruitment. A lifestyle questionnaire and a validated food frequency questionnaire were administered at recruitment (1993-97). Low adherence to a Mediterranean-style diet was used to determine an unhealthy dietary pattern. Lifestyle-related factors included body mass index, waist circumference, smoking status, physical activity level, dietary supplement use and daily breakfast consumption. Multivariate logistic regression analyses were performed for the total population and by strata of educational level. Results: In total 30% of the study population had an unhealthy dietary pattern: 39% in the lowest educated group and 20% in the highest educated group. Physical inactivity, a large waist circumference, no dietary supplement use and skipping breakfast were associated with an unhealthy dietary pattern in both low and high educated participants. Among low educated participants, current smokers had a greater odds of an unhealthy diet compared with never smokers: OR 1.42 (95% CI: 1.25; 1.61). This association was not observed in the high educated group. Conclusions: Most associations between lifestyle-related factors and unhealthy diet were consistent across educational levels, except for smoking. Only among low educated participants, current smokers reported an unhealthier dietary pattern in comparison to never smokers. These results can be used in the development of targeted health promotion strategies.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15610b, title = {Osteoprotegerin and breast cancer risk by hormone receptor subtype: a nested case-control study in the EPIC cohort}, author = {R T Fortner and D Sarink and H Schock and T Johnson and A Tjonneland and A Olsen and K Overvad and A Affret and M His and M C Boutron-Ruault and H Boeing and A Trichopoulou and A Naska and P Orfanos and D Palli and S Sieri and A Mattiello and R Tumino and F Ricceri and H B Bueno-de-Mesquita and P H Peeters and C H Van Gils and E Weiderpass and E Lund and J R Quiros and A Agudo and M J Sanchez and M D Chirlaque and E Ardanaz and M Dorronsoro and T Key and K T Khaw and S Rinaldi and L Dossus and M Gunter and M A Merritt and E Riboli and R Kaaks}, doi = {10.1186/s12916-017-0786-8}, issn = {1741-7015}, year = {2017}, date = {2017-01-01}, journal = {BMC Med}, volume = {15}, number = {1}, pages = {26}, abstract = {BACKGROUND: Circulating osteoprotegerin (OPG), a member of the receptor activator of nuclear factor kappa-B (RANK) axis, may influence breast cancer risk via its role as the decoy receptor for both the RANK ligand (RANKL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL). Circulating OPG and breast cancer risk has been examined in only one prior study. METHODS: A case-control study was nested in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. A total of 2008 incident invasive breast cancer cases (estrogen receptor (ER)+}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15625b, title = {Endometrial cancer risk prediction including serum-based biomarkers: results from the EPIC cohort}, author = {R T Fortner and A Husing and T Kuhn and M Konar and K Overvad and A Tjonneland and L Hansen and M C Boutron-Ruault and G Severi and A Fournier and H Boeing and A Trichopoulou and V Benetou and P Orfanos and G Masala and C Agnoli and A Mattiello and R Tumino and C Sacerdote and H B Bueno-de-Mesquita and P H Peeters and E Weiderpass and I T Gram and O Gavrilyuk and J R Quiros and J Maria Huerta and E Ardanaz and N Larranaga and L Lujan-Barroso and E Sanchez-Cantalejo and S T Butt and S Borgquist and A Idahl and E Lundin and K T Khaw and N E Allen and S Rinaldi and L Dossus and M Gunter and M A Merritt and I Tzoulaki and E Riboli and R Kaaks}, doi = {10.1002/ijc.30560}, issn = {0020-7136}, year = {2017}, date = {2017-01-01}, journal = {Int J Cancer}, volume = {140}, number = {6}, pages = {1317-1323}, abstract = {Endometrial cancer risk prediction models including lifestyle, anthropometric and reproductive factors have limited discrimination. Adding biomarker data to these models may improve predictive capacity; to our knowledge, this has not been investigated for endometrial cancer. Using a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, we investigated the improvement in discrimination gained by adding serum biomarker concentrations to risk estimates derived from an existing risk prediction model based on epidemiologic factors. Serum concentrations of sex steroid hormones, metabolic markers, growth factors, adipokines and cytokines were evaluated in a step-wise backward selection process; biomarkers were retained at p \< 0.157 indicating improvement in the Akaike information criterion (AIC). Improvement in discrimination was assessed using the C-statistic for all biomarkers alone, and change in C-statistic from addition of biomarkers to preexisting absolute risk estimates. We used internal validation with bootstrapping (1000-fold) to adjust for over-fitting. Adiponectin, estrone, interleukin-1 receptor antagonist, tumor necrosis factor-alpha and triglycerides were selected into the model. After accounting for over-fitting, discrimination was improved by 2.0 percentage points when all evaluated biomarkers were included and 1.7 percentage points in the model including the selected biomarkers. Models including etiologic markers on independent pathways and genetic markers may further improve discrimination.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15704b, title = {Effect of multi-strain probiotics (multi-strain microbial cell preparation) on glycemic control and other diabetes-related outcomes in people with type 2 diabetes: a randomized controlled trial}, author = {S Firouzi and H A Majid and A Ismail and N A Kamaruddin and M Y Barakatun-Nisak}, doi = {10.1007/s00394-016-1199-8}, issn = {1436-6207}, year = {2017}, date = {2017-01-01}, journal = {Eur J Nutr}, volume = {56}, number = {4}, pages = {1535-1550}, abstract = {AIM: Evidence of a possible connection between gut microbiota and several physiological processes linked to type 2 diabetes is increasing. However, the effect of multi-strain probiotics in people with type 2 diabetes remains unclear. This study investigated the effect of multi-strain microbial cell preparation-also refers to multi-strain probiotics-on glycemic control and other diabetes-related outcomes in people with type 2 diabetes. DESIGN: A randomized, double-blind, parallel-group, controlled clinical trial. SETTING: Diabetes clinic of a teaching hospital in Kuala Lumpur, Malaysia. PARTICIPANTS: A total of 136 participants with type 2 diabetes, aged 30-70 years, were recruited and randomly assigned to receive either probiotics (n = 68) or placebo (n = 68) for 12 weeks. OUTCOMES: Primary outcomes were glycemic control-related parameters, and secondary outcomes were anthropomorphic variables, lipid profile, blood pressure and high-sensitivity C-reactive protein. The Lactobacillus and Bifidobacterium quantities were measured before and after intervention as an indicator of successful passage of the supplement through gastrointestinal tract. STATISTICAL ANALYSIS: Intention-to-treat (ITT) analysis was performed on all participants, while per-protocol (PP) analysis was performed on those participants who had successfully completed the trial with good compliance rate. RESULTS: With respect to primary outcomes, glycated hemoglobin decreased by 0.14 % in the probiotics and increased by 0.02 % in the placebo group in PP analysis (p \< 0.05, small effect size of 0.050), while these changes were not significant in ITT analysis. Fasting insulin increased by 1.8 microU/mL in placebo group and decreased by 2.9 microU/mL in probiotics group in PP analysis. These changes were significant between groups at both analyses (p \< 0.05, medium effect size of 0.062 in PP analysis and small effect size of 0.033 in ITT analysis). Secondary outcomes did not change significantly. Probiotics successfully passed through the gastrointestinal tract. CONCLUSION: Probiotics modestly improved HbA1c and fasting insulin in people with type 2 diabetes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15599b, title = {Exposure to bacterial products lipopolysaccharide and flagellin and hepatocellular carcinoma: a nested case-control study}, author = {V Fedirko and H Q Tran and A T Gewirtz and M Stepien and A Trichopoulou and K Aleksandrova and A Olsen and A Tjonneland and K Overvad and F Carbonnel and M C Boutron-Ruault and G Severi and T Kuhn and R Kaaks and H Boeing and C Bamia and P Lagiou and S Grioni and S Panico and D Palli and R Tumino and A Naccarati and P H Peeters and H B Bueno-de-Mesquita and E Weiderpass and J M Castano and A Barricarte and M J Sanchez and M Dorronsoro and J R Quiros and A Agudo and K Sjoberg and B Ohlsson and O Hemmingsson and M Werner and K E Bradbury and K T Khaw and N Wareham and K K Tsilidis and D Aune and A Scalbert and I Romieu and E Riboli and M Jenab}, doi = {10.1186/s12916-017-0830-8}, issn = {1741-7015}, year = {2017}, date = {2017-01-01}, journal = {BMC Med}, volume = {15}, number = {1}, pages = {72}, abstract = {BACKGROUND: Leakage of bacterial products across the gut barrier may play a role in liver diseases which often precede the development of liver cancer. However, human studies, particularly from prospective settings, are lacking. METHODS: We used a case-control study design nested within a large prospective cohort to assess the association between circulating levels of anti-lipopolysaccharide (LPS) and anti-flagellin immunoglobulin A (IgA) and G (IgG) (reflecting long-term exposures to LPS and flagellin, respectively) and risk of hepatocellular carcinoma. A total of 139 men and women diagnosed with hepatocellular carcinoma between 1992 and 2010 were matched to 139 control subjects. Multivariable rate ratios (RRs), including adjustment for potential confounders, hepatitis B/C positivity, and degree of liver dysfunction, were calculated with conditional logistic regression. RESULTS: Antibody response to LPS and flagellin was associated with a statistically significant increase in the risk of hepatocellular carcinoma (highest vs. lowest quartile: RR = 11.76, 95% confidence interval = 1.70-81.40; P trend = 0.021). This finding did not vary substantially by time from enrollment to diagnosis, and did not change after adjustment for chronic infection with hepatitis B and C viruses. CONCLUSIONS: These novel findings, based on exposures up to several years prior to diagnosis, support a role for gut-derived bacterial products in hepatocellular carcinoma development. Further study into the role of gut barrier failure and exposure to bacterial products in liver diseases is warranted.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15608b, title = {Use of physical restraint: Nurses' knowledge, attitude, intention and practice and influencing factors}, author = {F Eskandari and K L Abdullah and N Z Zainal and L P Wong}, doi = {10.1111/jocn.13778}, issn = {0962-1067}, year = {2017}, date = {2017-01-01}, journal = {J Clin Nurs}, volume = {26}, number = {23-24}, pages = {4479-4488}, abstract = {AIMS AND OBJECTIVES: To investigate the knowledge, attitude, intention and practice of nurses towards physical restraint and factors influencing these variables. BACKGROUND: A literature review showed a lack of studies focused on the intention of nurses regarding physical restraint throughout the world. Considering that very little research on physical restraint use has been carried out in Malaysia, assessment of nurses' knowledge, attitude, intention and practice is necessary before developing a minimising programme in hospitals. DESIGN: A cross-sectional study was used. METHODS: A questionnaire to assess the knowledge, attitude, intention and practice was completed by all nurses (n = 309) in twelve wards of a teaching hospital in Kuala Lumpur. RESULTS: Moderate knowledge and attitude with strong intention to use physical restraint were found among the nurses. Less than half of nurses considered alternatives to physical restraint and most of them did not understand the reasons for the physical restraint. Nurses' academic qualification, read any information source during past year and nurses' work unit showed a significant association with nurses' knowledge. Multiple linear regression analysis found knowledge, attitude and intention were significantly associated with nurses' practice to use physical restraint. CONCLUSION: This study showed some important misunderstandings of nurses about using physical restraint and strong intention regarding using physical restraint. Findings of this study serve as a supporting reason for importance of educating nurses about the use of physical restraint. RELEVANCE TO CLINICAL PRACTICE: Exploring the knowledge, attitude, intention and current practice of nurses towards physical restraint is important so that an effective strategy can be formulated to minimise the use of physical restraints in hospitals.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15614b, title = {Measuring health literacy in Asia: Validation of the HLS-EU-Q47 survey tool in six Asian countries}, author = {T V Duong and A Aringazina and G Baisunova and Nurjanah and T V Pham and K M Pham and T Q Truong and K T Nguyen and W M Oo and E Mohamad and T T Su and H L Huang and K Sorensen and J M Pelikan and S Van Broucke and P W Chang}, doi = {10.1016/j.je.2016.09.005}, issn = {0917-5040}, year = {2017}, date = {2017-01-01}, journal = {J Epidemiol}, volume = {27}, number = {2}, pages = {80-86}, abstract = {BACKGROUND: Health literacy has been increasingly recognized as one of the most important social determinants for health. However, an appropriate and comprehensive assessment tool is not available in many Asian countries. This study validates a comprehensive health literacy survey tool European health literacy questionnaire (HLS-EU-Q47) for the general public in several Asian countries. METHODS: A cross-sectional survey based on multistage random sampling in the target countries. A total of 10,024 participants aged \>/=15 years were recruited during 2013-2014 in Indonesia, Kazakhstan, Malaysia, Myanmar, Taiwan, and Vietnam. The questionnaire was translated into local languages to measure general health literacy and its three domains. To evaluate the validity of the tool in these countries, data were analyzed by confirmatory factor analysis, internal consistency analysis, and regression analysis. RESULTS: The questionnaire was shown to have good construct validity, satisfactory goodness-of-fit of the data to the hypothetical model in three health literacy domains, high internal consistency (Cronbach's alpha \>0.90), satisfactory item-scale convergent validity (item-scale correlation \>/=0.40), and no floor/ceiling effects in these countries. General health literacy index score was significantly associated with level of education (P from \<0.001 to 0.011) and perceived social status (P from \<0.001 to 0.016), with evidence of known-group validity. CONCLUSIONS: The HLS-EU-Q47 was a satisfactory and comprehensive health literacy survey tool for use in Asia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15586b, title = {Plasma microRNAs as biomarkers of pancreatic cancer risk in a prospective cohort study}, author = {E J Duell and L Lujan-Barroso and N Sala and S Deitz McElyea and K Overvad and A Tjonneland and A Olsen and E Weiderpass and L T Busund and L Moi and D Muller and P Vineis and D Aune and G Matullo and A Naccarati and S Panico and G Tagliabue and R Tumino and D Palli and R Kaaks and V A Katzke and H Boeing and H B A Bueno-de-Mesquita and P H Peeters and A Trichopoulou and P Lagiou and A Kotanidou and R C Travis and N Wareham and K T Khaw and J Ramon Quiros and M Rodriguez-Barranco and M Dorronsoro and M D Chirlaque and E Ardanaz and G Severi and M C Boutron-Ruault and V Rebours and P Brennan and M Gunter and G Scelo and G Cote and S Sherman and M Korc}, doi = {10.1002/ijc.30790}, issn = {0020-7136}, year = {2017}, date = {2017-01-01}, journal = {Int J Cancer}, volume = {141}, number = {5}, pages = {905-915}, abstract = {Noninvasive biomarkers for early pancreatic ductal adenocarcinoma (PDAC) diagnosis and disease risk stratification are greatly needed. We conducted a nested case-control study within the Prospective Investigation into Cancer and Nutrition (EPIC) cohort to evaluate prediagnostic microRNAs (miRs) as biomarkers of subsequent PDAC risk. A panel of eight miRs (miR-10a, -10b, -21-3p, -21-5p, -30c, -106b, -155 and -212) based on previous evidence from our group was evaluated in 225 microscopically confirmed PDAC cases and 225 controls matched on center, sex, fasting status and age/date/time of blood collection. MiR levels in prediagnostic plasma samples were determined by quantitative RT-PCR. Logistic regression was used to model levels and PDAC risk, adjusting for covariates and to estimate area under the receiver operating characteristic curves (AUC). Plasma miR-10b, -21-5p, -30c and -106b levels were significantly higher in cases diagnosed within 2 years of blood collection compared to matched controls (all p-values \<0.04). Based on adjusted logistic regression models, levels for six miRs (miR-10a, -10b, -21-5p, -30c, -155 and -212) overall, and for four miRs (-10a, -10b, -21-5p and -30c) at shorter follow-up time between blood collection and diagnosis (\</=5 yr, \</=2 yr), were statistically significantly associated with risk. A score based on the panel showed a linear dose-response trend with risk (p-value = 0.0006). For shorter follow-up (\</=5 yr), AUC for the score was 0.73, and for individual miRs ranged from 0.73 (miR-212) to 0.79 (miR-21-5p).}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15538b, 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 = {2017}, date = {2017-01-01}, journal = {Int J Cancer}, abstract = {Other than the influence of ionizing radiation and benign thyroid disease, little is known about the risk factors for differentiated thyroid cancer (TC) which is an increasing common cancer worldwide. Consistent evidence shows that body mass is positively associated with TC risk. As excess weight is a state of chronic inflammation, we investigated the relationship between concentrations of leptin, adiponectin, C-reactive protein, interleukin (IL)-6, IL-10 and tumor necrosis factor (TNF)-alpha and the risk of TC. A case-control study was nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study and included 475 first primary incident TC cases (399 women and 76 men) and 1,016 matched cancer-free cohort participants. Biomarkers were measured in serum samples using validated and highly sensitive commercially available immunoassays. Odds ratios (ORs) of TC by levels of each biomarker were estimated using conditional logistic regression models, adjusting for BMI and alcohol consumption. Adiponectin was inversely associated with TC risk among women (ORT3vs.T1 = 0.69, 95% CI: 0.49-0.98}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15598b, title = {Interactions Between Genome-Wide Significant Genetic Variants and Circulating Concentrations of 25-Hydroxyvitamin D in Relation to Prostate Cancer Risk in the National Cancer Institute BPC3}, author = {V I Dimitrakopoulou and R C Travis and I M Shui and A Mondul and D Albanes and J Virtamo and A Agudo and H Boeing and H B Bueno-de-Mesquita and M J Gunter and M Johansson and K T Khaw and K Overvad and D Palli and A Trichopoulou and E Giovannucci and D J Hunter and S Lindstrom and W Willett and J M Gaziano and M Stampfer and C Berg and S I Berndt and A Black and R N Hoover and P Kraft and T J Key and K K Tsilidis}, doi = {10.1093/aje/kww143}, issn = {0002-9262}, year = {2017}, date = {2017-01-01}, journal = {Am J Epidemiol}, volume = {185}, number = {6}, pages = {452-464}, abstract = {Genome-wide association studies (GWAS) have identified over 100 single nucleotide polymorphisms (SNPs) associated with prostate cancer. However, information on the mechanistic basis for some associations is limited. Recent research has been directed towards the potential association of vitamin D concentrations and prostate cancer, but little is known about whether the aforementioned genetic associations are modified by vitamin D. We investigated the associations of 46 GWAS-identified SNPs, circulating concentrations of 25-hydroxyvitamin D (25(OH)D), and prostate cancer (3,811 cases, 511 of whom died from the disease, compared with 2,980 controls-from 5 cohort studies that recruited participants over several periods beginning in the 1980s). We used logistic regression models with data from the National Cancer Institute Breast and Prostate Cancer Cohort Consortium (BPC3) to evaluate interactions on the multiplicative and additive scales. After allowing for multiple testing, none of the SNPs examined was significantly associated with 25(OH)D concentration, and the SNP-prostate cancer associations did not differ by these concentrations. A statistically significant interaction was observed for each of 2 SNPs in the 8q24 region (rs620861 and rs16902094), 25(OH)D concentration, and fatal prostate cancer on both multiplicative and additive scales (P \</= 0.001). We did not find strong evidence that associations between GWAS-identified SNPs and prostate cancer are modified by circulating concentrations of 25(OH)D. The intriguing interactions between rs620861 and rs16902094, 25(OH)D concentration, and fatal prostate cancer warrant replication.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15601b, title = {Depression, distress and self-efficacy: The impact on diabetes self-care practices}, author = {C Devarajooh and K Chinna}, doi = {10.1371/journal.pone.0175096}, issn = {1932-6203}, year = {2017}, date = {2017-01-01}, journal = {PLoS One}, volume = {12}, number = {3}, pages = {e0175096}, abstract = {The prevalence of type 2 diabetes is increasing in Malaysia, and people with diabetes have been reported to suffer from depression and diabetes distress which influences their self-efficacy in performing diabetes self-care practices. This interviewer administered, cross sectional study, conducted in the district of Hulu Selangor, Malaysia, involving 371 randomly selected patients with type 2 diabetes, recruited from 6 health clinics, aimed to examine a conceptual model regarding the association between depression, diabetes distress and self-efficacy with diabetes self-care practices using the partial least square approach of structural equation modeling. In this study, diabetes self-care practices were similar regardless of sex, age group, ethnicity, education level, diabetes complications or type of diabetes medication. This study found that self-efficacy had a direct effect on diabetes self-care practice (path coefficient = 0.438, p\<0.001). Self-care was not directly affected by depression and diabetes distress, but indirectly by depression (path coefficient = -0.115, p\<0.01) and diabetes distress (path coefficient = -0.122, p\<0.001) via self-efficacy. In conclusion, to improve self-care practices, effort must be focused on enhancing self-efficacy levels, while not forgetting to deal with depression and diabetes distress, especially among those with poorer levels of self-efficacy.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15633b, title = {Epidemiological Differences Between Localized and Nonlocalized Low Back Pain}, author = {D Coggon and G Ntani and K Walker-Bone and K T Palmer and V E Felli and R Harari and L H Barrero and S A Felknor and D Gimeno and A Cattrell and S Vargas-Prada and M Bonzini and E Solidaki and E Merisalu and R R Habib and F Sadeghian and M M Kadir and S S Warnakulasuriya and K Matsudaira and B Nyantumbu and M R Sim and H Harcombe and K Cox and L M M Sarquis and M H Marziale and F Harari and R Freire and N Harari and M V Monroy and L A Quintana and M Rojas and E C Harris and C Serra and J M Martinez and G Delclos and F G Benavides and M Carugno and M M Ferrario and A C Pesatori and L Chatzi and P Bitsios and M Kogevinas and K Oha and T Freimann and A Sadeghian and R J Peiris-John and N Sathiakumar and A R Wickremasinghe and N Yoshimura and H L Kelsall and V C W Hoe and D M Urquhart and S Derrett and D McBride and P Herbison and A Gray and E J Salazar Vega}, doi = {10.1097/brs.0000000000001956}, issn = {0362-2436}, year = {2017}, date = {2017-01-01}, journal = {Spine (Phila Pa 1976)}, volume = {42}, number = {10}, pages = {740-747}, abstract = {STUDY DESIGN: A cross-sectional survey with a longitudinal follow-up. OBJECTIVES: The aim of this study was to test the hypothesis that pain, which is localized to the low back, differs epidemiologically from that which occurs simultaneously or close in time to pain at other anatomical sites SUMMARY OF BACKGROUND DATA.: Low back pain (LBP) often occurs in combination with other regional pain, with which it shares similar psychological and psychosocial risk factors. However, few previous epidemiological studies of LBP have distinguished pain that is confined to the low back from that which occurs as part of a wider distribution of pain. METHODS: We analyzed data from CUPID, a cohort study that used baseline and follow-up questionnaires to collect information about musculoskeletal pain, associated disability, and potential risk factors, in 47 occupational groups (office workers, nurses, and others) from 18 countries. RESULTS: Among 12,197 subjects at baseline, 609 (4.9%) reported localized LBP in the past month, and 3820 (31.3%) nonlocalized LBP. Nonlocalized LBP was more frequently associated with sciatica in the past month (48.1% vs. 30.0% of cases), occurred on more days in the past month and past year, was more often disabling for everyday activities (64.1% vs. 47.3% of cases), and had more frequently led to medical consultation and sickness absence from work. It was also more often persistent when participants were followed up after a mean of 14 months (65.6% vs. 54.1% of cases). In adjusted Poisson regression analyses, nonlocalized LBP was differentially associated with risk factors, particularly female sex, older age, and somatizing tendency. There were also marked differences in the relative prevalence of localized and nonlocalized LBP by occupational group. CONCLUSION: Future epidemiological studies should distinguish where possible between pain that is limited to the low back and LBP that occurs in association with pain at other anatomical locations. LEVEL OF EVIDENCE: 2.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15602b, title = {Is universal HLA-B*15:02 screening a cost-effective option in an ethnically diverse population? A case study of Malaysia}, author = {H Y Chong and Z Mohamed and L L Tan and D B C Wu and F H Shabaruddin and M Dahlui and Y D Apalasamy and S R Snyder and M S Williams and J Hao and L H Cavallari and N Chaiyakunapruk}, doi = {10.1111/bjd.15498}, issn = {0007-0963}, year = {2017}, date = {2017-01-01}, journal = {Br J Dermatol}, volume = {177}, number = {4}, pages = {1102-1112}, abstract = {BACKGROUND: A strong association has been documented between HLA-B*15:02 and carbamazepine-induced severe cutaneous adverse reactions (SCARs) in Asians. Human leucocyte antigen testing is potentially valuable in many countries to facilitate early recognition of patient susceptibility to SCARs. OBJECTIVES: To determine the cost-effectiveness of universal HLA-B*15:02 screening in preventing carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis in an ethnically diverse Malaysian population. METHODS: A hybrid model of a decision tree and Markov model was developed to evaluate three strategies for treating newly diagnosed epilepsy among adults: (i) carbamazepine initiation without HLA-B*15:02 screening (current practice); (ii) universal HLA-B*15:02 screening prior to carbamazepine initiation; and (iii) alternative treatment [sodium valproate (VPA)] prescribing without HLA-B*15:02 screening. Base-case analysis and sensitivity analyses were performed over a lifetime time horizon. Incremental cost-effectiveness ratios were calculated. RESULTS: Both universal HLA-B*15:02 screening and VPA prescribing were dominated by current practice. Compared with current practice, universal HLA-B*15:02 screening resulted in a loss of 0.0255 quality-adjusted life years (QALYs) at an additional cost of 707 U.S. dollars (USD); VPA prescribing resulted in a loss of 0.2622 QALYs at an additional cost of USD 4127, owing to estimated differences in antiepileptic treatment efficacy. CONCLUSIONS: Universal HLA-B*15:02 screening is unlikely to be a cost-effective intervention in Malaysia. However, with the emergence of an ethnically diverse population in many other countries, this may render HLA-B*15:02 screening a viable intervention when an increasing proportion of the population is at risk and an equally effective yet safer antiepileptic drug is available.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15618b, title = {Are interventions to increase the uptake of screening for cardiovascular disease risk factors effective? A systematic review and meta-analysis}, author = {A T Cheong and S M Liew and E M Khoo and N F Mohd Zaidi and K Chinna}, doi = {10.1186/s12875-016-0579-8}, issn = {1471-2296}, year = {2017}, date = {2017-01-01}, journal = {BMC Fam Pract}, volume = {18}, number = {1}, pages = {4}, abstract = {BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death globally. However, many individuals are unaware of their CVD risk factors. The objective of this systematic review is to determine the effectiveness of existing intervention strategies to increase uptake of CVD risk factors screening. METHODS: A systematic search was conducted through Pubmed, CINAHL, EMBASE and Cochrane Central Register of Controlled Trials. Additional articles were located through cross-checking of the references list and bibliography citations of the included studies and previous review papers. We included intervention studies with controlled or baseline comparison groups that were conducted in primary care practices or the community, targeted at adult populations (randomized controlled trials, non-randomized trials with controlled groups and pre- and post-intervention studies). The interventions were targeted either at individuals, communities, health care professionals or the health-care system. The main outcome of interest was the relative risk (RR) of screening uptake rates due to the intervention. RESULTS: We included 21 studies in the meta-analysis. The risk of bias for randomization was low to medium in the randomized controlled trials, except for one, and high in the non-randomized trials. Two analyses were performed; optimistic (using the highest effect sizes) and pessimistic (using the lowest effect sizes). Overall, interventions were shown to increase the uptake of screening for CVD risk factors (RR 1.443; 95% CI 1.264 to 1.648 for pessimistic analysis and RR 1.680; 95% CI 1.420 to 1.988 for optimistic analysis). Effective interventions that increased screening participation included: use of physician reminders (RR ranged between 1.392; 95% CI 1.192 to 1.625, and 1.471; 95% CI 1.304 to 1.660), use of dedicated personnel (RR ranged between 1.510; 95% CI 1.014 to 2.247, and 2.536; 95% CI 1.297 to 4.960) and provision of financial incentives for screening (RR 1.462; 95% CI 1.068 to 2.000). Meta-regression analysis showed that the effect of CVD risk factors screening uptake was not associated with study design, types of population nor types of interventions. CONCLUSIONS: Interventions using physician reminders, using dedicated personnel to deliver screening, and provision of financial incentives were found to be effective in increasing CVD risk factors screening uptake.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15539b, title = {Determinants for cardiovascular disease health check questionnaire: A validation study}, author = {A T Cheong and K Chinna and E M Khoo and S M Liew}, doi = {10.1371/journal.pone.0188259}, issn = {1932-6203}, year = {2017}, date = {2017-01-01}, journal = {PLoS One}, volume = {12}, number = {11}, pages = {e0188259}, abstract = {BACKGROUND: To improve individuals' participation in cardiovascular disease (CVD) screening, it is necessary to understand factors that influence their intention to undergo health checks. This study aimed to develop and validate an instrument that assess determinants that influence individuals' intention to undergo CVD health checks. METHODS: The concepts and items were developed based on findings from our prior exploratory qualitative study on factors influencing individuals' intention to undergo CVD health checks. Content validity of the questionnaire was assessed by a panel of six experts and the item-level content validity index (I-CVI) was determined. After pretesting the questionnaire was pilot tested to check reliability of the items. Exploratory factor analysis was used to test for dimensionality using a sample of 240 participants. RESULTS: The finalized questionnaire consists of 36 items, covering nine concepts. The I-CVI for all items was satisfactory with values ranging from 0.83 to 1.00. The exploratory factor analysis showed that the number of factors extracted was consistent with the theoretical concepts. Correlations values between items ranged from 0.30 to 0.85 and all the factor loadings were more than 0.40, indicating satisfactory structural validity. All concepts showed good internal consistency, Cronbach's alpha values ranged 0.66-0.85. CONCLUSIONS: The determinants for CVD health check questionnaire has good content and structural validity, and its reliability was established. It can be used to assess determinants influencing individuals' intention to undergo CVD health checks.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15615b, title = {A systematic review of psychometric testing of instruments that measure intention to work with older people}, author = {C C Che and N N Hairi and M C Chong}, doi = {10.1111/jan.13265}, issn = {0309-2402}, year = {2017}, date = {2017-01-01}, journal = {J Adv Nurs}, volume = {73}, number = {9}, pages = {2049-2064}, abstract = {AIMS: To review systematically the psychometric properties of instruments used to measure intention to work with older people. BACKGROUND: Nursing students are part of the future healthcare workforce; thus, being aware of their intention to work with older people would give valuable insights to nursing education and practice. Despite a plethora of research on measuring intention to work with older people, a valid and reliable instrument has not been identified. DESIGN: A systematic literature review of evidence and psychometric properties. DATA SOURCES: Eight database searches were conducted between 2006 - 2016. REVIEW METHODS: English articles were selected based on inclusion and exclusion criteria. The COSMIN checklist was used to assess instruments reporting a psychometric evaluation of validity and reliability. RESULTS: Of 41 studies identified for full text review, 36 met the inclusion criteria. Seven different types of instruments were identified for psychometric evaluation. Measures of reliability were reported in eight papers and validity in five papers. Evidence for each measurement property was limited, with each instrument demonstrating a lack of information on measurement properties. Based on the COSMIN checklist, the overall quality of the psychometric properties was rated as poor to good. CONCLUSION: No single instrument was found to be optimal for use. Studies of high methodological quality are needed to properly assess the measurement properties of the instruments that are currently available. Until such studies are available, we recommend using existing instruments with caution.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15605b, 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 Lim and M Dahlui}, doi = {10.1177/0890117117695888}, issn = {0890-1171}, year = {2017}, date = {2017-01-01}, journal = {Am J Health Promot}, pages = {890117117695888}, abstract = {PURPOSE: To assess the awareness, facilitators, and barriers to policy implementation related to obesity prevention for primary school children. DESIGN: A cross-sectional study administered using an online questionnaire. SETTING: Conducted in 447 primary schools in a state in Malaysia. PARTICIPANTS: One school administrator from each school served as a participant. MEASURES: The questionnaires consisted of 32 items on awareness, policy implementation, and facilitators and barriers to policy implementation. ANALYSIS: Descriptive analysis was used to describe the awareness, facilitators, and barriers of policies implementation. Association between schools' characteristics and policy implementation was assessed using logistic regression. RESULTS: The majority (90%) of school administrators were aware of the policies. However, only 50% to 70% of schools had implemented the policies fully. Reported barriers were lack of equipment, insufficient training, and limited time to complete implementation. Facilitators of policy implementation were commitment from the schools, staff members, students, and canteen operators. Policy implementation was comparable in all school types and locality; except the policy on "Food and Drinks sold at the school canteens" was implemented by more rural schools compared to urban schools (odds ratio: 1.74, 95% confidence interval: 1.13-2.69). CONCLUSION: Majority of the school administrators were aware of the existing policies; however, the implementation was only satisfactory. The identified barriers to policy implementation were modifiable and thus, the stakeholders should consider restrategizing plans in overcoming them.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15529b, 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 Srinivasaiah Sridhar and K Chinna and E Lim}, url = {https://insights.ovid.com/crossref?an=00019501-900000000-99119}, doi = {10.1097/mca.0000000000000596}, issn = {0954-6928}, year = {2017}, date = {2017-01-01}, journal = {Coron Artery Dis}, abstract = {OBJECTIVE: This study investigated the intraventricular flow dynamics in ischaemic heart disease patients. PATIENTS AND METHODS: Fourteen patients with normal ejection fraction and 16 patients with reduced ejection fraction were compared with 20 healthy individuals. Phase-contrast MRI was used to assess intraventricular flow variables and speckle-tracking echocardiography to assess myocardial strain and left ventricular (LV) dyssynchrony. Infarct size was acquired using delayed-enhancement MRI. RESULTS: The results obtained showed no significant differences in intraventricular flow variables between the healthy group and the patients with normal ejection fraction group, whereas considerable reductions in kinetic energy (KE) fluctuation index, E' (P\<0.001) and vortex KE (P=0.003) were found in the patients with reduced ejection fraction group. In multivariate analysis, only vortex KE and infarct size were significantly related to LV ejection fraction (P\<0.001); furthermore, vortex KE was correlated negatively with energy dissipation, energy dissipation index (r=-0.44}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15555b, title = {A prospective evaluation of plasma phospholipid fatty acids and breast cancer risk in the EPIC study}, author = {V Chajes and N Assi and C Biessy and P Ferrari and S Rinaldi and N Slimani and G M Lenoir and L Baglietto and M His and M C Boutron-Ruault and A Trichopoulou and P Lagiou and M Katsoulis and R Kaaks and T Kuhn and S Panico and V Pala and G Masala and H B Bueno-de-Mesquita and P H Peeters and C Gils and A Hjartaker and K Standahl Olsen and R Borgund Barnung and A Barricarte and D Redondo-Sanchez and V Menendez and P Amiano and M Wennberg and T Key and K T Khaw and M A Merritt and E Riboli and M J Gunter and I Romieu}, doi = {10.1093/annonc/mdx482}, issn = {0923-7534}, year = {2017}, date = {2017-01-01}, journal = {Ann Oncol}, volume = {28}, number = {11}, pages = {2836-2842}, abstract = {Background: Intakes of specific fatty acids have been postulated to impact breast cancer risk but epidemiological data based on dietary questionnaires remain conflicting. Materials and methods: We assessed the association between plasma phospholipid fatty acids and breast cancer risk in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition study. Sixty fatty acids were measured by gas chromatography in pre-diagnostic plasma phospholipids from 2982 incident breast cancer cases matched to 2982 controls. Conditional logistic regression models were used to estimate relative risk of breast cancer by fatty acid level. The false discovery rate (q values) was computed to control for multiple comparisons. Subgroup analyses were carried out by estrogen receptor (ER) and progesterone receptor expression in the tumours. Results: A high level of palmitoleic acid [odds ratio (OR) for the highest quartile compared with the lowest OR (Q4-Q1) 1.37; 95% confidence interval (CI), 1.14-1.64; P for trend = 0.0001, q value = 0.004] as well as a high desaturation index (DI16) (16:1n-7/16:0) [OR (Q4-Q1), 1.28; 95% C, 1.07-1.54; P for trend = 0.002, q value = 0.037], as biomarkers of de novo lipogenesis, were significantly associated with increased risk of breast cancer. Levels of industrial trans-fatty acids were positively associated with ER-negative tumours [OR for the highest tertile compared with the lowest (T3-T1)=2.01; 95% CI, 1.03-3.90; P for trend = 0.047], whereas no association was found for ER-positive tumours (P-heterogeneity =0.01). No significant association was found between n-3 polyunsaturated fatty acids and breast cancer risk, overall or by hormonal receptor. Conclusion: These findings suggest that increased de novo lipogenesis, acting through increased synthesis of palmitoleic acid, could be a relevant metabolic pathway for breast tumourigenesis. Dietary trans-fatty acids derived from industrial processes may specifically increase ER-negative breast cancer risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15567b, title = {Blood Metabolic Signatures of Body Mass Index: A Targeted Metabolomics Study in the EPIC Cohort}, author = {M Carayol and M F Leitzmann and P Ferrari and R Zamora-Ros and D Achaintre and M Stepien and J A Schmidt and R C Travis and K Overvad and A Tjonneland and L Hansen and R Kaaks and T Kuhn and H Boeing and U Bachlechner and A Trichopoulou and C Bamia and D Palli and C Agnoli and R Tumino and P Vineis and S Panico and J R Quiros and E Sanchez-Cantalejo and J M Huerta and E Ardanaz and L Arriola and A Agudo and J Nilsson and O Melander and B Bueno-de-Mesquita and P H Peeters and N Wareham and K T Khaw and M Jenab and T J Key and A Scalbert and S Rinaldi}, doi = {10.1021/acs.jproteome.6b01062}, issn = {1535-3893}, year = {2017}, date = {2017-01-01}, journal = {J Proteome Res}, volume = {16}, number = {9}, pages = {3137-3146}, abstract = {Metabolomics is now widely used to characterize metabolic phenotypes associated with lifestyle risk factors such as obesity. The objective of the present study was to explore the associations of body mass index (BMI) with 145 metabolites measured in blood samples in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Metabolites were measured in blood from 392 men from the Oxford (UK) cohort (EPIC-Oxford) and in 327 control subjects who were part of a nested case-control study on hepatobiliary carcinomas (EPIC-Hepatobiliary). Measured metabolites included amino acids, acylcarnitines, hexoses, biogenic amines, phosphatidylcholines, and sphingomyelins. Linear regression models controlled for potential confounders and multiple testing were run to evaluate the associations of metabolite concentrations with BMI. 40 and 45 individual metabolites showed significant differences according to BMI variations, in the EPIC-Oxford and EPIC-Hepatobiliary subcohorts, respectively. Twenty two individual metabolites (kynurenine, one sphingomyelin, glutamate and 19 phosphatidylcholines) were associated with BMI in both subcohorts. The present findings provide additional knowledge on blood metabolic signatures of BMI in European adults, which may help identify mechanisms mediating the relationship of BMI with obesity-related diseases.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15609b, title = {Coffee, tea and melanoma risk: findings from the European Prospective Investigation into Cancer and Nutrition}, author = {S Caini and G Masala and C Saieva and M Kvaskoff and I Savoye and C Sacerdote and O Hemmingsson and B Hammer Bech and K Overvad and A Tjonneland and K E Petersen and F R Mancini and M C Boutron-Ruault and I Cervenka and R Kaaks and T Kuhn and H Boeing and A Floegel and A Trichopoulou and E Valanou and M Kritikou and G Tagliabue and S Panico and R Tumino and H B Bueno-de-Mesquita and P H Peeters and M B Veierod and R Ghiasvand and M Lukic and J R Quiros and M D Chirlaque and E Ardanaz and E Salamanca Fernandez and N Larranaga and R Zamora-Ros and L Maria Nilsson and I Ljuslinder and K Jirstrom and E Sonestedt and T J Key and N Wareham and K T Khaw and M Gunter and I Huybrechts and N Murphy and K K Tsilidis and E Weiderpass and D Palli}, doi = {10.1002/ijc.30659}, issn = {0020-7136}, year = {2017}, date = {2017-01-01}, journal = {Int J Cancer}, volume = {140}, number = {10}, pages = {2246-2255}, abstract = {In vitro and animal studies suggest that bioactive constituents of coffee and tea may have anticarcinogenic effects against cutaneous melanoma; however, epidemiological evidence is limited to date. We examined the relationships between coffee (total, caffeinated or decaffeinated) and tea consumption and risk of melanoma in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is a multicentre prospective study that enrolled over 500,000 participants aged 25-70 years from ten European countries in 1992-2000. Information on coffee and tea drinking was collected at baseline using validated country-specific dietary questionnaires. We used adjusted Cox proportional hazards regression models to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) for the associations between coffee and tea consumption and melanoma risk. Overall, 2,712 melanoma cases were identified during a median follow-up of 14.9 years among 476,160 study participants. Consumption of caffeinated coffee was inversely associated with melanoma risk among men (HR for highest quartile of consumption vs. non-consumers 0.31, 95% CI 0.14-0.69) but not among women (HR 0.96, 95% CI 0.62-1.47). There were no statistically significant associations between consumption of decaffeinated coffee or tea and the risk of melanoma among both men and women. The consumption of caffeinated coffee was inversely associated with melanoma risk among men in this large cohort study. Further investigations are warranted to confirm our findings and clarify the possible role of caffeine and other coffee compounds in reducing the risk of melanoma.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15647b, title = {Time-dependent risk and predictors of venous thromboembolism in breast cancer patients: A population-based cohort study}, author = {J S Brand and E Hedayati and N Bhoo-Pathy and J Bergh and P Hall and K Humphreys and J F Ludvigsson and K Czene}, doi = {10.1002/cncr.30364}, issn = {0008-543x}, year = {2017}, date = {2017-01-01}, journal = {Cancer}, volume = {123}, number = {3}, pages = {468-475}, abstract = {BACKGROUND: Venous thromboembolism (VTE) is a serious complication of cancer and its treatment. The current study assessed the risk and clinical predictors of VTE in breast cancer patients by time since diagnosis. METHODS: This Swedish population-based study included 8338 breast cancer patients diagnosed from 2001 to 2008 in the Stockholm-Gotland region with complete follow-up until 2012. Their incidence of VTE was compared with the incidence among 39,013 age-matched reference individuals from the general population. Cox and flexible parametric models were used to examine associations with patient, tumor, and treatment characteristics, accounting for time-dependent effects. RESULTS: Over a median follow-up of 7.2 years, 426 breast cancer patients experienced a VTE event (cumulative incidence, 5.1%). The VTE incidence was 3-fold increased (hazard ratio [HR], 3.28; 95% confidence interval [CI], 2.87-3.74) in comparison with the incidence in the general population and was highest 6 months after diagnosis (HR, 8.62; 95% CI, 6.56-11.33) with a sustained increase in risk thereafter (HR at 5 years, 2.19; 95% CI, 1.80-2.67). Independent predictors of VTE included the following: older age, being overweight, preexisting VTE, comorbid disease, tumor size \> 40 mm, progesterone receptor (PR)-negative status, more than 4 affected lymph nodes, and receipt of chemo- and endocrine therapy. The impact of chemotherapy was limited to early-onset VTE, whereas comorbid disease and PR-negative status were more strongly associated with late-onset events. CONCLUSIONS: This study confirms the long-term risk of VTE in breast cancer patients and identifies a comprehensive set of clinical risk predictors. Temporal associations with patient, tumor, and treatment characteristics provide insight into the time-dependent etiology of VTE. Cancer 2017;123:468-475. (c) 2016 American Cancer Society.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15565b, title = {Willingness to use pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia: findings from a qualitative study}, author = {A Bourne and M Cassolato and C K Thuan Wei and B Wang and J Pang and S H Lim and I Azwa and I Yee and G Mburu}, doi = {10.7448/ias.20.1.21899}, issn = {1758-2652}, year = {2017}, date = {2017-01-01}, journal = {J Int AIDS Soc}, volume = {20}, number = {1}, pages = {21899}, abstract = {BACKGROUND: Men who have sex with men (MSM) continue to be disproportionately affected by HIV in Malaysia. Recent success has been observed within demonstration projects examining the efficacy of HIV pre-exposure prophylaxis (PrEP), an antiretroviral -based medication taken by HIV-negative men to prevent sero-conversion. In order for such promising findings to be translated in real-world settings, it is important to understand the acceptability of PrEP, including perceived barriers to access or uptake. METHODS: As part of a larger mixed-methods study exploring acceptability and willingness to use PrEP among MSM in Malaysia, 19 men took part in audio-recorded focus group discussions hosted by a community-based HIV organization and facilitated by a trained researcher. Discussions focussed on awareness and potential information management, general perceptions of PrEP and potential motivations or barriers to the use of PrEP, including those at the personal, social, health system or structural level. Data were transcribed verbatim and underwent a detailed thematic analysis. RESULTS: Rather than perceiving PrEP as a replacement for condoms in terms of having safer sex, many participants viewed it as an additional layer protection, serving as a crucial barrier to infection on occasions where condom use was intended, but did not occur. It was also perceived as more valuable to "at-risk" men, such as those in HIV sero-discordant relationships or those with a higher number of sexual partners. Elements of discussion tended to suggest that some men taking PrEP may be subject to stigma from others, on the assumption they may be promiscuous or engage in high-risk sexual behaviours. CONCLUSIONS: This qualitative study indicates that, broadly speaking, PrEP may be acceptable to MSM in Malaysia. However, in order for its potential to be realized, and uptake achieved, educative interventions are required to inform the target population as to the efficacy and potential, positive impact of PrEP. Given concerns for how those taking it may be stigmatized, it is crucial that the use of PrEP is presented as a responsible course of action, and one of a range of strategies that men can use to keep themselves safe from HIV.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15600b, title = {Impact of adjuvant chemotherapy on survival of women with T1N0M0, hormone receptor negative breast cancer}, author = {N T Bhoo-Pathy and S Inaida and S Tanaka and N A Taib and C H Yip and M Saad and K Kawakami and N Bhoo-Pathy}, doi = {10.1016/j.canep.2017.03.007}, issn = {1877-7821}, year = {2017}, date = {2017-01-01}, journal = {Cancer Epidemiol}, volume = {48}, pages = {56-61}, abstract = {BACKGROUND: The benefit of adjuvant chemotherapy in women with T1N0M0 breast cancers is unclear. While gene expression-based prognostic assays may aid management of women with early estrogen receptor (ER) positive tumors, therapeutic decision-making in women with early stage ER negative tumors remains fraught with difficulties. We investigated the association between adjuvant chemotherapy and overall survival in women with T1N0M0, hormone receptor negative breast cancers. METHOD: All newly diagnosed breast cancer patients with node-negative and hormone receptor negative tumors measuring\</=2cm at the University Malaya Medical Centre (Malaysia) from 1993 to 2013 were included. Mortality of patients with and without adjuvant chemotherapy were compared and adjusted for possible confounders using propensity score. RESULTS: Of 6732 breast cancer patients, 341 (5.1%) had small (\</=2cm), node-negative and hormone receptor negative tumors at diagnosis. Among them, only 214 (62.8%) received adjuvant chemotherapy. Five-year overall survival was 88.1% (95% confidence interval (CI): 82.0%-94.2%) for patients receiving chemotherapy and 89.6% (95% CI: 85.1%-94.1%) for patients without chemotherapy. Chemotherapy was not associated with survival following adjustment for age, ethnicity, tumor size, tumor grade, HER2 status, lympho-vascular invasion, type of surgery and radiotherapy administration. However, chemotherapy was associated with a significant survival advantage (adjusted hazard ratio: 0.35, 95%CI: 0.14-0.91) in a subgroup of women with high-grade tumors. CONCLUSION: Adjuvant chemotherapy does not appear to be associated with a survival benefit in women with T1N0M0, hormone receptor negative breast cancer except in those with high-grade tumors.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15596b, title = {Moderate alcohol consumption is associated with lower chronic disease burden expressed in disability-adjusted life years: a prospective cohort study}, author = {J W J Beulens and H P Fransen and E A Struijk and J M A Boer and G A Wit and N C Onland-Moret and J Hoekstra and H B Bueno-de-Mesquita and P H M Peeters and A M May}, doi = {10.1007/s10654-017-0247-x}, issn = {0393-2990}, year = {2017}, date = {2017-01-01}, journal = {Eur J Epidemiol}, volume = {32}, number = {4}, pages = {317-326}, abstract = {The relation of alcohol consumption with disease burden remains debated partly due to opposite associations with cardiovascular disease (CVD) and cancer. The relation of alcohol consumption with disease burden expressed in disability-adjusted life years (DALYs) summarizes opposing associations of alcohol consumption on chronic diseases. This study aimed to investigate the association of alcohol consumption with chronic disease burden expressed in DALYs based on individual-participant data. The study was a prospective study among 33,066 men and women from the EPIC-NL cohort. At baseline, alcohol consumption was assessed with a validated food-frequency questionnaire. Participants were followed for occurrence of and mortality from chronic diseases and DALYs were calculated. After 12.4 years follow-up, 6647 disease incidences and 1482 deaths were documented, resulting in 68,225 healthy years of life lost (6225 DALYs). Moderate drinkers (women 5-14.9 g/day, men 5-29.9 g/day) had a lower chronic disease burden (mean DALYs -0.27; 95% CI -0.43; -0.11) than light drinkers (0-4.9 g/day), driven by a lower disease burden due to CVD (-0.18: -0.29; -0.06) but not cancer (-0.05: -0.16; 0.06). The associations were most pronounced among older participants (\>/=50 years; -0.32; -0.53; -0.10) and not observed among younger women (-0.08; -0.43; 0.35), albeit non-significant (pinteraction \> 0.14). Substantial drinking (women 15-29.9 g/day, men 30-59.9 g/day) compared to light drinking was not associated with chronic disease burden. Our results show that moderate compared to light alcohol consumption was associated with living approximately 3 months longer in good health. These results were mainly observed among older participants and not seen among younger women.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15616b, title = {No association of alcohol use and the risk of ulcerative colitis or Crohn's disease: data from a European Prospective cohort study (EPIC)}, author = {M M Bergmann and V Hernandez and W Bernigau and H Boeing and S S Chan and R Luben and K T Khaw and F Schaik and B Oldenburg and B Bueno-de-Mesquita and K Overvad and D Palli and G Masala and F Carbonnel and M C Boutron-Ruault and A Olsen and A Tjonneland and R Kaaks and V Katzke and E Riboli and A R Hart}, doi = {10.1038/ejcn.2016.271}, issn = {0954-3007}, year = {2017}, date = {2017-01-01}, journal = {Eur J Clin Nutr}, volume = {71}, number = {4}, pages = {512-518}, abstract = {BACKGROUND/OBJECTIVES: The role of long-term alcohol consumption for the risk of developing ulcerative colitis (UC) and Crohn's disease (CD) is unclear. For the first time, to prospectively assess the role of pre-disease alcohol consumption on the risk of developing UC or CD. SUBJECTS/METHODS: Nested within the European Prospective Investigation into Cancer and Nutrition (EPIC-IBD), incident UC and CD cases and matched controls where included. At recruitment, participants completed validated food frequency and lifestyle questionnaires. Alcohol consumption was classified as either: non-use, former, light (0.5 and 1 drink per week), below the recommended limits (BRL) (1 and 2 drinks per day), moderate (2.5 and 5 drinks per day), or heavy use (\>2.5 and \>5 drinks per day) for women and men, respectively; and was expressed as consumption at enrolment and during lifetime. Conditional logistic regression was applied adjusting for smoking and education, taking light users as the reference. RESULTS: Out of 262 451 participants in six countries, 198 UC incident cases/792 controls and 84 CD cases/336 controls were included. At enrolment, 8%/27%/32%/23%/11% UC cases and 7%/29%/40%/19%/5% CD cases were: non-users, light, BRL, moderate and heavy users, respectively. The corresponding figures for lifetime non-use, former, light, BRL, moderate and heavy use were: 3%/5%/23%/44%/19%/6% and 5%/2%/25%/44%/23%/1% for UC and CD cases, respectively. There were no associations between any categories of alcohol consumption and risk of UC or CD in the unadjusted and adjusted odds ratios. CONCLUSION: There was no evidence of associations between alcohol use and the odds of developing either UC or CD.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15566b, title = {Self-rated health and all-cause and cause-specific mortality of older adults: Individual data meta-analysis of prospective cohort studies in the CHANCES Consortium}, author = {C Bamia and P Orfanos and H Juerges and B Schottker and H Brenner and R Lorbeer and M Aadahl and C E Matthews and E Klinaki and M Katsoulis and P Lagiou and H B A Bueno-de-Mesquita and S Eriksson and U Mons and K U Saum and R Kubinova and A Pajak and A Tamosiunas and S Malyutina and J Gardiner and A Peasey and L C Groot and T Wilsgaard and P Boffetta and A Trichopoulou and D Trichopoulos}, doi = {10.1016/j.maturitas.2017.06.023}, issn = {0378-5122}, year = {2017}, date = {2017-01-01}, journal = {Maturitas}, volume = {103}, pages = {37-44}, abstract = {OBJECTIVES: To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as "at-least-good". STUDY DESIGN: Individual data on SRH and important covariates were obtained for 424,791 European and United States residents, \>/=60 years at recruitment (1982-2008), in eight prospective studies in the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). In each study, adjusted mortality ratios (hazard ratios, HRs) in relation to SRH were calculated and subsequently combined with random-effect meta-analyses. MAIN OUTCOME MEASURES: All-cause, cardiovascular and cancer mortality. RESULTS: Within the median 12.5 years of follow-up, 93,014 (22%) deaths occurred. SRH "fair" or "poor" vs. "at-least-good" was associated with increased mortality: HRs 1.46 (95% CI 1.23-1.74) and 2.31 (1.79-2.99), respectively. These associations were evident: for cardiovascular and, to a lesser extent, cancer mortality, and within-study, within-subgroup analyses. Accounting for lifestyle, sociodemographic, somatometric factors and, subsequently, for medical history explained only a modest amount of the unadjusted associations. Factors favourably associated with SRH were: sex (males), age (younger-old), education (high), marital status (married/cohabiting), physical activity (active), body mass index (non-obese), alcohol consumption (low to moderate) and previous morbidity (absence). CONCLUSION: SRH provides a quick and simple tool for assessing health and identifying groups of elders at risk of early mortality that may be useful also in clinical settings. Modifying determinants of favourably rating health, e.g. by increasing physical activity and/or by eliminating obesity, may be important for older adults to "feel healthy" and "be healthy".}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15574b, title = {Impact of Time Since Last Childbirth on Survival of Women with Premenopausal and Postmenopausal Breast Cancers}, author = {N Balakrishnan and S H Teo and S Sinnadurai and N T Bhoo Pathy and M H See and N A Taib and C H Yip and N Bhoo Pathy}, doi = {10.1007/s00268-017-4081-9}, issn = {0364-2313}, year = {2017}, date = {2017-01-01}, journal = {World J Surg}, volume = {41}, number = {11}, pages = {2735-2745}, abstract = {BACKGROUND: Reproductive factors are associated with risk of breast cancer, but the association with breast cancer survival is less well known. Previous studies have reported conflicting results on the association between time since last childbirth and breast cancer survival. We determined the association between time since last childbirth (LCB) and survival of women with premenopausal and postmenopausal breast cancers in Malaysia. METHOD: A historical cohort of 986 premenopausal, and 1123 postmenopausal, parous breast cancer patients diagnosed from 2001 to 2012 in University Malaya Medical Centre were included in the analyses. Time since LCB was categorized into quintiles. Multivariable Cox regression was used to determine whether time since LCB was associated with survival following breast cancer, adjusting for demographic, tumor, and treatment characteristics. RESULTS: Premenopausal breast cancer patients with the most recent childbirth (LCB quintile 1) were younger, more likely to present with unfavorable prognostic profiles and had the lowest 5-year overall survival (OS) (66.9; 95% CI 60.2-73.6%), compared to women with longer duration since LCB (quintile 2 thru 5). In univariable analysis, time since LCB was inversely associated with risk of mortality and the hazard ratio for LCB quintile 2, 3, 4, and 5 versus quintile 1 were 0.53 (95% CI 0.36-0.77), 0.49 (95% CI 0.33-0.75), 0.61 (95% CI 0.43-0.85), and 0.64 (95% CI 0.44-0.93), respectively; P trend = 0.016. However, this association was attenuated substantially following adjustment for age at diagnosis and other prognostic factors. Similarly, postmenopausal breast cancer patients with the most recent childbirth were also more likely to present with unfavorable disease profiles. Compared to postmenopausal breast cancer patients in LCB quintile 1, patients in quintile 5 had a higher risk of mortality. This association was not significant following multivariable adjustment. CONCLUSION: Time since LCB is not independently associated with survival in premenopausal or postmenopausal breast cancers. The apparent increase in risks of mortality in premenopausal breast cancer patients with a recent childbirth, and postmenopausal patients with longer duration since LCB, appear to be largely explained by their age at diagnosis.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15646b, title = {Interventions for preventing elder abuse: applying findings of a new Cochrane review}, author = {P R Baker and D P Francis and N N Mohd Hairi and S Othman and W Y Choo}, doi = {10.1093/ageing/afw186}, issn = {0002-0729}, year = {2017}, date = {2017-01-01}, journal = {Age Ageing}, volume = {46}, number = {3}, pages = {346-348}, abstract = {There is evidence that elder abuse is a significant public health problem that is destined to grow as population age. Countries are considering how best to act and this requires an understanding of the complex causal mechanisms contributing to its occurrence and the identification of effective interventions which can potentially make a difference. Previously, a high quality synthesis of evidence for policy and practice has been missing. In this paper, we describe a new Cochrane review of interventions to prevent the occurrence or reoccurrence of elder abuse. Overall, the quality of the evidence available for decision making is very low and there is little to guide practice. Amongst the interventions, there is some evidence that teaching coping skills to family carers of persons with dementia might make the situation better. We argue that poor quality and wasteful research needs to be avoided, and front-line agencies be supported in undertaking comparative evaluation of their services.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15550b, title = {Catastrophic Health Expenditure Among Colorectal Cancer Patients and Families: A Case of Malaysia}, author = {M Azzani and A Yahya and A C Roslani and T T Su}, doi = {10.1177/1010539517732224}, issn = {1010-5395}, year = {2017}, date = {2017-01-01}, journal = {Asia Pac J Public Health}, volume = {29}, number = {6}, pages = {485-494}, abstract = {This study aimed to estimate the cost of colorectal cancer (CRC) management and to explore the prevalence and determinants of catastrophic health expenditure (CHE) among CRC patients and their families arising from the costs of CRC management. Data were collected prospectively from 138 CRC patients. Patients were interviewed by using a structured questionnaire at the time of the diagnosis, then at 6 months and 12 months following diagnosis. Simple descriptive methods and multivariate binary logistic regression were used in the analysis. The mean cost of managing CRC was RM8306.9 (US$2595.9), and 47.8% of patients' families experienced CHE. The main determinants of CHE were the economic status of the family and the likelihood of the patient undergoing surgery. The results of this study strongly suggest that stakeholders and policy makers should provide individuals with financial protection against the consequences of cancer, a costly illness that often requires prolonged treatment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15582b, title = {Evaluation of awareness \& utilisation of clinical practise guideline for management of adult Dengue infection among Malaysia doctors}, author = {M I Ariff and A Yahya and R Zaki and R Sarimin and I M Mohamed Ghazali and B S Gill and Z Suli and M A Mohd Yusof and N Ahmad Lutfi and S L Thye and F Ismail and M Mahmud and R Bakri}, doi = {10.1371/journal.pone.0178137}, issn = {1932-6203}, year = {2017}, date = {2017-01-01}, journal = {PLoS One}, volume = {12}, number = {5}, pages = {e0178137}, abstract = {Clinical Practice Guideline (CPG) provides evidence-based guidance for the management of Dengue Infection in adult patients. A cross sectional study was conducted to evaluate awareness and utilization of CPG among doctors in public or private hospitals and clinics in Malaysia. Doctors practicing only at hospital Medical and Emergency Departments were included, while private specialist clinics were excluded in this study. A multistage proportionate random sampling according to region (Central, Northern, Southern, Eastern, Sabah and Sarawak) was performed to select study participants. The overall response rate was 74% (84% for public hospitals, 82% for private hospitals, 70% for public clinics, and 64% for private clinics). The CPG Awareness and Utilization Feedback Form were used to determine the percentage in the study. The total numbers of respondent were 634 with response rate of 74%. The mean lengths of service of the respondent were 13.98 (11.55).A higher percentages of doctors from public facilities (99%) were aware of the CPG compared to those in private facilities (84%). The percentage of doctors utilising the CPG were also higher (98%) in public facilities compared to private facilities (86%). The percentage of Medical Officer in private facilities that utilizing the CPG were 84% compares to Medical Officer in public facilities 98%. The high percentage of doctors using the CPG in both public (97%) and private (94%) hospitals were also observed. However, only 69% of doctors in private clinics utilised the CPG compared to doctors in public clinics (98%). Doctors in both public and private facilities were aware of the dengue CPG. However, most doctors in private clinic were less likely to utilise the CPG. Therefore, there is a need to increase the level of CPG utilisation especially in private clinics.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15547b, title = {Long-Term Exposure to Ambient Air Pollution and Incidence of Postmenopausal Breast Cancer in 15 European Cohorts within the ESCAPE Project}, author = {Z J Andersen and M Stafoggia and G Weinmayr and M Pedersen and C Galassi and J T Jorgensen and A Oudin and B Forsberg and D Olsson and B Oftedal and G Marit Aasvang 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 K T Eriksen and A Tjonneland and P H Peeters and B Bueno-de-Mesquita and M Plusquin and T J Key and A Jaensch and G Nagel and A Lang and M Wang and M Y Tsai and A Fournier and M C Boutron-Ruault and L Baglietto and S Grioni and A Marcon and V Krogh and F Ricceri and C Sacerdote and E Migliore and I Tamayo-Uria and P Amiano and M Dorronsoro 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 = {10.1289/ehp1742}, issn = {0091-6765}, year = {2017}, date = {2017-01-01}, journal = {Environ Health Perspect}, volume = {125}, number = {10}, pages = {107005}, abstract = {BACKGROUND: Epidemiological evidence on the association between ambient air pollution and breast cancer risk is inconsistent. OBJECTIVE: We examined the association between long-term exposure to ambient air pollution and incidence of postmenopausal breast cancer in European women. METHODS: In 15 cohorts from nine European countries, individual estimates of air pollution levels at the residence were estimated by standardized land-use regression models developed within the European Study of Cohorts for Air Pollution Effects (ESCAPE) and Transport related Air Pollution and Health impacts - Integrated Methodologies for Assessing Particulate Matter (TRANSPHORM) projects: particulate matter (PM) \</=2.5mum, \</=10mum, and 2.5-10mum in diameter (PM2.5, PM10, and PMcoarse, respectively); PM2.5 absorbance; nitrogen oxides (NO2 and NOx); traffic intensity; and elemental composition of PM. We estimated cohort-specific associations between breast cancer and air pollutants using Cox regression models, adjusting for major lifestyle risk factors, and pooled cohort-specific estimates using random-effects meta-analyses. RESULTS: Of 74,750 postmenopausal women included in the study, 3,612 developed breast cancer during 991,353 person-years of follow-up. We found positive and statistically insignificant associations between breast cancer and PM2.5 hazard ratio (HR)=1.08 [95% confidence interval (CI): 0.77, 1.51] per 5 mug/m(3), PM10 [1.07 (95% CI: 0.89, 1.30) per 10 mug/m(3)], PMcoarse[1.20 (95% CI: 0.96, 1.49 per 5 mug/m(3)], and NO(2) [1.02 (95% CI: 0.98, 1.07 per 10 mug/m(3)], and a statistically significant association with NOx [1.04 (95% CI: 1.00, 1.08) per 20 mug/m(3)}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15551b, 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 De Faire and C G Ostenson and L Fratiglioni and K T Eriksen and A H Poulsen and A Tjonneland and E Vaclavik 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 = {2017}, date = {2017-01-01}, journal = {Neuro Oncol}, abstract = {Background: Epidemiological evidence on the association between ambient air pollution and brain tumor risk is sparse and inconsistent. Methods: In 12 cohorts from six European countries, individual estimates of annual mean air pollution levels at the baseline residence were estimated by standardized land-use regression models developed within the ESCAPE and TRANSPHORM projects: particulate matter (PM) \</= 2.5, \</= 10, and 2.5-10 mum in diameter (PM2.5, PM10, and PMcoarse), PM2.5 absorbance, nitrogen oxides (NO2 and NOx) and elemental composition of PM. We estimated cohort-specific associations of air pollutant concentrations and traffic intensity with total, malignant and nonmalignant brain tumor, in separate Cox regression models, adjusting for risk factors, and pooled cohort-specific estimates using random-effects meta-analyses. Results: Of 282,194 subjects from 12 cohorts, 466 developed malignant brain tumors during 12 years of follow-up. Six of the cohorts had also data on nonmalignant brain tumor, where among 106,786 subjects, 366 developed brain tumor: 176 nonmalignant and 190 malignant. We found a positive, statistically non-significant association between malignant brain tumor and PM2.5 absorbance (Hazard Ratio and 95% Confidence Interval: 1.67; 0.89-3.14 per 10 -5/m 3), and weak positive or null associations with the other pollutants. Hazard ratio for PM2.5 absorbance (1.01; 0.38-2.71 per 10 -5/m 3) and all other pollutants were lower for nonmalignant than for malignant brain tumors. Conclusion: We found suggestive evidence of an association between long-term exposure to PM2.5 absorbance indicating traffic-related air pollution and malignant brain tumors, and no association with overall or nonmalignant brain tumors.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15548b, title = {Physical activity, mediating factors and risk of colon cancer: insights into adiposity and circulating biomarkers from the EPIC cohort}, author = {K Aleksandrova and M Jenab and M Leitzmann and B Bueno-de-Mesquita and R Kaaks and A Trichopoulou and C Bamia and P Lagiou and S Rinaldi and H Freisling and M Carayol and T Pischon and D Drogan and E Weiderpass and P Jakszyn and K Overvad and C C Dahm and A Tjonneland and M C Bouton-Ruault and T Kuhn and E Peppa and E Valanou and C La Vecchia and D Palli and S Panico and C Sacerdote and C Agnoli and R Tumino and A May and J Vulpen and K Benjaminsen Borch and S Oluwafemi Oyeyemi and J R Quiros and C Bonet and M J Sanchez and M Dorronsoro and C Navarro and A Barricarte and B Guelpen and P Wennberg and T J Key and K T Khaw and N Wareham and N Assi and H A Ward and D Aune and E Riboli and H Boeing}, doi = {10.1093/ije/dyx174}, issn = {0300-5771}, year = {2017}, date = {2017-01-01}, journal = {Int J Epidemiol}, volume = {46}, number = {6}, pages = {1823-1835}, abstract = {Background: There is convincing evidence that high physical activity lowers the risk of colon cancer; however, the underlying biological mechanisms remain largely unknown. We aimed to determine the extent to which body fatness and biomarkers of various biologically plausible pathways account for the association between physical activity and colon cancer. Methods: We conducted a nested case-control study in a cohort of 519 978 men and women aged 25 to 70 years followed from 1992 to 2003. A total of 713 incident colon cancer cases were matched, using risk-set sampling, to 713 controls on age, sex, study centre, fasting status and hormonal therapy use. The amount of total physical activity during the past year was expressed in metabolic equivalent of task [MET]-h/week. Anthropometric measurements and blood samples were collected at study baseline. Results: High physical activity was associated with a lower risk of colon cancer: relative risk \>/=91 MET-h/week vs \<91 MET-h/week = 0.75 [95% confidence interval (CI): 0.57 to 0.96]. In mediation analyses, this association was accounted for by waist circumference: proportion explained effect (PEE) = 17%; CI: 4% to 52%; and the biomarkers soluble leptin receptor (sOB-R): PEE = 15%; 95% CI: 1% to 50% and 5-hydroxyvitamin D (25[OH]D): PEE = 30%; 95% CI: 12% to 88%. In combination, these factors explained 45% (95% CI: 20% to 125%) of the association. Beyond waist circumference, sOB-R and 25[OH]D additionally explained 10% (95% CI: 1%; 56%) and 23% (95% CI: 6%; 111%) of the association, respectively. Conclusions: Promoting physical activity, particularly outdoors, and maintaining metabolic health and adequate vitamin D levels could represent a promising strategy for colon cancer prevention.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15662, title = {Missed Opportunities for Loco-Regional Treatment of Elderly Women with Breast Cancer}, author = {N Bhoo-Pathy and N Balakrishnan and M H See and N A Taib and C H Yip}, doi = {10.1007/s00268-016-3658-z}, issn = {0364-2313}, year = {2016}, date = {2016-01-01}, journal = {World J Surg}, volume = {40}, number = {12}, pages = {2913-2921}, abstract = {BACKGROUND: Factors associated with surgery, adjuvant radiotherapy, and chemotherapy and whether there were missed opportunities for treatment in elderly patients were determined in an Asian setting. METHODS: All 5616 patients, diagnosed with breast cancer in University Malaya Medical Centre from 1999 to 2013 were included. In 945 elderly patients (aged 65 years and above), multivariable logistic regression was performed to identify factors associated with treatment, following adjustment for age, ethnicity, tumor, and other treatment characteristics. The impact of lack of treatment on survival of the elderly was assessed while accounting for comorbidities. RESULTS: One in five elderly patients had comorbidities. Compared to younger patients, the elderly had more favorable tumor characteristics, and received less loco-regional treatment and chemotherapy. Within stage I-IIIa elderly breast cancer patients, 10 % did not receive any surgery. These patients were older, more likely to be Malays, have comorbidities, and bigger tumors. In elderlies with indications for adjuvant radiotherapy, no irradiation (30 %) was associated with increasing age, comorbidity, and the absence of systemic therapy. Hormone therapy was optimal, but only 35 % of elderly women with ER negative tumors received chemotherapy. Compared to elderly women who received adequate treatment, those not receiving surgery (adjusted hazard ratio: 2.30, 95 %CI: 1.10-4.79), or radiotherapy (adjusted hazard ratio: 1.56, 95 %CI: 1.10-2.19), were associated with higher mortality. Less than 25 % of the survival discrepancy between elderly women receiving loco-regional treatment and no treatment were attributed to excess comorbidities in untreated patients. CONCLUSION: While the presence of comorbidities significantly influenced loco-regional treatment decisions in the elderly, it was only able to explain the lower survival rates in untreated patients up to a certain extent, suggesting missed opportunities for treatment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15716, title = {Plasma carotenoids, vitamin C, tocopherols, and retinol and the risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition cohort}, author = {M F Bakker and P H Peeters and V M Klaasen and H B Bueno-de-Mesquita and E H Jansen and M M Ros and N Travier and A Olsen and A Tjonneland and K Overvad and S Rinaldi and I Romieu and P Brennan and M C Boutron-Ruault and F Perquier and C Cadeau and H Boeing and K Aleksandrova and R Kaaks and T Kuhn and A Trichopoulou and P Lagiou and D Trichopoulos and P Vineis and V Krogh and S Panico and G Masala and R Tumino and E Weiderpass and G Skeie and E Lund and J R Quiros and E Ardanaz and C Navarro and P Amiano and M J Sanchez and G Buckland and U Ericson and E Sonestedt and M Johansson and M Sund and R C Travis and T J Key and K T Khaw and N Wareham and E Riboli and C H Gils}, doi = {10.3945/ajcn.114.101659}, issn = {0002-9165}, year = {2016}, date = {2016-01-01}, journal = {Am J Clin Nutr}, volume = {103}, number = {2}, pages = {454-64}, abstract = {BACKGROUND: Carotenoids and vitamin C are thought to be associated with reduced cancer risk because of their antioxidative capacity. OBJECTIVE: This study evaluated the associations of plasma carotenoid, retinol, tocopherol, and vitamin C concentrations and risk of breast cancer. DESIGN: In a nested case-control study within the European Prospective Investigation into Cancer and Nutrition cohort, 1502 female incident breast cancer cases were included, with an oversampling of premenopausal (n = 582) and estrogen receptor-negative (ER-) cases (n = 462). Controls (n = 1502) were individually matched to cases by using incidence density sampling. Prediagnostic samples were analyzed for alpha-carotene, beta-carotene, lycopene, lutein, zeaxanthin, beta-cryptoxanthin, retinol, alpha-tocopherol, gamma-tocopherol, and vitamin C. Breast cancer risk was computed according to hormone receptor status and age at diagnosis (proxy for menopausal status) by using conditional logistic regression and was further stratified by smoking status, alcohol consumption, and body mass index (BMI). All statistical tests were 2-sided. RESULTS: In quintile 5 compared with quintile 1, alpha-carotene (OR: 0.61; 95% CI: 0.39, 0.98) and beta-carotene (OR: 0.41; 95% CI: 0.26, 0.65) were inversely associated with risk of ER- breast tumors. The other analytes were not statistically associated with ER- breast cancer. For estrogen receptor-positive (ER+) tumors, no statistically significant associations were found. The test for heterogeneity between ER- and ER+ tumors was statistically significant only for beta-carotene (P-heterogeneity = 0.03). A higher risk of breast cancer was found for retinol in relation to ER-/progesterone receptor-negative tumors (OR: 2.37; 95% CI: 1.20, 4.67; P-heterogeneity with ER+/progesterone receptor positive = 0.06). We observed no statistically significant interaction between smoking, alcohol, or BMI and all investigated plasma analytes (based on tertile distribution). CONCLUSION: Our results indicate that higher concentrations of plasma beta-carotene and alpha-carotene are associated with lower breast cancer risk of ER- tumors.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15685, title = {Financial burden of colorectal cancer treatment among patients and their families in a middle-income country}, author = {M Azzani and A C Roslani and T T Su}, doi = {10.1007/s00520-016-3283-2}, issn = {0941-4355}, year = {2016}, date = {2016-01-01}, journal = {Support Care Cancer}, volume = {24}, number = {10}, pages = {4423-32}, abstract = {BACKGROUND: In Malaysia, the healthcare system consists of a government-run universal healthcare system and a co-existing private healthcare system. However, with high and ever rising healthcare spending on cancer management, cancer patients and their families are likely to become vulnerable to a healthcare-related financial burden. Moreover, they may have to reduce their working hours and lose income. To better understand this issue, this study aims to assess the financial burden of colorectal cancer patients and their families in the first year following diagnosis. METHODS: Data on patient costs were collected prospectively in the first year following diagnosis by using a self-administered questionnaire and telephone interviews at three time points for all four stages of colorectal cancer. The patient cost data consisted of direct out-of-pocket payments for medical-related expenses such as hospital stays, tests and treatment and for non-medical items such as travel and food associated with hospital visits. In addition, indirect cost data related to the loss of productivity of the patient and caregiver(s) was assessed. The patient's perceived level of financial difficulty and types of coping strategy were also explored. RESULT: The total 1-year patient cost (both direct and indirect) increased with the stage of colorectal cancer: RM 6544.5 (USD 2045.1) for stage I, RM 7790.1 (USD 2434.4) for stage II, RM 8799.1 (USD 2749.7) for stage III and RM 8638.2 (USD 2699.4) for stage IV. The majority of patients perceived paying for their healthcare as somewhat difficult. The most frequently used financial coping strategy was a combination of current income and savings. CONCLUSION: Despite the high subsidisation in public hospitals, the management of colorectal cancer imposes a substantial financial burden on patients and their families. Moreover, the majority of patients and their families perceive healthcare payments as difficult. Therefore, it is recommended that policy- and decision-makers should further consider some financial protection strategies and support for cancer treatment because cancer is a very costly and chronic disease.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15659, title = {Different patterns of pfcrt and pfmdr1 polymorphism in Plasmodium falciparum isolates from Tehama region, Yemen}, author = {W M Atroosh and H M Al-Mekhlafi and A Al-Jasari and H Sady and S S Dawaki and F N Elyana and M A Al-Areeqi and N A Nasr and A M Abdulsalam and L R Subramaniam and M Azzani and I Ithoi and Y L Lau and J Surin}, doi = {10.7717/peerj.2191}, issn = {2167-8359 (Print)}, year = {2016}, date = {2016-01-01}, journal = {PeerJ}, volume = {4}, pages = {e2191}, abstract = {Introduction. Despite the efforts of the malaria control programme, malaria morbidity is still a common health problem in Yemen, with 60% of the population at risk. Plasmodium falciparum is responsible for 99% of malaria cases. The emergence in Yemen of parasite resistance to chloroquine (CQ) prompted the adoption of artemisinin combination therapy (ACT) in 2009, which involves the use of artesunate plus sulphadoxine-pyrimethamine (AS + SP). However, CQ was retained as the drug of choice for vivax malaria. To assess the impact of the change in the malaria treatment policy five years after its introduction, the present study investigated the mutations in the CQ resistance transporter (pfcrt) and multidrug resistance 1 (pfmdr1) genes. Method. A molecular investigation of 10 codons of pfcrt (72-76, 220, 271, 326, 356, and 371) and five codons of pfmdr1 (86, 184, 1034, 1042, and 1246) was conducted on P. falciparum isolates from districts with the highest malaria endemicity in the Hodeidah and Al-Mahwit governorates in Tehama region, Yemen. A total of 86 positive cases of falciparum monoinfection were investigated for the presence of mutations related to CQ and other antimalarials using a PCR-RFLP assay. Results. There was a wide prevalence of pfcrt gene mutations with the pfcrt 76T CQ resistance marker being predominant (97.7%). The prevalence of other pfcrt mutations varied from high (75E: 88%) to moderate (74I: 79.1%, 220S: 69.8%, 271E and 371I: 53.5%) or low (326S: 36%, 72S: 10.5%). Mutated pfcrt 72-76 amino acids haplotypes were highly prevalent (98.8%). Among these, the CVIET classic, old-world African/Southeast Asian haplotype was the most predominant, and was mostly found in the isolates from the Khamis Bani Saad district of Al-Mahwit (93.1%) and the AdDahi district of Hodeidah (88.9%). However, it was only found in 26.3% of the isolates from the Bajil district of Hodeidah. Surprisingly, the SVMNT new-world South American haplotype was exclusively detected in 9.3% of the isolates from the Bajil district of Hodeidah. Mutations at Y184F of pfmdr1 were found in all isolates (100%) from all districts. The mutation for codons 1034C and 86Y were found only in the isolates from the AdDahi and Khamis Bani Saad districts. Overall, the AdDahi and Khamis Bani Saad districts were similar in terms of carrying most of the mutations in the pfcrt and pfmdr1 genes, while there was a lower prevalence of mutation in the isolates from the Bajil district. Conclusion. The high prevalence of mutations in pfcrt 5 years after the official cessation of CQ use against P. falciparum suggests that there is sustained CQ pressure on P. falciparum isolates in the study area. Moreover, the low prevalence of mutations in the pfmdr1 gene could be a good indicator of the high susceptibility of P. falciparum isolates to antimalarials other than CQ. A new strategy to ensure the complete nationwide withdrawal of CQ from the private drug market is recommended.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15854, title = {Job satisfaction of Malaysian registered nurses: a qualitative study}, author = {N Atefi and K L Abdullah and L P Wong}, doi = {10.1111/nicc.12100}, issn = {1362-1017}, year = {2016}, date = {2016-01-01}, journal = {Nurs Crit Care}, volume = {21}, number = {1}, pages = {8-17}, abstract = {BACKGROUND: Job satisfaction is an important factor in health care settings. Strong empirical evidence supports a causal relationship between job satisfaction, patient safety and quality of care. However, there have not been any studies exploring the job satisfaction of Malaysian nurses. AIM: The main purpose of this qualitative descriptive study was to explore the factors related to feelings of job satisfaction as well as job dissatisfaction experienced by registered nurses in Malaysia. METHOD: A convenient sample of 46 Malaysian nurses recruited from a large hospital (number of beds = 895) participated in the study. A total of seven focus group discussions were conducted with nurses from surgical, medical and critical care wards. A semi-structured interview guide was used to facilitate the interviews, which were audio-recorded, transcribed verbatim and checked. The transcripts were used as data and were analysed using a thematic approach. FINDING: The study identified three main themes that influenced job satisfaction: (1) nurses' personal values and beliefs; (2) work environment factors and (3) motivation factors. Concerning the nurses' personal values and beliefs, the ability to help people made the nurses felt honoured and happy, which indirectly contributed to job satisfaction. For work environment factors, team cohesion, benefit and reward, working conditions play an important role in the nurses' job satisfaction. Motivation factors, namely, professional development and clinical autonomy contributed to job satisfaction. CONCLUSION: It is important for nurse leaders to provide more rewards, comfortable work environments and to understand issues that affect nurses' job satisfaction. RELEVANCE TO CLINICAL PRACTICE: Our findings highlight the importance of factors that can improve nurses' job satisfaction. The study provides basic information for hospital administrators in planning effective and efficient policies to improve nursing job satisfaction in order to increase the quality of patient care and decrease nursing turnover.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15677, title = {Overweight duration in older adults and cancer risk: a study of cohorts in Europe and the United States}, author = {M Arnold and H Freisling and R Stolzenberg-Solomon and F Kee and M G O'Doherty and J M Ordonez-Mena and T Wilsgaard and A M May and H B Bueno-de-Mesquita and A Tjonneland and P Orfanos and A Trichopoulou and P Boffetta and F Bray and M Jenab and I Soerjomataram}, doi = {10.1007/s10654-016-0169-z}, issn = {0393-2990}, year = {2016}, date = {2016-01-01}, journal = {Eur J Epidemiol}, volume = {31}, number = {9}, pages = {893-904}, abstract = {Recent studies have shown that cancer risk related to overweight and obesity is mediated by time and might be better approximated by using life years lived with excess weight. In this study we aimed to assess the impact of overweight duration and intensity in older adults on the risk of developing different forms of cancer. Study participants from seven European and one US cohort study with two or more weight assessments during follow-up were included (n = 329,576). Trajectories of body mass index (BMI) across ages were estimated using a quadratic growth model; overweight duration (BMI \>/= 25) and cumulative weighted overweight years were calculated. In multivariate Cox models and random effects analyses, a longer duration of overweight was significantly associated with the incidence of obesity-related cancer [overall hazard ratio (HR) per 10-year increment: 1.36; 95 % CI 1.12-1.60], but also increased the risk of postmenopausal breast and colorectal cancer. Additionally accounting for the degree of overweight further increased the risk of obesity-related cancer. Risks associated with a longer overweight duration were higher in men than in women and were attenuated by smoking. For postmenopausal breast cancer, increased risks were confined to women who never used hormone therapy. Overall, 8.4 % of all obesity-related cancers could be attributed to overweight at any age. These findings provide further insights into the role of overweight duration in the etiology of cancer and indicate that weight control is relevant at all ages. This knowledge is vital for the development of effective and targeted cancer prevention strategies.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15687, title = {Combined effects of smoking and HPV16 in oropharyngeal cancer}, author = {D Anantharaman and D C Muller and P Lagiou and W Ahrens and I Holcatova and F Merletti and K Kjaerheim and J Polesel and L Simonato and C Canova and X Castellsague and T V Macfarlane and A Znaor and P Thomson and M Robinson and D I Conway and C M Healy and A Tjonneland and U Westin and J Ekstrom and J Chang-Claude and R Kaaks and K Overvad and D Drogan and G Hallmans and G Laurell and H B Bueno-de-Mesquita and P H Peeters and A Agudo and N Larranaga and R C Travis and D Palli and A Barricarte and A Trichopoulou and S George and D Trichopoulos and J R Quiros and S Grioni and C Sacerdote and C Navarro and M J Sanchez and R Tumino and G Severi and M C Boutron-Ruault and F Clavel-Chapelon and S Panico and E Weiderpass and E Lund and I T Gram and E Riboli and M Pawlita and T Waterboer and A R Kreimer and M Johansson and P Brennan}, doi = {10.1093/ije/dyw069}, issn = {0300-5771}, year = {2016}, date = {2016-01-01}, journal = {Int J Epidemiol}, volume = {45}, number = {3}, pages = {752-61}, abstract = {BACKGROUND: Although smoking and HPV infection are recognized as important risk factors for oropharyngeal cancer, how their joint exposure impacts on oropharyngeal cancer risk is unclear. Specifically, whether smoking confers any additional risk to HPV-positive oropharyngeal cancer is not understood. METHODS: Using HPV serology as a marker of HPV-related cancer, we examined the interaction between smoking and HPV16 in 459 oropharyngeal (and 1445 oral cavity and laryngeal) cancer patients and 3024 control participants from two large European multi-centre studies. Odds ratios and credible intervals [CrI], adjusted for potential confounders, were estimated using Bayesian logistic regression. RESULTS: Both smoking [odds ratio (OR [CrI]: 6.82 [4.52, 10.29]) and HPV seropositivity (OR [CrI]: 235.69 [99.95, 555.74]) were independently associated with oropharyngeal cancer. The joint association of smoking and HPV seropositivity was consistent with that expected on the additive scale (synergy index [CrI]: 1.32 [0.51, 3.45]), suggesting they act as independent risk factors for oropharyngeal cancer. CONCLUSIONS: Smoking was consistently associated with increase in oropharyngeal cancer risk in models stratified by HPV16 seropositivity. In addition, we report that the prevalence of oropharyngeal cancer increases with smoking for both HPV16-positive and HPV16-negative persons. The impact of smoking on HPV16-positive oropharyngeal cancer highlights the continued need for smoking cessation programmes for primary prevention of head and neck cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15710, title = {Tobacco smoking-associated genome-wide DNA methylation changes in the EPIC study}, author = {S Ambatipudi and C Cuenin and H Hernandez-Vargas and A Ghantous and F Le Calvez-Kelm and R Kaaks and M Barrdahl and H Boeing and K Aleksandrova and A Trichopoulou and P Lagiou and A Naska and D Palli and V Krogh and S Polidoro and R Tumino and S Panico and B Bueno-de-Mesquita and P H Peeters and J R Quiros and C Navarro and E Ardanaz and M Dorronsoro and T Key and P Vineis and N Murphy and E Riboli and I Romieu and Z Herceg}, doi = {10.2217/epi-2016-0001}, issn = {1750-192x}, year = {2016}, date = {2016-01-01}, journal = {Epigenomics}, volume = {8}, number = {5}, pages = {599-618}, abstract = {AIM: Epigenetic changes may occur in response to environmental stressors, and an altered epigenome pattern may represent a stable signature of environmental exposure. MATERIALS \& METHODS: Here, we examined the potential of DNA methylation changes in 910 prediagnostic peripheral blood samples as a marker of exposure to tobacco smoke in a large multinational cohort. RESULTS: We identified 748 CpG sites that were differentially methylated between smokers and nonsmokers, among which we identified novel regionally clustered CpGs associated with active smoking. Importantly, we found a marked reversibility of methylation changes after smoking cessation, although specific genes remained differentially methylated up to 22 years after cessation. CONCLUSION: Our study has comprehensively cataloged the smoking-associated DNA methylation alterations and showed that these alterations are reversible after smoking cessation.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15668, title = {Selenium and Prostate Cancer: Analysis of Individual Participant Data From Fifteen Prospective Studies}, author = {N E Allen and R C Travis and P N Appleby and D Albanes and M J Barnett and A Black and H B Bueno-de-Mesquita and M Deschasaux and P Galan and G E Goodman and P J Goodman and M J Gunter and M Heliovaara and K J Helzlsouer and B E Henderson and S Hercberg and P Knekt and L N Kolonel and C Lasheras and J Linseisen and E J Metter and M L Neuhouser and A Olsen and V Pala and E A Platz and H Rissanen and M E Reid and J M Schenk and M J Stampfer and P Stattin and C M Tangen and M Touvier and A Trichopoulou and P A Brandt and T J Key}, doi = {10.1093/jnci/djw153}, issn = {0027-8874}, year = {2016}, date = {2016-01-01}, journal = {J Natl Cancer Inst}, volume = {108}, number = {11}, abstract = {BACKGROUND: Some observational studies suggest that a higher selenium status is associated with a lower risk of prostate cancer but have been generally too small to provide precise estimates of associations, particularly by disease stage and grade. METHODS: Collaborating investigators from 15 prospective studies provided individual-participant records (from predominantly men of white European ancestry) on blood or toenail selenium concentrations and prostate cancer risk. Odds ratios of prostate cancer by selenium concentration were estimated using multivariable-adjusted conditional logistic regression. All statistical tests were two-sided. RESULTS: Blood selenium was not associated with the risk of total prostate cancer (multivariable-adjusted odds ratio [OR] per 80 percentile increase = 1.01, 95% confidence interval [CI] = 0.83 to 1.23, based on 4527 case patients and 6021 control subjects). However, there was heterogeneity by disease aggressiveness (ie, advanced stage and/or prostate cancer death}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15653, title = {Vitamin D deficiency in Malaysian adolescents aged 13 years: findings from the Malaysian Health and Adolescents Longitudinal Research Team study (MyHeARTs)}, author = {N Al-Sadat and H A Majid and P Y Sim and T T Su and M Dahlui and M F Abu Bakar and N Dzaki and S Norbaya and L Murray and M M Cantwell and M Y Jalaludin}, doi = {10.1136/bmjopen-2015-010689}, issn = {2044-6055}, year = {2016}, date = {2016-01-01}, journal = {BMJ Open}, volume = {6}, number = {8}, pages = {e010689}, abstract = {OBJECTIVE: To determine the prevalence of vitamin D deficiency (\<37.5 nmol/L) among young adolescents in Malaysia and its association with demographic characteristics, anthropometric measures and physical activity. DESIGN: This is a cross-sectional study among Form 1 (year 7) students from 15 schools selected using a stratified random sampling design. Information regarding sociodemographic characteristics, clinical data and environmental factors was collected and blood samples were taken for total vitamin D. Descriptive and multivariable logistic regression was performed on the data. SETTING: National secondary schools in Peninsular Malaysia. PARTICIPANTS: 1361 students (mean age 12.9+/-0.3 years) (61.4% girls) completed the consent forms and participated in this study. Students with a chronic health condition and/or who could not understand the questionnaires due to lack of literacy were excluded. MAIN OUTCOME MEASURES: Vitamin D status was determined through measurement of sera 25-hydroxyvitamin D (25(OH)D). Body mass index (BMI) was classified according to International Obesity Task Force (IOTF) criteria. Self-reported physical activity levels were assessed using the validated Malay version of the Physical Activity Questionnaire for Older Children (PAQ-C). RESULTS: Deficiency in vitamin D was seen in 78.9% of the participants. The deficiency was significantly higher in girls (92.6%, p\<0.001), Indian adolescents (88.6%, p\<0.001) and urban-living adolescents (88.8%, p\<0.001). Females (OR=8.98; 95% CI 6.48 to 12.45), adolescents with wider waist circumference (OR=2.64; 95% CI 1.65 to 4.25) and in urban areas had higher risks (OR=3.57; 95% CI 2.54 to 5.02) of being vitamin D deficient. CONCLUSIONS: The study shows a high prevalence of vitamin D deficiency among young adolescents. Main risk factors are gender, ethnicity, place of residence and obesity.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15692, title = {Understanding of elder abuse and neglect among health care professionals in Malaysia: An exploratory survey}, author = {A Ahmed and W Y Choo and S Othman and N N Hairi and F M Hairi and F H Mohd Mydin and S N Illiani Jaafar}, doi = {10.1080/08946566.2016.1185985}, issn = {0894-6566}, year = {2016}, date = {2016-01-01}, journal = {J Elder Abuse Negl}, volume = {28}, number = {3}, pages = {163-77}, abstract = {Elder abuse and neglect (EAN) is a hidden public health challenge for Malaysia. This cross-sectional survey studied the awareness of EAN among 148 doctors and nurses from two neighboring states in Malaysia using a self-administered questionnaire exploring their knowledge, perceptions, practices, and experience concerning EAN. Both doctors and nurses demonstrated poor understanding of signs of EAN and exhibited misperceptions on reporting requirements. Both groups perceived EAN as a national burden and reporting it as their responsibility; but most felt they had not been trained to diagnose it. Many were unsure of procedures and whether their own intervention could be effective. Only four (nurses) of 41 participants who suspected abuse during the past year reported the cases. Targeted education and uniform protocols are mandatory to ensure best practice with regards to EAN. Further research is crucial to extend this inquiry into the broader health care workforce.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15744, title = {Application of TOPSIS and VIKOR improved versions in a multi criteria decision analysis to develop an optimized municipal solid waste management model}, author = {M Aghajani Mir and P Taherei Ghazvinei and N M Sulaiman and N E Basri and S Saheri and N Z Mahmood and A Jahan and R A Begum and N Aghamohammadi}, doi = {10.1016/j.jenvman.2015.09.028}, issn = {0301-4797}, year = {2016}, date = {2016-01-01}, journal = {J Environ Manage}, volume = {166}, pages = {109-15}, abstract = {Selecting a suitable Multi Criteria Decision Making (MCDM) method is a crucial stage to establish a Solid Waste Management (SWM) system. Main objective of the current study is to demonstrate and evaluate a proposed method using Multiple Criteria Decision Making methods (MCDM). An improved version of Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) applied to obtain the best municipal solid waste management method by comparing and ranking the scenarios. Applying this method in order to rank treatment methods is introduced as one contribution of the study. Besides, Viekriterijumsko Kompromisno Rangiranje (VIKOR) compromise solution method applied for sensitivity analyses. The proposed method can assist urban decision makers in prioritizing and selecting an optimized Municipal Solid Waste (MSW) treatment system. Besides, a logical and systematic scientific method was proposed to guide an appropriate decision-making. A modified TOPSIS methodology as a superior to existing methods for first time was applied for MSW problems. Applying this method in order to rank treatment methods is introduced as one contribution of the study. Next, 11 scenarios of MSW treatment methods are defined and compared environmentally and economically based on the waste management conditions. Results show that integrating a sanitary landfill (18.1%), RDF (3.1%), composting (2%), anaerobic digestion (40.4%), and recycling (36.4%) was an optimized model of integrated waste management. An applied decision-making structure provides the opportunity for optimum decision-making. Therefore, the mix of recycling and anaerobic digestion and a sanitary landfill with Electricity Production (EP) are the preferred options for MSW management.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15694, title = {Role of Individual, Family, and Peers in Sexual Initiation Among Late Adolescents Attending Institutions of Higher Learning in Malaysia}, author = {S Abdul Samad and N N Hairi and M Ismail}, doi = {10.1177/1010539516645158}, issn = {1010-5395}, year = {2016}, date = {2016-01-01}, journal = {Asia Pac J Public Health}, volume = {28}, number = {4}, pages = {313-24}, abstract = {This cross-sectional study aimed to determine the prevalence and the factors associated with sexual initiation among the late adolescents in 6 institutions of higher learning in Malaysia. A total of 1572 students completed self-administered questionnaires between April and September 2013. Hierarchical multivariate logistic regression analyses stratified by gender were employed to identify the correlates of sexual initiation. The analyses were further adjusted by sampling weights. The overall prevalence of sexual initiation was 9.8% (95% confidence interval [CI] = 8.3-11.6), 18.1% (95% CI = 15.1-21.5) among males, and 4.1% (95% CI = 2.9-5.9) among females. The risk factors identified in this study supported the influence of the individual, family, and peer factors in the social-ecological model on adolescents' behaviors. The findings suggest the need for risk-reduction strategies aimed at the individual, family, and peer levels as well as the importance of gender-specific focus in assuring better outcomes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15688, title = {Dietary Intake among Adolescents in a Middle-Income Country: An Outcome from the Malaysian Health and Adolescents Longitudinal Research Team Study (the MyHeARTs Study)}, author = {H Abdul Majid and L Ramli and S P Ying and T T Su and M Y Jalaludin and N A Abdul Mohsein}, doi = {10.1371/journal.pone.0155447}, issn = {1932-6203}, year = {2016}, date = {2016-01-01}, journal = {PLoS One}, volume = {11}, number = {5}, pages = {e0155447}, abstract = {Optimal nutrition is essential for healthy growth during adolescence. This study aims to investigate the baseline nutritional intake of Malaysian adolescents by gender, body mass index, and places of residence, both urban and rural. A cohort study was conducted consisting of 794 adolescents (aged 13-years) attending 15 public secondary schools from the Central (Kuala Lumpur and Selangor) and Northern (Perak) Regions of Peninsular Malaysia. Qualified dietitians conducted a 7-day historical assessment of habitual food intakes. Facilitated by flipcharts and household measurement tools, detailed information on portion sizes and meal contents were recorded. Nutritionist Pro Diet Analysis software was also used to analyze the dietary records.The mean age of the adolescents was 12.86 +/- 0.33 y; the mean energy intake was 1659.0 +/- 329.6 kcal/d. Males had significantly (P \< .001) higher energy intake than females (1774.0 +/- 369.8 vs 1595.2 +/- 320.6 kcal/d); adolescents in rural schools consumed more energy and cholesterol (P \< .001) compared to adolescents in urban schools (1706.1 +/- 377.7 kcal/d and 244.1 +/- 100.2 mg/d, respectively). Obese adolescents in rural schools consumed more energy and sugar (1987.6 +/- 374.0 kcal/d and 48.9 +/- 23.0 g/d) (p-value \<0.001).The dietary intake of normal weight versus obese adolescents differs by the location of their school. Thus, the implementation of a structured and tailored intervention is recommended to help minimize this nutritional inequality.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15724, title = {A Longitudinal Study of Association between Adiposity Markers and Intraocular Pressure: The Kangbuk Samsung Health Study}, author = {D Zhao and M H Kim and R Pastor-Barriuso and Y Chang and S Ryu and Y Zhang and S Rampal and H Shin and J M Kim and D S Friedman and E Guallar and J Cho}, doi = {10.1371/journal.pone.0146057}, issn = {1932-6203}, year = {2016}, date = {2016-01-01}, journal = {PLoS One}, volume = {11}, number = {1}, pages = {e0146057}, abstract = {IMPORTANCE: Intraocular pressure (IOP) reduction or stabilization is the only proven method for glaucoma management. Identifying risk factors for IOP is crucial to understand the pathophysiology of glaucoma. OBJECTIVE: To examine the associations of change in body mass index (BMI), waist circumference, and percent fat mass with change in intraocular pressure (IOP) in a large sample of Korean adults. DESIGN, SETTING AND PARTICIPANTS: Cohort study of 274,064 young and middle age Korean adults with normal fundoscopic findings who attended annual or biennial health exams from January 1, 2002 to Feb 28, 2010 (577,981 screening visits). EXPOSURES: BMI, waist circumference, and percent fat mass. MAIN OUTCOME MEASURE(S): At each visit, IOP was measured in both eyes with automated noncontact tonometers. RESULTS: In multivariable-adjusted models, the average increase in IOP (95% confidence intervals) over time per interquartile increase in BMI (1.26 kg/m2), waist circumference (6.20 cm), and percent fat mass (3.40%) were 0.18 mmHg (0.17 to 0.19), 0.27 mmHg (0.26 to 0.29), and 0.10 mmHg (0.09 to 0.11), respectively (all P \< 0.001). The association was stronger in men compared to women (P \< 0.001) and it was only slightly attenuated after including diabetes and hypertension as potential mediators in the model. CONCLUSIONS AND RELEVANCE: Increases in adiposity were significantly associated with an increase in IOP in a large cohort of Korean adults attending health screening visits, an association that was stronger for central obesity. Further research is needed to understand better the underlying mechanisms of this association, and to establish the role of weight gain in increasing IOP and the risk of glaucoma and its complications.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15651, title = {Three new pancreatic cancer susceptibility signals identified on chromosomes 1q32.1, 5p15.33 and 8q24.21}, author = {M Zhang and Z Wang and O Obazee and J Jia and E J Childs and J Hoskins and G Figlioli and E Mocci and I Collins and C C Chung and C Hautman and A A Arslan and L Beane-Freeman and P M Bracci and J Buring and E J Duell and S Gallinger and G G Giles and G E Goodman and P J Goodman and A Kamineni and L N Kolonel and M H Kulke and N Malats and S H Olson and H D Sesso and K Visvanathan and E White and W Zheng and C C Abnet and D Albanes and G Andreotti and L Brais and H B Bueno-de-Mesquita and D Basso and S I Berndt and M C Boutron-Ruault and M F Bijlsma and H Brenner and L Burdette and D Campa and N E Caporaso and G Capurso and G M Cavestro and M Cotterchio and E Costello and J Elena and U Boggi and J M Gaziano and M Gazouli and E L Giovannucci and M Goggins and M Gross and C A Haiman and M Hassan and K J Helzlsouer and N Hu and D J Hunter and E Iskierka-Jazdzewska and M Jenab and R Kaaks and T J Key and K T Khaw and E A Klein and M Kogevinas and V Krogh and J Kupcinskas and R C Kurtz and M T Landi and S Landi and L Le Marchand and A Mambrini and S Mannisto and R L Milne and R E Neale and A L Oberg and S Panico and A V Patel and P H Peeters and U Peters and R Pezzilli and M Porta and M Purdue and J R Quiros and E Riboli and N Rothman and A Scarpa and G Scelo and X O Shu and D T Silverman and P Soucek and O Strobel and M Sund and E Malecka-Panas and P R Taylor and F Tavano and R C Travis and M Thornquist and A Tjonneland and G S Tobias and others}, doi = {10.18632/oncotarget.11041}, issn = {1949-2553}, year = {2016}, date = {2016-01-01}, journal = {Oncotarget}, volume = {7}, number = {41}, pages = {66328-66343}, abstract = {Genome-wide association studies (GWAS) have identified common pancreatic cancer susceptibility variants at 13 chromosomal loci in individuals of European descent. To identify new susceptibility variants, we performed imputation based on 1000 Genomes (1000G) Project data and association analysis using 5,107 case and 8,845 control subjects from 27 cohort and case-control studies that participated in the PanScan I-III GWAS. This analysis, in combination with a two-staged replication in an additional 6,076 case and 7,555 control subjects from the PANcreatic Disease ReseArch (PANDoRA) and Pancreatic Cancer Case-Control (PanC4) Consortia uncovered 3 new pancreatic cancer risk signals marked by single nucleotide polymorphisms (SNPs) rs2816938 at chromosome 1q32.1 (per allele odds ratio (OR) = 1.20}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15766, title = {Energy and macronutrient intake and risk of differentiated thyroid carcinoma in the European Prospective Investigation into Cancer and Nutrition study}, author = {R Zamora-Ros and S Rinaldi and K K Tsilidis and E Weiderpass and M C Boutron-Ruault and A L Rostgaard-Hansen and A Tjonneland and F Clavel-Chapelon and S Mesrine and V A Katzke and T Kuhn and J Forster and H Boeing and A Trichopoulou and P Lagiou and E Klinaki and G Masala and S Sieri and F Ricceri and R Tumino and A Mattiello and P H Peeters and H B Bueno-de-Mesquita and D Engeset and G Skeie and M Arguelles and A Agudo and M J Sanchez and M D Chirlaque and A Barricarte and S Chamosa and M Almquist and A Tosovic and J Hennings and M Sandstrom and J A Schmidt and K T Khaw and N J Wareham and A J Cross and N Slimani and G Byrnes and I Romieu and E Riboli and S Franceschi}, doi = {10.1002/ijc.29693}, issn = {0020-7136}, year = {2016}, date = {2016-01-01}, journal = {Int J Cancer}, volume = {138}, number = {1}, pages = {65-73}, abstract = {Incidence rates of differentiated thyroid carcinoma (TC) have increased in many countries. Adiposity and dietary risk factors may play a role, but little is known on the influence of energy intake and macronutrient composition. The aim of this study was to investigate the associations between TC and the intake of energy, macronutrients, glycemic index (GI) and glycemic load in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 477,274 middle-age participants (70.2% women) from ten European countries. Dietary data were collected using country-specific validated dietary questionnaires. Total carbohydrates, proteins, fats, saturated, monounsaturated and polyunsaturated fats (PUFA), starch, sugar, and fiber were computed as g/1,000 kcal. Multivariable Cox regression was used to calculate multivariable adjusted hazard ratios (HR) and 95% confidence interval (CI) by intake quartile (Q). After a mean follow-up time of 11 years, differentiated TC was diagnosed in 556 participants (90% women). Overall, we found significant associations only with total energy (HRQ4 vs .Q1 , 1.29; 95% CI, 1.00-1.68) and PUFA intakes (HRQ4 vs .Q1 , 0.74; 95% CI, 0.57-0.95). However, the associations with starch and sugar intake and GI were significantly heterogeneous across body mass index (BMI) groups, i.e., positive associations with starch and GI were found in participants with a BMI \>/= 25 and with sugar intake in those with BMI \< 25. Moreover, inverse associations with starch and GI were observed in subjects with BMI \< 25. In conclusion, our results suggest that high total energy and low PUFA intakes may increase the risk of differentiated TC. Positive associations with starch intake and GI in participants with BMI \>/= 25 suggest that those persons may have a greater insulin response to high starch intake and GI than lean people.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15777, title = {Dietary polyphenol intake in Europe: the European Prospective Investigation into Cancer and Nutrition (EPIC) study}, author = {R Zamora-Ros and V Knaze and J A Rothwell and B Hemon and A Moskal and K Overvad and A Tjonneland and C Kyro and G Fagherazzi and M C Boutron-Ruault and M Touillaud and V Katzke and T Kuhn and H Boeing and J Forster and A Trichopoulou and E Valanou and E Peppa and D Palli and C Agnoli and F Ricceri and R Tumino and M S Magistris and P H Peeters and H B Bueno-de-Mesquita and D Engeset and G Skeie and A Hjartaker and V Menendez and A Agudo and E Molina-Montes and J M Huerta and A Barricarte and P Amiano and E Sonestedt and L M Nilsson and R Landberg and T J Key and K T Khaw and N J Wareham and Y Lu and N Slimani and I Romieu and E Riboli and A Scalbert}, doi = {10.1007/s00394-015-0950-x}, issn = {1436-6207}, year = {2016}, date = {2016-01-01}, journal = {Eur J Nutr}, volume = {55}, number = {4}, pages = {1359-75}, abstract = {BACKGROUND/OBJECTIVES: Polyphenols are plant secondary metabolites with a large variability in their chemical structure and dietary occurrence that have been associated with some protective effects against several chronic diseases. To date, limited data exist on intake of polyphenols in populations. The current cross-sectional analysis aimed at estimating dietary intakes of all currently known individual polyphenols and total intake per class and subclass, and to identify their main food sources in the European Prospective Investigation into Cancer and Nutrition cohort. METHODS: Dietary data at baseline were collected using a standardized 24-h dietary recall software administered to 36,037 adult subjects. Dietary data were linked with Phenol-Explorer, a database with data on 502 individual polyphenols in 452 foods and data on polyphenol losses due to cooking and food processing. RESULTS: Mean total polyphenol intake was the highest in Aarhus-Denmark (1786 mg/day in men and 1626 mg/day in women) and the lowest in Greece (744 mg/day in men and 584 mg/day in women). When dividing the subjects into three regions, the highest intake of total polyphenols was observed in the UK health-conscious group, followed by non-Mediterranean (non-MED) and MED countries. The main polyphenol contributors were phenolic acids (52.5-56.9 %), except in men from MED countries and in the UK health-conscious group where they were flavonoids (49.1-61.7 %). Coffee, tea, and fruits were the most important food sources of total polyphenols. A total of 437 different individual polyphenols were consumed, including 94 consumed at a level \>1 mg/day. The most abundant ones were the caffeoylquinic acids and the proanthocyanidin oligomers and polymers. CONCLUSION: This study describes the large number of dietary individual polyphenols consumed and the high variability of their intakes between European populations, particularly between MED and non-MED countries.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15589, title = {Prevalence of falls among community-dwelling elderly and its associated factors: A cross-sectional study in Perak, Malaysia}, author = {U Y Yeong and S Y Tan and J F Yap and W Y Choo}, issn = {1985-207X (Print) 1985-2274}, year = {2016}, date = {2016-01-01}, journal = {Malays Fam Physician}, volume = {11}, number = {1}, pages = {7-14}, abstract = {INTRODUCTION: Fall is a major cause of injuries and can increase the risk of early mortality among elderly. The objective of this study was to determine the prevalence of falls among community-dwelling elderly in rural Malaysia and its associated factors. METHODS: Data were obtained from a cross-sectional survey in five randomly selected districts in the state of Perak, Malaysia. A total of 250 households were randomly selected. A total of 811 individuals aged 60 years or more were recruited and interviewed using a structured questionnaire. Information about socio-demographic, history of falls in the past 1 year, medical history, drug history and physical activity level were enquired. RESULTS: The prevalence of falls in the past 1 year among community-dwelling elderly was reported to be 4.07%. Indigenous elderly (Adjusted odd ratio}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15700, title = {Antenatal Care Utilisation and Content between Low-Risk and High-Risk Pregnant Women}, author = {P L Yeoh and K Hornetz and M Dahlui}, doi = {10.1371/journal.pone.0152167}, issn = {1932-6203}, year = {2016}, date = {2016-01-01}, journal = {PLoS One}, volume = {11}, number = {3}, pages = {e0152167}, abstract = {BACKGROUND: The purpose of antenatal care is to monitor and improve the wellbeing of the mother and foetus. The World Health Organization recommends risk-oriented strategy that includes: (i) routine care to all women, (ii) additional care for women with moderately severe diseases and complications, (iii) specialised obstetrical and neonatal care for women with severe diseases and complications. Antenatal care is concerned with adequate care in order to be effective. Measurement for adequacy of antenatal care often applies indexes that assess initiation of care and number of visits. In addition, adequacy of care content should also be assessed. Results of studies in developed settings demonstrate that women without risk factors use antenatal services more frequently than recommended. Such over-utilisation is problematic for low-resourced settings. Moreover, studies show that a substantial proportion of high-risk women had utilisation or content of care below the recommended standard. Yet studies in developing countries have seldom included a comparison between low-risk and high-risk women. The purpose of the study was therefore to assess adequacy of care and pregnancy outcomes for the different risk groups. METHODS: A retrospective study using a multistage sampling technique, at public-funded primary health care clinics was conducted. Antenatal utilisation level was assessed using a modified Adequacy of Prenatal Care Utilisation index that measures the timing for initiation of care and observed-to-expected visits ratio. Adequacy of antenatal care content assessed compliance to routine care based on the local guidelines. RESULTS: Intensive or "adequate-plus" antenatal care utilisation as defined by the modified index was noted in over half of the low-risk women. On the other hand, there were 26% of the high-risk women without the expected intensive utilisation. Primary- or non-educated high-risk women were less likely to have a higher antenatal care utilisation level compared with tertiary educated ones (OR = 0.20}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15648, title = {Nationwide Survey of Knowledge and Health Beliefs regarding Human Papillomavirus among HPV-Vaccinated Female Students in Malaysia}, author = {L P Wong and R N Raja Muhammad Yusoff and Z Edib and I C Sam and G D Zimet}, doi = {10.1371/journal.pone.0163156}, issn = {1932-6203}, year = {2016}, date = {2016-01-01}, journal = {PLoS One}, volume = {11}, number = {9}, pages = {e0163156}, abstract = {The National HPV Immunization Programme, which offers free human papillomavirus (HPV) vaccines to teenaged female students, was launched in Malaysia in 2010. HPV vaccination paired with adequate knowledge about HPV infection provides the best protection against cervical cancer. To identify the level of knowledge and the health beliefs towards HPV and the HPV vaccine among HPV-vaccinated female students in Malaysia. A nationwide cross-sectional survey among 14 years old female students who had received three doses of the HPV vaccine was conducted in 32 randomly selected schools from 13 states and 3 federal territories in Malaysia between February 2013 and April 2013. Among 2482 respondents, knowledge about HPV infection and the HPV vaccine was extremely poor. The mean total knowledge score was only 3.56 (SD +/- 1.76), out of a possible score of 10. The majority of respondents were unaware that vaccinating boys with HPV can help protect girls against HPV infection (91.6%), HPV cannot be cured (81.6%) and that HPV is a sexually transmitted infection (70.3%). Most of the respondents had the misconception that only females get HPV (95.1%), and that the HPV vaccine eliminates the need for Pap smear tests (68.3%). Most respondents (91.6%) believed that they would not get an HPV infection. Almost half of the respondents (42.9%) held the misconception that HPV infection could not lead to serious illness. Findings revealed poor knowledge about both HPV and the HPV vaccine, low perceived susceptibility to HPV infection and misinformation about HPV infection among HPV-vaccinated girls. Therefore, it is essential to increase the knowledge and awareness of health risks regarding HPV infection among teenaged girls who have received the HPV vaccine.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15638, title = {Reasons for Using Electronic Cigarettes and Intentions to Quit Among Electronic Cigarette Users in Malaysia}, author = {L P Wong and S M Mohamad Shakir and H Alias and N Aghamohammadi and V C Hoe}, doi = {10.1007/s10900-016-0196-4}, issn = {0094-5145}, year = {2016}, date = {2016-01-01}, journal = {J Community Health}, volume = {41}, number = {6}, pages = {1101-1109}, abstract = {The rapidly increasing uptake of e-cigarettes in Malaysia as of late demands a study to identify factors leading to its increased popularity and user intentions to quit smoking e-cigarettes. A convenience sample of e-cigarette smokers visiting e-cigarette retail shops in Selangor and Kuala Lumpur was recruited. The majority of e-cigarette smokers were youth in colleges or universities (39 %), and young professionals and managers (36 %). The main reasons for using e-cigarettes were to help the user quit tobacco cigarettes (88 %), the perception that e-cigarettes are not as intrusive as tobacco cigarettes (85 %) and can be used in public areas (70 %), the perception that e-cigarettes are healthier than tobacco cigarettes (85 %), and its relatively lower cost compared to tobacco cigarettes (65 %). A total of 65.3 % of respondents expressed intentions to quit e-cigarettes. In a multivariate analysis, the respondents who earned monthly income of RM1000 or less were significantly more likely to intend to quit smoking e-cigarettes [OR 1.551; 95 % CI 1.022-2.355; p = 0.015] compared to the respondents who earned a monthly income of more than RM2000. The respondents who disagreed with the statement 'Smoking e-cigs is relatively cheaper compared to tobacco cigarettes' were significantly more likely to intend to quit smoking e-cigarettes [OR 1.548; 95 % CI 1.045-2.293; p = 0.027] compared to respondents who did not agree. e-cigarette preventive interventions should target areas related to the identified main reasons for using e-cigarettes, namely as an aid for quitting tobacco cigarettes, the perception that e-cigarettes are not as intrusive as tobacco cigarettes and can be used in public areas, the idea that e-cigarettes are healthier than tobacco cigarettes, and its relatively lower cost compared to tobacco cigarettes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15655, title = {Nationwide study of factors associated with public's willingness to use home self-test kit for dengue fever in Malaysia}, author = {L P Wong and N Atefi and S AbuBakar}, doi = {10.1186/s12889-016-3409-y}, issn = {1471-2458}, year = {2016}, date = {2016-01-01}, journal = {BMC Public Health}, volume = {16}, pages = {780}, abstract = {BACKGROUND: As there is no specific treatment for dengue, early detection and access to proper treatment may lower dengue fatality. Therefore, having new techniques for the early detection of dengue fever, such as the use of dengue test kit, is vitally important. The aims of the study were: 1) identify factors associated with acceptance of a home self-test kit for dengue fever if the dengue test is available to the public and 2) find out the characteristics of the test kits that influence the use of the dengue test kit. METHODS: A national telephone survey was carried out with 2,512 individuals of the Malaysian public aged 18-60 years old. Individuals were contacted by random digit dialling covering the whole of Malaysia from February 2012 to June 2013. RESULTS: From 2,512 participants, 6.1 % reported to have heard of the availability of the dengue home test kit and of these, 44.8 % expressed their intention to use the test kit if it was available. Multivariate logistic regressions indicated that participants with primary (OR: 0.65; 95 % CI: 0.43-0.89; p = 0.02, vs. tertiary educational level) and secondary educational levels (OR: 0.73; 95 % CI: 0.57-0.90; p = 0.01, vs. tertiary educational level) were less likely than participants with a tertiary educational level to use a home self-testing dengue kit for dengue if the kit was available. Participants with lower perceived barriers to dengue prevention (level of barriers 0-5) were less likely (OR: 0.67, 95 % CI: 0.53-0.85, p \< 0.001, vs. higher perceived barriers) to use a home self-testing dengue kit for dengue if the kit was available compared to those with higher perceived barriers to dengue prevention (level of barriers 6-10). Participants with a lower total dengue fever knowledge score (range 0-22) were also less likely to use a home self-testing dengue kit for dengue if the kit was available (OR: 0.75; 95 % CI: 0.61-0.91}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15626, title = {The Self-Regulation Model of Illness: Comparison between Zika and Dengue and Its Application to Predict Mosquito Prevention Behaviours in Malaysia, a Dengue-Endemic Country}, author = {L P Wong and H Alias and N Aghamohammadi and I C Sam and S AbuBakar}, doi = {10.3390/ijerph13121210}, issn = {1660-4601}, year = {2016}, date = {2016-01-01}, journal = {Int J Environ Res Public Health}, volume = {13}, number = {12}, abstract = {Perceptions about illnesses may influence self-care and preventive health behaviours. Illness perceptions of the Zika virus (ZIKV) infection were investigated under the framework of the Self-Regulation Model of Illness. Illness perception differences between ZIKV and dengue fever were also examined. Lastly, associations between illness perceptions of ZIKV with mosquito prevention practices were studied. Samples were drawn from landline telephone numbers using computer-assisted telephone interviewing in Malaysia. A total of 567 respondents completed the survey between February 2015 and May 2016. The median and interquartile range (IQR) for the total six dimensions of illness perceptions score was higher for dengue (23.0 (IQR 17.0-28.0)) than ZIKV (20.0 (IRQ 11.0-28.0)), p \< 0.001. Respondents who planned to have children (OR 1.670, 95% CI 1.035-2.694 vs. no intention to have children) and had friends or acquaintances who died of dengue (OR 2.372, 95% CI 1.300-4.327 vs. no friends who died of dengue) were more likely to have a higher total score for six illness perceptions for ZIKV compared to dengue. Multivariate analysis indicated that the best predictors for mosquito control practices after the ZIKV outbreak was declared a Public Health Emergency of International Concern, in descending order, were causes, control, timeline, and consequences dimensions of illness perception. Understanding the context in which a person perceives ZIKV may contribute to developing interventions that influence prevention behaviours.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15663, title = {Shisha Smoking Practices, Use Reasons, Attitudes, Health Effects and Intentions to Quit among Shisha Smokers in Malaysia}, author = {L P Wong and H Alias and N Aghamohammadi and S Aghazadeh and V C Hoe}, doi = {10.3390/ijerph13070726}, issn = {1660-4601}, year = {2016}, date = {2016-01-01}, journal = {Int J Environ Res Public Health}, volume = {13}, number = {7}, abstract = {Despite its popularity, shisha smoking practices, reasons for its use, attitudes, detrimental health effects and intention to quit among shisha users in Malaysia have never been investigated. A total of 503 shisha users responded to a cross-sectional study conducted between July 2015 and March 2016. The majority of users were young people aged 21-30; a small minority were underage. The reasons for shisha use were its growing popularity as a favourite pastime activity and the perception of shisha use as cool and trendy. Just over half (57.3%) agree that shisha use exposes the smoker to large amounts of smoke and the majority were unsure about the health risks of shisha smoking compared to tobacco smoking. The three most common detrimental health effects reported by the study respondents were dry throat, headache and nausea. Regular shisha users have significantly higher detrimental health effects compared to no-regular shisha users. Shisha users with a duration of smoking of 6-12 months (odds ratio (OR) 3.212; 95% confidence interval (CI) 1.651-6.248) and 6 months and below (OR 2.601; 95% CI 1.475-4.584) were significantly more likely to have a higher proportion who intend quitting smoking than shisha users of more than 12 months duration.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15637, title = {Factors affecting the employability in people with epilepsy}, author = {M C Wo and K S Lim and W Y Choo and C T Tan}, doi = {10.1016/j.eplepsyres.2016.10.003}, issn = {0920-1211}, year = {2016}, date = {2016-01-01}, journal = {Epilepsy Res}, volume = {128}, pages = {6-11}, abstract = {PURPOSE: People with epilepsy (PWE) are negatively prejudiced in their ability to work. This study aimed to examine demographic, clinical and psychological factors associated with employability in PWE. METHODS: This study recruited epilepsy patients from a neurology clinic in Malaysia. Employability was measured using employment ratio, with a ratio \>/=90% (ER90) classified as high employability. Basic demographic data such as age, gender, marital status, religion, education level and household income was collected. Clinical measures consisted of age of seizure onset, seizure frequency, type of epilepsy, aura, polytherapy, nocturnal seizures and seizure control. Psychological measures included Work Self-Determination Index (WSDI), Rosenberg Self-Esteem Scale (SES), and Multidimensional Scale of Perceived Social Support (MSPSS). RESULTS: Of 146 PWE, 64.4% had high employability. The participants were predominantly female (52%), Chinese (50.7%), single (50%), having tertiary education (55.5%) and focal epilepsy (72.6%). Clinically, only type of epilepsy was significantly correlated to employability of PWE. Employability of PWE was associated with ability to work (indicated by education level, work performance affected by seizures, ability to travel independently and ability to cope with stress at work) and family overprotection. The high employability group was found to have lower self-perceived stigma (ESS), higher self-determined motivation (WSDI), self-esteem (SES) and perceived social support (MSPSS), than the low employability group. Logistic regression analysis showed that tertiary education level (AOR 3.42, CI: 1.46-8.00), higher self-determination (WSDI, AOR 1.09, CI: 1.012-1.17), lower family overprotection (AOR 0.76, CI: 0.61-0.95), and generalised epilepsy (AOR 4.17, CI: 1.37-12.70) were significant predictors for higher employability in PWE. CONCLUSION: Ability to work (education level), clinical factor (type of epilepsy) and psychological factor (self-determined motivation and family overprotection) were important factors affecting employability in PWE.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15630, 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 = {2016}, date = {2016-01-01}, journal = {Eur J Cancer Prev}, abstract = {Diets high in red or processed meat have been associated positively with some cancers, and several possible underlying mechanisms have been proposed, including iron-related pathways. However, the role of meat intake in adult glioma risk has yielded conflicting findings because of small sample sizes and heterogeneous tumour classifications. The aim of this study was to examine red meat, processed meat and iron intake in relation to glioma risk in the European Prospective Investigation into Cancer and Nutrition study. In this prospective cohort study, 408 751 individuals from nine European countries completed demographic and dietary questionnaires at recruitment. Multivariable Cox proportional hazards models were used to examine intake of red meat, processed meat, total dietary iron and haem iron in relation to incident glioma. During an average follow-up of 14.1 years, 688 incident glioma cases were diagnosed. There was no evidence that any of the meat variables (red, processed meat or subtypes of meat) or iron (total or haem) were associated with glioma; results were unchanged when the first 2 years of follow-up were excluded. This study suggests that there is no association between meat or iron intake and adult glioma. This is the largest prospective analysis of meat and iron in relation to glioma and as such provides a substantial contribution to a limited and inconsistent literature.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15650, title = {Comparing the mechanical strength of hip spica cast between a conventional and a new method of application}, author = {K L Wan and R Shanmugam and K Y Lee and A Saw}, doi = {10.1007/s11832-016-0770-4}, issn = {1863-2521 (Print) 1863-2521}, year = {2016}, date = {2016-01-01}, journal = {J Child Orthop}, volume = {10}, number = {5}, pages = {387-94}, abstract = {PURPOSE: The current technique of hip spica application is mostly based on a publication by Kumar (J Pediatr Orthop 1(1):97-99, 1981). We modified the technique of hip spica application in order to reduce the rate of breakage across the hip joint and designed this study to compare the strength between hip spica applied according to Kumar's technique and the new technique. METHODS: We created 12 hip spica casts with 24 hips according to Kumar's technique, and another 12 casts according to a new technique. The two types of spica were tested with a mechanical testing machine (Instron 3365 series) by using compression loading to failure in flexion, extension, abduction and adduction. Data were analysed in SPSS version 20.0. Comparison of means was done with an independent T test for normally distributed data and the Mann-Whitney test for skewed data. RESULTS: The new technique involved the creation of three slabs, instead of 14 slabs as described by Kumar. The loads to failure for hip spica cast applied according to the new technique were higher than those applied according to Kumar's technique, and the differences were statistically significant. The stiffness was also higher in spica casts applied with the new technique; the difference was not statistically significant under extension force. CONCLUSION: Hip spica applied with the new technique was stronger than that applied according to Kumar's technique based on load to failure testing. The new technique of application would potentially reduce the risk of cast breakage during the management of developmental dysplasia of the hip (DDH) and femur fracture in children.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15693, title = {Descriptive Epidemiology of Somatising Tendency: Findings from the CUPID Study}, author = {S Vargas-Prada and D Coggon and G Ntani and K Walker-Bone and K T Palmer and V E Felli and R Harari and L H Barrero and S A Felknor and D Gimeno and A Cattrell and M Bonzini and E Solidaki and E Merisalu and R R Habib and F Sadeghian and M M Kadir and S S Warnakulasuriya and K Matsudaira and B Nyantumbu and M R Sim and H Harcombe and K Cox and L M Sarquis and M H Marziale and F Harari and R Freire and N Harari and M V Monroy and L A Quintana and M Rojas and E C Harris and C Serra and J M Martinez and G Delclos and F G Benavides and M Carugno and M M Ferrario and A C Pesatori and L Chatzi and P Bitsios and M Kogevinas and K Oha and T Freimann and A Sadeghian and R J Peiris-John and N Sathiakumar and A R Wickremasinghe and N Yoshimura and H L Kelsall and V C Hoe and D M Urquhart and S Derrett and D McBride and P Herbison and A Gray and E J Vega}, doi = {10.1371/journal.pone.0153748}, issn = {1932-6203}, year = {2016}, date = {2016-01-01}, journal = {PLoS One}, volume = {11}, number = {4}, pages = {e0153748}, abstract = {Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is importantly associated with various aspects of health and health-related behaviour, including musculoskeletal pain and associated disability. To explore its epidemiological characteristics, and how it can be specified most efficiently, we analysed data from an international longitudinal study. A baseline questionnaire, which included questions from the Brief Symptom Inventory about seven common symptoms, was completed by 12,072 participants aged 20-59 from 46 occupational groups in 18 countries (response rate 70%). The seven symptoms were all mutually associated (odds ratios for pairwise associations 3.4 to 9.3), and each contributed to a measure of somatising tendency that exhibited an exposure-response relationship both with multi-site pain (prevalence rate ratios up to six), and also with sickness absence for non-musculoskeletal reasons. In most participants, the level of somatising tendency was little changed when reassessed after a mean interval of 14 months (75% having a change of 0 or 1 in their symptom count), although the specific symptoms reported at follow-up often differed from those at baseline. Somatising tendency was more common in women than men, especially at older ages, and varied markedly across the 46 occupational groups studied, with higher rates in South and Central America. It was weakly associated with smoking, but not with level of education. Our study supports the use of questions from the Brief Symptom Inventory as a method for measuring somatising tendency, and suggests that in adults of working age, it is a fairly stable trait.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15708, title = {A Meta-analysis of Individual Participant Data Reveals an Association between Circulating Levels of IGF-I and Prostate Cancer Risk}, author = {R C Travis and P N Appleby and R M Martin and J M P Holly and D Albanes and A Black and H B A Bueno-de-Mesquita and J M Chan and C Chen and M D Chirlaque and M B Cook and M Deschasaux and J L Donovan and L Ferrucci and P Galan and G G Giles and E L Giovannucci and M J Gunter and L A Habel and F C Hamdy and K J Helzlsouer and S Hercberg and R N Hoover and Jamjl Janssen and R Kaaks and T Kubo and L Le Marchand and E J Metter and K Mikami and J K Morris and D E Neal and M L Neuhouser and K Ozasa and D Palli and E A Platz and M Pollak and A J Price and M J Roobol and C Schaefer and J M Schenk and G Severi and M J Stampfer and P Stattin and A Tamakoshi and C M Tangen and M Touvier and N J Wald and N S Weiss and R G Ziegler and T J Key and N E Allen}, doi = {10.1158/0008-5472.Can-15-1551}, issn = {0008-5472}, year = {2016}, date = {2016-01-01}, journal = {Cancer Res}, volume = {76}, number = {8}, pages = {2288-2300}, abstract = {The role of insulin-like growth factors (IGF) in prostate cancer development is not fully understood. To investigate the association between circulating concentrations of IGFs (IGF-I, IGF-II, IGFBP-1, IGFBP-2, and IGFBP-3) and prostate cancer risk, we pooled individual participant data from 17 prospective and two cross-sectional studies, including up to 10,554 prostate cancer cases and 13,618 control participants. Conditional logistic regression was used to estimate the ORs for prostate cancer based on the study-specific fifth of each analyte. Overall, IGF-I, IGF-II, IGFBP-2, and IGFBP-3 concentrations were positively associated with prostate cancer risk (Ptrend all \</= 0.005), and IGFBP-1 was inversely associated weakly with risk (Ptrend = 0.05). However, heterogeneity between the prospective and cross-sectional studies was evident (Pheterogeneity = 0.03), unless the analyses were restricted to prospective studies (with the exception of IGF-II}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15664, title = {Assessment of Risk and Sero-Prevalence of Helicobacter pylori Colonization among Remote Orang Asli Tribes in Peninsula Malaysia}, author = {K Thevakumar and J R Chandren and G I Perez-Perez and E G Chua and L K Teh and M Z Salleh and J A Tan and A H Leow and K L Goh and A C Tay and B J Marshall and J Vadivelu and M F Loke and L P Wong}, doi = {10.1371/journal.pone.0159830}, issn = {1932-6203}, year = {2016}, date = {2016-01-01}, journal = {PLoS One}, volume = {11}, number = {7}, pages = {e0159830}, abstract = {The epidemiology of Helicobacter pylori (H. pylori) infection is related to human poverty with marked differences between developing and developed countries. Socioeconomic factors and living standards are the main determinants of the age-dependent acquisition rate of H. pylori, and consequently its prevalence. The aim of this study was to assess the risk and sero-prevalence of H. pylori colonization among Orang Asli in Peninsula Malaysia. This cross-sectional study was conducted on Orang Asli subjects in seven isolated settlements spanning across all three major tribes (Negrito, Proto Malay and Senoi) in Malaysia. Socio-demographic characteristics of the subjects were obtained through interview. Subjects were tested for H. pylori colonization based on CagA and whole cell (WC) antigen serological assays. A total of 275 subjects participated in this study. Among these subjects, 115 (44.7%) were H. pylori sero-positive with highest sero-prevalence among Negrito (65.7%). Among subjects who were H. pylori sero-positive, CagA sero positivity was also significantly higher among Negrito. The highest proportion of respondents reported to be H. pylori sero-positive was from age group 30 years old and below (57.9%), males (56.2%), Negrito (48.6%) and live in bamboo house (92.3%). The highest proportion of respondents reported to be CagA sero-positive was from age group 30 years old and below (41.4%), males (35.6%) and Negrito (48.6%). The results of this study demonstrate that H. pylori colonization can be related to age, gender, tribes and house materials and CagA sero-positive stain closely associated with age, gender and tribes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15639, title = {Vitamin D and Calcium Intakes, Physical Activity, and Calcaneus BMC among School-Going 13-Year Old Malaysian Adolescents}, author = {A A Suriawati and H A Majid and N Al-Sadat and M N Mohamed and M Y Jalaludin}, doi = {10.3390/nu8100666}, issn = {2072-6643}, year = {2016}, date = {2016-01-01}, journal = {Nutrients}, volume = {8}, number = {10}, abstract = {BACKGROUND: Dietary calcium and vitamin D are essential for bone development. Apart from diet, physical activity may potentially improve and sustain bone health. OBJECTIVE: To investigate the relationship between the dietary intake of calcium and vitamin D, physical activity, and bone mineral content (BMC) in 13-year-old Malaysian adolescents. DESIGN: Cross-sectional. SETTING: Selected public secondary schools from the central and northern regions of Peninsular Malaysia. PARTICIPANTS: The subjects were from the Malaysian Health and Adolescents Longitudinal Research Team Cohort study (MyHeARTs). METHODS: The data included seven-day diet histories, anthropometric measurements, and the BMC of calcaneal bone using a portable broadband ultrasound bone densitometer. Nutritionist Pro software was used to calculate the dietary calcium and vitamin D intakes from the diet histories, based on the Nutrient Composition of Malaysian Food Database guidance for the dietary calcium intake and the Singapore Energy and Nutrient Composition of Food Database for vitamin D intake. RESULTS: A total of 289 adolescents (65.7% females) were recruited. The average dietary intakes of calcium and vitamin D were 377 +/- 12 mg/day and 2.51 +/- 0.12 microg/day, respectively, with the majority of subjects failing to meet the Recommended Nutrient Intake (RNI) of Malaysia for dietary calcium and vitamin D. All the subjects had a normal Z-score for the BMC (-2.00 or higher) with a mean of 0.55 +/- 0.01. From the statistical analysis of the factors contributing to BMC, it was found that for those subjects with a higher intake of vitamin D, a higher combination of the intake of vitamin D and calcium resulted in significantly higher BMC quartiles. The regression analysis showed that the BMC might have been influenced by the vitamin D intake. CONCLUSIONS: A combination of the intake of vitamin D and calcium is positively associated with the BMC.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15725, title = {Effectiveness of progressive muscle relaxation therapy as a worksite health promotion program in the automobile assembly line}, author = {B M Sundram and M Dahlui and K Chinna}, doi = {10.2486/indhealth.2014-0091}, issn = {0019-8366}, year = {2016}, date = {2016-01-01}, journal = {Ind Health}, volume = {54}, number = {3}, pages = {204-14}, abstract = {The aim of this study was to examine the effectiveness of Progressive Muscle Relaxation (PMR) as part of a Worksite Health Promotion Program on self-perceived stress, anxiety and depression among male automotive assembly-line workers through a quasi-experimental trial. Two assembly plants were chosen with one receiving PMR therapy and the other Pamphlets. Intention-to-treat analysis was conducted to test the effectiveness of the relaxation therapy. Stress, Depression and Anxiety levels were measured using the shortened DASS-21 questionnaire. Data were analyzed using Chi-square, Independent sample t test and Repeated-measures analysis of variance to test the significance of the effects of intervention (time * group) for the measures of Stress, Depression and Anxiety. Significant favourable intervention effects on stress were found in the PMR group (Effect size=0.6) as compared to the Pamphlet group (Effect size=0.2). There was a significant group *time interaction effect (p\<0.001) on Stress levels. Depression and Anxiety levels were minimal at baseline in both the groups with mild or no reduction in levels. The improvement in stress levels showed the potential of PMR therapy as a coping strategy at the workplace. Further research in this field is necessary to examine the beneficial effects of coping strategies in the workplace.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15845, title = {Pain experience and satisfaction with postoperative pain control among surgical patients}, author = {P Subramanian and S Ramasamy and K H Ng and K Chinna and R Rosli}, doi = {10.1111/ijn.12363}, issn = {1322-7114}, year = {2016}, date = {2016-01-01}, journal = {Int J Nurs Pract}, volume = {22}, number = {3}, pages = {232-8}, abstract = {Alleviating acute pain and providing pain relief are central to caring for surgical patients as pain can lead to many adverse medical consequences. This study aimed to explore patients' experience of pain and satisfaction with postoperative pain control. A cross-sectional survey was carried out among 107 respondents who had undergone abdominal surgery in the surgical ward of an urban hospital using the Revised American Pain Society's Patient Outcome and Satisfaction Survey Questionnaires (APS-POQ-R). Data were analysed using descriptive statistics and chi-square test. Chi-square test showed significant association between race (P = 0.038), education level (P \</= 0.001), previous operation status (P = 0.032) and operation status (P \</= 0.001). Further analysis on nominal regression, association between dissatisfaction with factors of operation status (46.09 (95% CI 7.456, 284.947)) and previous operation status (13.38 (95% CI 1.39, 128.74)) was found to be significant. Moderate to high levels of pain intensity in the last 24 h after surgery, as well as moderate to high rates of pain-related interference with care activities were most reported. Pain still remains an issue among surgical patients, and effective pain management and health education are needed to manage pain more effectively after surgery.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15617, title = {The Effectiveness of a Wireless Modular Bed Absence Sensor Device for Fall Prevention among Older Inpatients}, author = {K Subermaniam and R Welfred and P Subramanian and K Chinna and F Ibrahim and M S Mohktar and M P Tan}, doi = {10.3389/fpubh.2016.00292}, issn = {2296-2565 (Print) 2296-2565}, year = {2016}, date = {2016-01-01}, journal = {Front Public Health}, volume = {4}, pages = {292}, abstract = {BACKGROUND: Falls and fall-related injuries are increasingly serious issues among elderly inpatients due to population aging. The bed-exit alarm has only previously been evaluated in a handful of studies with mixed results. Therefore, we evaluated the effectiveness of a modular bed absence sensor device (M-BAS) in detecting bed exits among older inpatients in a middle income nation in East Asia. METHODS: Patients aged \>/=65 years on an acute geriatric ward who were able to mobilize with or without walking aids and physical assistance were recruited to the study. The total number of alarms and the numbers of true and false alarms were recorded by ward nurses. The M-BAS device is placed across the mattress of all consenting participants. Nurses' workload was assessed using the National Aeronautics and Space Administration-Task Load Index (NASA-TLX) score, while nurses' perceptions were surveyed. RESULTS: The sensitivity of the M-BAS was 100% with a positive predictive value of 68% and a nuisance alarm rate of 31%. There was a significant reduction in total NASA-TLX workload score (mean difference = 14.34 +/- 13.96 SD, p \< 0.001) at the end of the intervention period. 83% of the nurses found the device useful for falls prevention, 97% found it user friendly, and 87% would use it in future. CONCLUSION: The M-BAS was able to accurately detect bed absence episodes among geriatric inpatients and alert nurses accordingly. The use of the device significantly reduced the total workload score, while the acceptability of the device was high among our nurses. A larger, cluster randomized study to measure actual falls outcome associated with the use of the device is now indicated.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15719, title = {Prospective association of liver function biomarkers with development of hepatobiliary cancers}, author = {M Stepien and V Fedirko and T Duarte-Salles and P Ferrari and H Freisling and E Trepo and A Trichopoulou and C Bamia and E Weiderpass and A Olsen and A Tjonneland and K Overvad and M C Boutron-Ruault and G Fagherazzi and A Racine and T Kuhn and R Kaaks and K Aleksandrova and H Boeing and P Lagiou and V Benetou and D Trichopoulos and D Palli and S Grioni and R Tumino and A Naccarati and S Panico and H B Bueno-de-Mesquita and P H Peeters and E Lund and J R Quiros and O C Napoles and M J Sanchez and M Dorronsoro and J M Huerta and E Ardanaz and B Ohlsson and K Sjoberg and M Werner and H Nystrom and K T Khaw and T J Key and M Gunter and A Cross and E Riboli and I Romieu and M Jenab}, doi = {10.1016/j.canep.2016.01.002}, issn = {1877-7821}, year = {2016}, date = {2016-01-01}, journal = {Cancer Epidemiol}, volume = {40}, pages = {179-87}, abstract = {INTRODUCTION: Serum liver biomarkers (gamma-glutamyl transferase, GGT; alanine aminotransferase, ALT; aspartate aminotransferase, AST; alkaline phosphatase, ALP; total bilirubin) are used as indicators of liver disease, but there is currently little data on their prospective association with risk of hepatobiliary cancers. METHODS: A nested-case control study was conducted within the prospective EPIC cohort (\>520,000 participants, 10 European countries). After a mean 7.5 mean years of follow-up, 121 hepatocellular carcinoma (HCC), 34 intrahepatic bile duct (IHBC) and 131 gallbladder and biliary tract (GBTC) cases were identified and matched to 2 controls each. Circulating biomarkers were measured in serum taken at recruitment into the cohort, prior to cancer diagnosis. Multivariable adjusted conditional logistic regression was used to calculate odds ratios and 95% confidence intervals (OR; 95%CI). RESULTS: In multivariable models, 1SD increase of each log-transformed biomarker was positively associated with HCC risk (OR(GGT)=4.23, 95%CI:2.72-6.59; OR(ALP)=3.43, 95%CI:2.31-5.10;OR(AST)=3.00, 95%CI:2.04-4.42; OR(ALT)=2.69, 95%CI:1.89-3.84; OR(Bilirubin)=2.25, 95%CI:1.58-3.20). Each liver enzyme (OR(GGT)=4.98; 95%CI:1.75-14.17; OR(AST)=3.10, 95%CI:1.04-9.30; OR(ALT)=2.86, 95%CI:1.26-6.48, OR(ALP)=2.31, 95%CI:1.10-4.86) but not bilirubin (OR(Bilirubin)=1.46,95%CI:0.85-2.51) showed a significant association with IHBC. Only ALP was significantly associated with GBTC risk (OR(ALP)=1.59, 95%CI:1.20-2.09). CONCLUSION: This study shows positive associations between circulating liver biomarkers in sera collected prior to cancer diagnoses and the risks of developing HCC or IHBC, but not GBTC.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15764, title = {Alteration of amino acid and biogenic amine metabolism in hepatobiliary cancers: Findings from a prospective cohort study}, author = {M Stepien and T Duarte-Salles and V Fedirko and A Floegel and D K Barupal and S Rinaldi and D Achaintre and N Assi and A Tjonneland and K Overvad and N Bastide and M C Boutron-Ruault and G Severi and T Kuhn and R Kaaks and K Aleksandrova and H Boeing and A Trichopoulou and C Bamia and P Lagiou and C Saieva and C Agnoli and S Panico and R Tumino and A Naccarati and H B Bueno-de-Mesquita and P H Peeters and E Weiderpass and J R Quiros and A Agudo and M J Sanchez and M Dorronsoro and D Gavrila and A Barricarte and B Ohlsson and K Sjoberg and M Werner and M Sund and N Wareham and K T Khaw and R C Travis and J A Schmidt and M Gunter and A Cross and P Vineis and I Romieu and A Scalbert and M Jenab}, doi = {10.1002/ijc.29718}, issn = {0020-7136}, year = {2016}, date = {2016-01-01}, journal = {Int J Cancer}, volume = {138}, number = {2}, pages = {348-60}, abstract = {Perturbations in levels of amino acids (AA) and their derivatives are observed in hepatocellular carcinoma (HCC). Yet, it is unclear whether these alterations precede or are a consequence of the disease, nor whether they pertain to anatomically related cancers of the intrahepatic bile duct (IHBC), and gallbladder and extrahepatic biliary tract (GBTC). Circulating standard AA, biogenic amines and hexoses were measured (Biocrates AbsoluteIDQ-p180Kit) in a case-control study nested within a large prospective cohort (147 HCC, 43 IHBC and 134 GBTC cases). Liver function and hepatitis status biomarkers were determined separately. Multivariable conditional logistic regression was used to calculate odds ratios and 95% confidence intervals (OR; 95%CI) for log-transformed standardised (mean = 0}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15743, title = {Gambling Risk Amongst Adolescents: Evidence from a School-Based Survey in the Malaysian Setting}, author = {P S Sheela and W Y Choo and L Y Goh and C P Tan}, doi = {10.1007/s10899-015-9577-3}, issn = {1050-5350}, year = {2016}, date = {2016-01-01}, journal = {J Gambl Stud}, volume = {32}, number = {2}, pages = {643-59}, abstract = {There has been emerging evidence regarding gambling experiences of young people in Asia recently, but to date, none in Malaysia. This study aimed to estimate the prevalence of gambling, and to identify individual, familial and high-risk behaviours factors among Malaysian adolescents. A cross-sectional study was conducted over 4 months at randomly selected secondary schools in Seremban in Negeri Sembilan state. A total of 2265 self-administered, anonymous questionnaires were distributed to the students. The students completed the questionnaire consisting of sociodemographic and family background, gambling behaviours, high risk behaviours and mental health questions. Approximately 29.6 % (95 % CI 27.7-31.5) of respondents reported participating in some forms of gambling activities in the previous 12 months. Among these, 3.6 % (95 % CI 2.8-4.3) of them were problem gamblers. Parental gambling was the strongest correlate with adolescent gambling behaviour. Signification association was found between gambling behaviour and gender (being males), but interestingly, not with ethnicity. Adolescents who reported engaging in high risk behaviours (such as smoking, alcohol consumption, involvement in physical fights, illegal vehicular racing) were also more likely to gamble. Gambling is not an uncommon phenomenon amongst Malaysian adolescents. Public awareness campaign, health education to targeted groups, revision of existing laws, and screening at primary care level should be implemented to address the issue of gambling among adolescents. This study also highlights the need to examine the national scope of the problem in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15706, title = {Vitamin D level and its association with adiposity among multi-ethnic adults in Kuala Lumpur, Malaysia: a cross sectional study}, author = {I S Shafinaz and F M Moy}, doi = {10.1186/s12889-016-2924-1}, issn = {1471-2458}, year = {2016}, date = {2016-01-01}, journal = {BMC Public Health}, volume = {16}, pages = {232}, abstract = {BACKGROUND: Vitamin D deficiency is highly prevalent in both temperate as well as tropical countries. Obesity is one of the factors contributing to vitamin D deficiency. As our country has a high prevalence of overweight and obesity, we aimed to study serum 25-hydroxyvitamin D (25(OH)D) level and its association with adiposity using various adiposity indicators; and to study other risk factors that affect serum 25(OH)D level among multi-ethnic adults in Kuala Lumpur, Malaysia. METHODS: This was a cross sectional study conducted with a multistage sampling. All permanent teachers working in government secondary schools in Kuala Lumpur were invited for the study. The data collection included serum 25(OH)D, Parathyroid Hormone (PTH), body fat percentage, waist circumference, body mass index (BMI) and blood pressure. Demographic characteristics, sun avoidance, sun exposure and physical activity were enquired from the participants using a self-administered questionnaire. The data was analyzed using a complex sample analysis. RESULTS: A total of 858 participants were recruited. Majority of them were Malays, females and had tertiary education. The overall prevalence of vitamin D deficiency (\<20 ng/ml) was 67.4 %. Indian participants (80.9 %) had the highest proportion of vitamin D deficiency, followed by Malays (75.6 %), others (44.9 %) and Chinese (25.1 %). There was a significant negative association between serum 25(OH)D level with BMI (beta = -0.23) and body fat percentage (beta = -0.14). In the multivariate linear regression analysis, Malays, Indians and females (p \< 0.001); higher BMI and larger waist circumference (p \< 0.05) were significantly associated with lower serum 25(OH)D level. The full model explained 32.8 % of the variation between participants in the serum 25(OH)D level. The two most influential factors affecting serum 25(OH)D level were ethnicity and gender. CONCLUSIONS: The prevalence of vitamin D deficiency among our participants was high. Adiposity was associated with serum 25(OH)D level. Skin pigmentation and gender based behaviours were more dominant in contributing to serum 25(OH)D level. Health education should be targeted in weight management, gender based behaviours on sun exposure, as skin pigmentation is non-modifiable.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15715, title = {The Influence of Hormonal Factors on the Risk of Developing Cervical Cancer and Pre-Cancer: Results from the EPIC Cohort}, author = {E Roura and N Travier and T Waterboer and S Sanjose and F X Bosch and M Pawlita and V Pala and E Weiderpass and N Margall and J Dillner and I T Gram and A Tjonneland and C Munk and D Palli and K T Khaw and K Overvad and F Clavel-Chapelon and S Mesrine and A Fournier and R T Fortner and J Ose and A Steffen and A Trichopoulou and P Lagiou and P Orfanos and G Masala and R Tumino and C Sacerdote and S Polidoro and A Mattiello and E Lund and P H Peeters and H B Bueno-de-Mesquita and J R Quiros and M J Sanchez and C Navarro and A Barricarte and N Larranaga and J Ekstrom and D Lindquist and A Idahl and R C Travis and M A Merritt and M J Gunter and S Rinaldi and M Tommasino and S Franceschi and E Riboli and X Castellsague}, doi = {10.1371/journal.pone.0147029}, issn = {1932-6203}, year = {2016}, date = {2016-01-01}, journal = {PLoS One}, volume = {11}, number = {1}, pages = {e0147029}, abstract = {BACKGROUND: In addition to HPV, high parity and hormonal contraceptives have been associated with cervical cancer (CC). However, most of the evidence comes from retrospective case-control studies. The aim of this study is to prospectively evaluate associations between hormonal factors and risk of developing cervical intraepithelial neoplasia grade 3 (CIN3)/carcinoma in situ (CIS) and invasive cervical cancer (ICC). METHODS AND FINDINGS: We followed a cohort of 308,036 women recruited in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study. At enrollment, participants completed a questionnaire and provided serum. After a 9-year median follow-up, 261 ICC and 804 CIN3/CIS cases were reported. In a nested case-control study, the sera from 609 cases and 1,218 matched controls were tested for L1 antibodies against HPV types 11,16,18,31,33,35,45,52,58, and antibodies against Chlamydia trachomatis and Human herpesvirus 2. Multivariate analyses were performed to estimate hazard ratios (HR), odds ratios (OR) and corresponding 95% confidence intervals (CI). The cohort analysis showed that number of full-term pregnancies was positively associated with CIN3/CIS risk (p-trend = 0.03). Duration of oral contraceptives use was associated with a significantly increased risk of both CIN3/CIS and ICC (HR = 1.6 and HR = 1.8 respectively for \>/= 15 years versus never use). Ever use of menopausal hormone therapy was associated with a reduced risk of ICC (HR = 0.5, 95%CI: 0.4-0.8). A non-significant reduced risk of ICC with ever use of intrauterine devices (IUD) was found in the nested case-control analysis (OR = 0.6). Analyses restricted to all cases and HPV seropositive controls yielded similar results, revealing a significant inverse association with IUD for combined CIN3/CIS and ICC (OR = 0.7). CONCLUSIONS: Even though HPV is the necessary cause of CC, our results suggest that several hormonal factors are risk factors for cervical carcinogenesis. Adherence to current cervical cancer screening guidelines should minimize the increased risk of CC associated with these hormonal risk factors.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15853, title = {Intervention to improve intensive care nurses' knowledge of sedation assessment and management}, author = {V Ramoo and K L Abdullah and P S Tan and L P Wong and P Y Chua}, doi = {10.1111/nicc.12105}, issn = {1362-1017}, year = {2016}, date = {2016-01-01}, journal = {Nurs Crit Care}, volume = {21}, number = {5}, pages = {287-94}, abstract = {BACKGROUND: Sedation management is an integral component of critical care practice. It requires the greatest attention of critical care practitioners because it carries significant risks to patients. Therefore, it is imperative that nurses are aware of potential adverse consequences of sedation therapy and current sedation practice recommendations. AIMS AND OBJECTIVES: To evaluate the impact of an educational intervention on nurses' knowledge of sedation assessment and management. DESIGNS AND METHODS: A quasi-experimental design with a pre- and post-test method was used. The educational intervention included theoretical sessions on assessing and managing sedation and hands-on sedation assessment practice using the Richmond Agitation Sedation Scale. Its effect was measured using self-administered questionnaire, completed at the baseline level and 3 months following the intervention. RESULTS: Participants were 68 registered nurses from an intensive care unit of a teaching hospital in Malaysia. Significant increases in overall mean knowledge scores were observed from pre- to post-intervention phases (mean of 79.00 versus 102.00, p \< 0.001). Nurses with fewer than 5 years of work experience, less than 26 years old, and with a only basic nursing education had significantly greater level of knowledge improvement at the post-intervention phase compared to other colleagues, with mean differences of 24.64 (p = 0.001), 23.81 (p = 0.027) and 27.25 (p = 0.0001), respectively. A repeated-measures analysis of variance revealed a statistically significant effect of educational intervention on knowledge score after controlling for age, years of work and level of nursing education (p = 0.0001, etap (2) = 0.431). CONCLUSION: An educational intervention consisting of theoretical sessions and hands-on sedation assessment practice was found effective in improving nurses' knowledge and understanding of sedation management. RELEVANCE TO CLINICAL PRACTICE: This study highlighted the importance of continuing education to increase nurses' understanding of intensive care practices, which is vital for improving the quality of patient care.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15726, title = {Dietary Patterns and Risk of Inflammatory Bowel Disease in Europe: Results from the EPIC Study}, author = {A Racine and F Carbonnel and S S Chan and A R Hart and H B Bueno-de-Mesquita and B Oldenburg and F D Schaik and A Tjonneland and A Olsen and C C Dahm and T Key and R Luben and K T Khaw and E Riboli and O Grip and S Lindgren and G Hallmans and P Karling and F Clavel-Chapelon and M M Bergman and H Boeing and R Kaaks and V A Katzke and D Palli and G Masala and P Jantchou and M C Boutron-Ruault}, doi = {10.1097/mib.0000000000000638}, issn = {1078-0998}, year = {2016}, date = {2016-01-01}, journal = {Inflamm Bowel Dis}, volume = {22}, number = {2}, pages = {345-54}, abstract = {BACKGROUND: Specific nutrients or foods have been inconsistently associated with ulcerative colitis (UC) or Crohn's disease (CD) risks. Thus, we investigated associations between diet as a whole, as dietary patterns, and UC and CD risks. METHODS: Within the prospective EPIC (European Prospective Investigation into Cancer) study, we set up a nested matched case-control study among 366,351 participants with inflammatory bowel disease data, including 256 incident cases of UC and 117 of CD, and 4 matched controls per case. Dietary intake was recorded at baseline from validated food frequency questionnaires. Incidence rate ratios of developing UC and CD were calculated for quintiles of the Mediterranean diet score and a posteriori dietary patterns produced by factor analysis. RESULTS: No dietary pattern was associated with either UC or CD risks. However, when excluding cases occurring within the first 2 years after dietary assessment, there was a positive association between a "high sugar and soft drinks" pattern and UC risk (incidence rate ratios for the fifth versus first quintile, 1.68 [1.00-2.82]; Ptrend = 0.02). When considering the foods most associated with the pattern, high consumers of sugar and soft drinks were at higher UC risk only if they had low vegetables intakes. CONCLUSIONS: A diet imbalance with high consumption of sugar and soft drinks and low consumption of vegetables was associated with UC risk. Further studies are needed to investigate whether microbiota alterations or other mechanisms mediate this association.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15731, title = {Particulate matter air pollution components and risk for lung cancer}, author = {O Raaschou-Nielsen and R Beelen and M Wang and G Hoek and Z J Andersen and B Hoffmann and M Stafoggia and E Samoli and G Weinmayr and K Dimakopoulou and M Nieuwenhuijsen and W W Xun and P Fischer and K T Eriksen and M Sorensen and A Tjonneland and F Ricceri and K Hoogh and T Key and M Eeftens and P H Peeters and H B Bueno-de-Mesquita and K Meliefste and B Oftedal and P E Schwarze and P Nafstad and C Galassi and E Migliore and A Ranzi and G Cesaroni and C Badaloni and F Forastiere and J Penell and U De Faire and M Korek and N Pedersen and C G Ostenson and G Pershagen and L Fratiglioni and H Concin and G Nagel and A Jaensch and A Ineichen and A Naccarati and M Katsoulis and A Trichpoulou and M Keuken and A Jedynska and I M Kooter and J Kukkonen and B Brunekreef and R S Sokhi and K Katsouyanni and P Vineis}, doi = {10.1016/j.envint.2015.11.007}, issn = {0160-4120}, year = {2016}, date = {2016-01-01}, journal = {Environ Int}, volume = {87}, pages = {66-73}, abstract = {BACKGROUND: Particulate matter (PM) air pollution is a human lung carcinogen; however, the components responsible have not been identified. We assessed the associations between PM components and lung cancer incidence. METHODS: We used data from 14 cohort studies in eight European countries. We geocoded baseline addresses and assessed air pollution with land-use regression models for eight elements (Cu, Fe, K, Ni, S, Si, V and Zn) in size fractions of PM2.5 and PM10. We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random effect models for meta-analysis. RESULTS: The 245,782 cohort members contributed 3,229,220 person-years at risk. During follow-up (mean, 13.1 years), 1878 incident cases of lung cancer were diagnosed. In the meta-analyses, elevated hazard ratios (HRs) for lung cancer were associated with all elements except V; none was statistically significant. In analyses restricted to participants who did not change residence during follow-up, statistically significant associations were found for PM2.5 Cu (HR, 1.25; 95% CI, 1.01-1.53 per 5 ng/m(3)), PM10 Zn (1.28; 1.02-1.59 per 20 ng/m(3)), PM10 S (1.58; 1.03-2.44 per 200 ng/m(3)), PM10 Ni (1.59; 1.12-2.26 per 2 ng/m(3)) and PM10 K (1.17; 1.02-1.33 per 100 ng/m(3)). In two-pollutant models, associations between PM10 and PM2.5 and lung cancer were largely explained by PM2.5 S. CONCLUSIONS: This study indicates that the association between PM in air pollution and lung cancer can be attributed to various PM components and sources. PM containing S and Ni might be particularly important.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15695, title = {Circulating Folate and Vitamin B12 and Risk of Prostate Cancer: A Collaborative Analysis of Individual Participant Data from Six Cohorts Including 6875 Cases and 8104 Controls}, author = {A J Price and R C Travis and P N Appleby and D Albanes and A Barricarte Gurrea and T Bjorge and H B Bueno-de-Mesquita and C Chen and J Donovan and R Gislefoss and G Goodman and M Gunter and F C Hamdy and M Johansson and I B King and T Kuhn and S Mannisto and R M Martin and K Meyer and D E Neal and M L Neuhouser and O Nygard and P Stattin and G S Tell and A Trichopoulou and R Tumino and P M Ueland and A Ulvik and S Vogel and S E Vollset and S J Weinstein and T J Key and N E Allen}, doi = {10.1016/j.eururo.2016.03.029}, issn = {0302-2838}, year = {2016}, date = {2016-01-01}, journal = {Eur Urol}, volume = {70}, number = {6}, pages = {941-951}, abstract = {BACKGROUND: Folate and vitamin B12 are essential for maintaining DNA integrity and may influence prostate cancer (PCa) risk, but the association with clinically relevant, advanced stage, and high-grade disease is unclear. OBJECTIVE: To investigate the associations between circulating folate and vitamin B12 concentrations and risk of PCa overall and by disease stage and grade. DESIGN, SETTING, AND PARTICIPANTS: A study was performed with a nested case-control design based on individual participant data from six cohort studies including 6875 cases and 8104 controls; blood collection from 1981 to 2008, and an average follow-up of 8.9 yr (standard deviation 7.3). Odds ratios (ORs) of incident PCa by study-specific fifths of circulating folate and vitamin B12 were calculated using multivariable adjusted conditional logistic regression. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Incident PCa and subtype by stage and grade. RESULTS AND LIMITATIONS: Higher folate and vitamin B12 concentrations were associated with a small increase in risk of PCa (ORs for the top vs bottom fifths were 1.13 [95% confidence interval (CI), 1.02-1.26]}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15568, 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 = {2016}, date = {2016-01-01}, journal = {Eur Urol Focus}, abstract = {BACKGROUND: Ambient air pollution contains low concentrations of carcinogens implicated in the etiology of urinary bladder cancer (BC). Little is known about whether exposure to air pollution influences BC in the general population. OBJECTIVE: To evaluate the association between long-term exposure to ambient air pollution and BC incidence. DESIGN, SETTING, AND PARTICIPANTS: We obtained data from 15 population-based cohorts enrolled between 1985 and 2005 in eight European countries (N=303431; mean follow-up 14.1 yr). We estimated exposure to nitrogen oxides (NO2 and NOx), particulate matter (PM) with diameter \<10mum (PM10), \<2.5mum (PM2.5), between 2.5 and 10mum (PM2.5-10), PM2.5absorbance (soot), elemental constituents of PM, organic carbon, and traffic density at baseline home addresses using standardized land-use regression models from the European Study of Cohorts for Air Pollution Effects project. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We used Cox proportional-hazards models with adjustment for potential confounders for cohort-specific analyses and meta-analyses to estimate summary hazard ratios (HRs) for BC incidence. RESULTS AND LIMITATIONS: During follow-up, 943 incident BC cases were diagnosed. In the meta-analysis, none of the exposures were associated with BC risk. The summary HRs associated with a 10-mug/m(3) increase in NO2 and 5-mug/m(3) increase in PM2.5 were 0.98 (95% confidence interval [CI] 0.89-1.08) and 0.86 (95% CI 0.63-1.18), respectively. Limitations include the lack of information about lifetime exposure. CONCLUSIONS: There was no evidence of an association between exposure to outdoor air pollution levels at place of residence and risk of BC. PATIENT SUMMARY: We assessed the link between outdoor air pollution at place of residence and bladder cancer using the largest study population to date and extensive assessment of exposure and comprehensive data on personal risk factors such as smoking. We found no association between the levels of outdoor air pollution at place of residence and bladder cancer risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15698, title = {Quantification of the smoking-associated cancer risk with rate advancement periods: meta-analysis of individual participant data from cohorts of the CHANCES consortium}, author = {J M Ordonez-Mena and B Schottker and U Mons and M Jenab and H Freisling and B Bueno-de-Mesquita and M G O'Doherty and A Scott and F Kee and B H Stricker and A Hofman and C E Keyser and R Ruiter and S Soderberg and P Jousilahti and K Kuulasmaa and N D Freedman and T Wilsgaard and L C Groot and E Kampman and N Hakansson and N Orsini and A Wolk and L M Nilsson and A Tjonneland and A Pajak and S Malyutina and R Kubinova and A Tamosiunas and M Bobak and M Katsoulis and P Orfanos and P Boffetta and A Trichopoulou and H Brenner}, doi = {10.1186/s12916-016-0607-5}, issn = {1741-7015}, year = {2016}, date = {2016-01-01}, journal = {BMC Med}, volume = {14}, pages = {62}, abstract = {BACKGROUND: Smoking is the most important individual risk factor for many cancer sites but its association with breast and prostate cancer is not entirely clear. Rate advancement periods (RAPs) may enhance communication of smoking related risk to the general population. Thus, we estimated RAPs for the association of smoking exposure (smoking status, time since smoking cessation, smoking intensity, and duration) with total and site-specific (lung, breast, colorectal, prostate, gastric, head and neck, and pancreatic) cancer incidence and mortality. METHODS: This is a meta-analysis of 19 population-based prospective cohort studies with individual participant data for 897,021 European and American adults. For each cohort we calculated hazard ratios (HRs) for the association of smoking exposure with cancer outcomes using Cox regression adjusted for a common set of the most important potential confounding variables. RAPs (in years) were calculated as the ratio of the logarithms of the HRs for a given smoking exposure variable and age. Meta-analyses were employed to summarize cohort-specific HRs and RAPs. RESULTS: Overall, 140,205 subjects had a first incident cancer, and 53,164 died from cancer, during an average follow-up of 12 years. Current smoking advanced the overall risk of developing and dying from cancer by eight and ten years, respectively, compared with never smokers. The greatest advancements in cancer risk and mortality were seen for lung cancer and the least for breast cancer. Smoking cessation was statistically significantly associated with delays in the risk of cancer development and mortality compared with continued smoking. CONCLUSIONS: This investigation shows that smoking, even among older adults, considerably advances, and cessation delays, the risk of developing and dying from cancer. These findings may be helpful in more effectively communicating the harmful effects of smoking and the beneficial effect of smoking cessation.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15795, title = {Pre-diagnostic vitamin D concentrations and cancer risks in older individuals: an analysis of cohorts participating in the CHANCES consortium}, author = {J M Ordonez-Mena and B Schottker and V Fedirko and M Jenab and A Olsen and J Halkjaer and E Kampman and L Groot and E Jansen and H B Bueno-de-Mesquita and P H Peeters and G Siganos and T Wilsgaard and L Perna and B Holleczek and U Pettersson-Kymmer and P Orfanos and A Trichopoulou and P Boffetta and H Brenner}, doi = {10.1007/s10654-015-0040-7}, issn = {0393-2990}, year = {2016}, date = {2016-01-01}, journal = {Eur J Epidemiol}, volume = {31}, number = {3}, pages = {311-23}, abstract = {The associations of circulating 25-hydroxyvitamin D [25(OH)D] concentrations with total and site-specific cancer incidence have been examined in several epidemiological studies with overall inconclusive findings. Very little is known about the association of vitamin D with cancer incidence in older populations. We assessed the association of pre-diagnostic serum 25(OH)D levels with incidence of all cancers combined and incidence of lung, colorectal, breast, prostate and lymphoid malignancies among older adults. Pre-diagnostic 25(OH)D concentrations and cancer incidence were available in total for 15,486 older adults (mean age 63, range 50-84 years) participating in two cohort studies: ESTHER (Germany) and TROMSO (Norway); and a subset of previously published nested-case control data from a another cohort study: EPIC-Elderly (Greece, Denmark, Netherlands, Spain and Sweden) from the CHANCES consortium on health and aging. Cox proportional hazards or logistic regression were used to derive multivariable adjusted hazard and odds ratios, respectively, and their 95% confidence intervals across 25(OH)D categories. Meta-analyses with random effects models were used to pool study-specific risk estimates. Overall, lower 25(OH)D concentrations were not significantly associated with increased incidence of most of the cancers assessed. However, there was some evidence of increased breast cancer and decreased lymphoma risk with higher 25(OH)D concentrations. Our meta-analyses with individual participant data from three large European population-based cohort studies provide at best limited support for the hypothesis that vitamin D may have a major role in cancer development and prevention among European older adults.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15661, title = {Exposure to Ambient Air Pollution and the Risk of Inflammatory Bowel Disease: A European Nested Case-Control Study}, author = {J L Opstelten and R M J Beelen and M Leenders and G Hoek and B Brunekreef and F D M Schaik and P D Siersema and K T Eriksen and O Raaschou-Nielsen and A Tjonneland and K Overvad and M C Boutron-Ruault and F Carbonnel and K Hoogh and T J Key and R Luben and S S M Chan and A R Hart and H B Bueno-de-Mesquita and B Oldenburg}, doi = {10.1007/s10620-016-4249-4}, issn = {0163-2116}, year = {2016}, date = {2016-01-01}, journal = {Dig Dis Sci}, volume = {61}, number = {10}, pages = {2963-2971}, abstract = {BACKGROUND: Industrialization has been linked to the etiology of inflammatory bowel disease (IBD). AIM: We investigated the association between air pollution exposure and IBD. METHODS: The European Prospective Investigation into Cancer and Nutrition cohort was used to identify cases with Crohn's disease (CD) (n = 38) and ulcerative colitis (UC) (n = 104) and controls (n = 568) from Denmark, France, the Netherlands, and the UK, matched for center, gender, age, and date of recruitment. Air pollution data were obtained from the European Study of Cohorts for Air Pollution Effects. Residential exposure was assessed with land-use regression models for particulate matter with diameters of \<10 mum (PM10), \<2.5 mum (PM2.5), and between 2.5 and 10 mum (PMcoarse), soot (PM2.5 absorbance), nitrogen oxides, and two traffic indicators. Conditional logistic regression analyses were performed to calculate odds ratios (ORs) with 95 % confidence intervals (CIs). RESULTS: Although air pollution was not significantly associated with CD or UC separately, the associations were mostly similar. Individuals with IBD were less likely to have higher exposure levels of PM2.5 and PM10, with ORs of 0.24 (95 % CI 0.07-0.81) per 5 mug/m(3) and 0.25 (95 % CI 0.08-0.78) per 10 mug/m(3), respectively. There was an inverse but nonsignificant association for PMcoarse. A higher nearby traffic load was positively associated with IBD [OR 1.60 (95 % CI 1.04-2.46) per 4,000,000 motor vehicles x m per day]. Other air pollutants were positively but not significantly associated with IBD. CONCLUSION: Exposure to air pollution was not found to be consistently associated with IBD.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15750, title = {Acrylamide and glycidamide hemoglobin adduct levels and endometrial cancer risk: A nested case-control study in nonsmoking postmenopausal women from the EPIC cohort}, author = {M Obon-Santacana and H Freisling and P H Peeters and L Lujan-Barroso and P Ferrari and M C Boutron-Ruault and S Mesrine and L Baglietto and R Turzanski-Fortner and V A Katzke and H Boeing and J R Quiros and E Molina-Portillo and N Larranaga and M D Chirlaque and A Barricarte and K T Khaw and N Wareham and R C Travis and M A Merritt and M J Gunter and A Trichopoulou and P Lagiou and A Naska and D Palli and S Sieri and R Tumino and V Fiano and R Galassom and H B Bueno-de-Mesquita and N C Onland-Moret and A Idahl and E Lundin and E Weiderpass and H Vesper and E Riboli and E J Duell}, doi = {10.1002/ijc.29853}, issn = {0020-7136}, year = {2016}, date = {2016-01-01}, journal = {Int J Cancer}, volume = {138}, number = {5}, pages = {1129-38}, abstract = {Acrylamide, classified in 1994 by IARC as "probably carcinogenic to humans," was discovered in 2002 in some heat-treated, carbohydrate-rich foods. Four prospective studies have evaluated the association between dietary acrylamide intake and endometrial cancer (EC) risk with inconsistent results. The purpose of this nested case-control study, based on the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, was to evaluate, for the first time, the association between hemoglobin adducts of acrylamide (HbAA) and glycidamide (HbGA) and the risk of developing EC in non-smoking postmenopausal women. Hemoglobin adducts were measured in red blood cells by HPLC/MS/MS. Four exposure variables were evaluated: HbAA, HbGA, their sum (HbAA+HbGA), and their ratio (HbGA/HbAA). The association between hemoglobin adducts and EC was evaluated using unconditional multivariable logistic regression models, and included 383 EC cases (171 were type-I EC), and 385 controls. Exposure variables were analyzed in quintiles based on control distributions. None of the biomarker variables had an effect on overall EC (HRHbAA;Q5vsQ1 : 0.84, 95%CI: 0.49-1.48; HRHbGA;Q5vsQ1 : 0.94, 95%CI: 0.54-1.63) or type-I EC risk. Additionally, none of the subgroups investigated (BMI \< 25 vs. \>/=25 kg m(-2) , alcohol drinkers vs. never drinkers, oral contraceptive users vs. non-users) demonstrated effect measure modification. Hemoglobin adducts of acrylamide or glycidamide were not associated with EC or type-I EC risk in 768 nonsmoking postmenopausal women from the EPIC cohort.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15686, title = {The value of adjuvant radiotherapy on survival and recurrence in triple-negative breast cancer: A systematic review and meta-analysis of 5507 patients}, author = {M A O'Rorke and L J Murray and J S Brand and N Bhoo-Pathy}, doi = {10.1016/j.ctrv.2016.05.001}, issn = {0305-7372}, year = {2016}, date = {2016-01-01}, journal = {Cancer Treat Rev}, volume = {47}, pages = {12-21}, abstract = {BACKGROUND: The value of adjuvant radiotherapy in triple negative breast cancer (TNBC) remains unclear. A systematic review and meta-analysis was conducted in TNBC patients to assess survival and recurrence outcomes associated with radiotherapy following either breast conserving therapy (BCT) or post-mastectomy radiotherapy (PMRT). METHODS: Four electronic databases were searched from January 2000 to November 2015 (PubMed, MEDLINE, EMBASE and Web of Science). Studies investigating overall survival and/or recurrence in TNBC patients according to radiotherapy administration were included. A random effects meta-analysis was conducted using mastectomy only patients as the reference. RESULTS: Twelve studies were included. The pooled hazard ratio (HR) for locoregional recurrence comparing BCT and PMRT to mastectomy only was 0.61 (95% confidence interval [CI] 0.41-0.90) and 0.62 (95% CI 0.44-0.86), respectively. Adjuvant radiotherapy was not significantly associated with distant recurrence. The pooled HR for overall survival comparing BCT and PMRT to mastectomy only was 0.57 (95% CI 0.36-0.88) and HR 1.12 (95% CI 0.75, 1.69). Comparing PMRT to mastectomy only, tests for interaction were not significant for stage (p=0.98) or age at diagnosis (p=0.85). However, overall survival was improved in patients with late-stage disease (T3-4, N2-3) pooled HR 0.53 (95% CI 0.32-0.86), and women \<40years, pooled HR 0.30 (95% CI 0.11-0.82). CONCLUSIONS: Adjuvant radiotherapy was associated with a significantly lower risk of locoregional recurrence in TNBC patients, irrespective of the type of surgery. While radiotherapy was not consistently associated with an overall survival gain, benefits may be obtained in women with late-stage disease and younger patients.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15701, title = {Cyclical Patterns of Hand, Foot and Mouth Disease Caused by Enterovirus A71 in Malaysia}, author = {N NikNadia and I C Sam and S Rampal and W WanNorAmalina and G NurAtifah and K Verasahib and C C Ong and M MohdAdib and Y F Chan}, doi = {10.1371/journal.pntd.0004562}, issn = {1935-2727}, year = {2016}, date = {2016-01-01}, journal = {PLoS Negl Trop Dis}, volume = {10}, number = {3}, pages = {e0004562}, abstract = {Enterovirus A71 (EV-A71) is an important emerging pathogen causing large epidemics of hand, foot and mouth disease (HFMD) in children. In Malaysia, since the first EV-A71 epidemic in 1997, recurrent cyclical epidemics have occurred every 2-3 years for reasons that remain unclear. We hypothesize that this cyclical pattern is due to changes in population immunity in children (measured as seroprevalence). Neutralizing antibody titers against EV-A71 were measured in 2,141 residual serum samples collected from children \</=12 years old between 1995 and 2012 to determine the seroprevalence of EV-A71. Reported national HFMD incidence was highest in children \<2 years, and decreased with age; in support of this, EV-A71 seroprevalence was significantly associated with age, indicating greater susceptibility in younger children. EV-A71 epidemics are also characterized by peaks of increased genetic diversity, often with genotype changes. Cross-sectional time series analysis was used to model the association between EV-A71 epidemic periods and EV-A71 seroprevalence adjusting for age and climatic variables (temperature, rainfall, rain days and ultraviolet radiance). A 10% increase in absolute monthly EV-A71 seroprevalence was associated with a 45% higher odds of an epidemic (adjusted odds ratio, aOR1.45; 95% CI 1.24-1.69; P\<0.001). Every 10% decrease in seroprevalence between preceding and current months was associated with a 16% higher odds of an epidemic (aOR = 1.16; CI 1.01-1.34 P\<0.034). In summary, the 2-3 year cyclical pattern of EV-A71 epidemics in Malaysia is mainly due to the fall of population immunity accompanying the accumulation of susceptible children between epidemics. This study will impact the future planning, timing and target populations for vaccine programs.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15656, title = {Sweet-beverage consumption and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)}, author = {E M Navarrete-Munoz and P A Wark and D Romaguera and N Bhoo-Pathy and D Michaud and E Molina-Montes and A Tjonneland and A Olsen and K Overvad and M C Boutron-Ruault and F Clavel-Chapelon and G Fagherazzi and V A Katzke and T Kuhn and A Steffen and A Trichopoulou and E Klinaki and E M Papatesta and G Masala and V Krogh and R Tumino and A Naccarati and A Mattiello and P H Peeters and C Rylander and C L Parr and G Skeie and E Weiderpass and J R Quiros and E J Duell and M Dorronsoro and J M Huerta and E Ardanaz and N Wareham and K T Khaw and R C Travis and T Key and M Stepien and H Freisling and E Riboli and H B Bueno-de-Mesquita}, doi = {10.3945/ajcn.116.130963}, issn = {0002-9165}, year = {2016}, date = {2016-01-01}, journal = {Am J Clin Nutr}, volume = {104}, number = {3}, pages = {760-8}, abstract = {BACKGROUND: The consumption of sweet beverages has been associated with greater risk of type 2 diabetes and obesity, which may be involved in the development of pancreatic cancer. Therefore, it has been hypothesized that sweet beverages may increase pancreatic cancer risk as well. OBJECTIVE: We examined the association between sweet-beverage consumption (including total, sugar-sweetened, and artificially sweetened soft drink and juice and nectar consumption) and pancreatic cancer risk. DESIGN: The study was conducted within the European Prospective Investigation into Cancer and Nutrition cohort. A total of 477,199 participants (70.2% women) with a mean age of 51 y at baseline were included, and 865 exocrine pancreatic cancers were diagnosed after a median follow-up of 11.60 y (IQR: 10.10-12.60 y). Sweet-beverage consumption was assessed with the use of validated dietary questionnaires at baseline. HRs and 95% CIs were obtained with the use of multivariable Cox regression models that were stratified by age, sex, and center and adjusted for educational level, physical activity, smoking status, and alcohol consumption. Associations with total soft-drink consumption were adjusted for juice and nectar consumption and vice versa. RESULTS: Total soft-drink consumption (HR per 100 g/d: 1.03; 95% CI: 0.99, 1.07), sugar-sweetened soft-drink consumption (HR per 100 g/d: 1.02; 95% CI: 0.97, 1.08), and artificially sweetened soft-drink consumption (HR per 100 g/d: 1.04; 95% CI: 0.98, 1.10) were not associated with pancreatic cancer risk. Juice and nectar consumption was inversely associated with pancreatic cancer risk (HR per 100 g/d: 0.91; 95% CI: 0.84, 0.99); this association remained statistically significant after adjustment for body size, type 2 diabetes, and energy intake. CONCLUSIONS: Soft-drink consumption does not seem to be associated with pancreatic cancer risk. Juice and nectar consumption might be associated with a modest decreased pancreatic cancer risk. Additional studies with specific information on juice and nectar subtypes are warranted to clarify these results.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15665, title = {Missense Mutation of Brain Derived Neurotrophic Factor (BDNF) Alters Neurocognitive Performance in Patients with Mild Traumatic Brain Injury: A Longitudinal Study}, author = {V Narayanan and V Veeramuthu and A Ahmad-Annuar and N Ramli and V Waran and K Chinna and M W Bondi and L Delano-Wood and D Ganesan}, doi = {10.1371/journal.pone.0158838}, issn = {1932-6203}, year = {2016}, date = {2016-01-01}, journal = {PLoS One}, volume = {11}, number = {7}, pages = {e0158838}, abstract = {The predictability of neurocognitive outcomes in patients with traumatic brain injury is not straightforward. The extent and nature of recovery in patients with mild traumatic brain injury (mTBI) are usually heterogeneous and not substantially explained by the commonly known demographic and injury-related prognostic factors despite having sustained similar injuries or injury severity. Hence, this study evaluated the effects and association of the Brain Derived Neurotrophic Factor (BDNF) missense mutations in relation to neurocognitive performance among patients with mTBI. 48 patients with mTBI were prospectively recruited and MRI scans of the brain were performed within an average 10.1 (SD 4.2) hours post trauma with assessment of their neuropsychological performance post full Glasgow Coma Scale (GCS) recovery. Neurocognitive assessments were repeated again at 6 months follow-up. The paired t-test, Cohen's d effect size and repeated measure ANOVA were performed to delineate statistically significant differences between the groups [wildtype G allele (Val homozygotes) vs. minor A allele (Met carriers)] and their neuropsychological performance across the time point (T1 = baseline/ admission vs. T2 = 6th month follow-up). Minor A allele carriers in this study generally performed more poorly on neuropsychological testing in comparison wildtype G allele group at both time points. Significant mean differences were observed among the wildtype group in the domains of memory (M = -11.44}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15697, title = {A Nested Case-Control Study of Metabolically Defined Body Size Phenotypes and Risk of Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)}, author = {N Murphy and A J Cross and M Abubakar and M Jenab and K Aleksandrova and M C Boutron-Ruault and L Dossus and A Racine and T Kuhn and V A Katzke and A Tjonneland and K E Petersen and K Overvad and J R Quiros and P Jakszyn and E Molina-Montes and M Dorronsoro and J M Huerta and A Barricarte and K T Khaw and N Wareham and R C Travis and A Trichopoulou and P Lagiou and D Trichopoulos and G Masala and V Krogh and R Tumino and P Vineis and S Panico and H B Bueno-de-Mesquita and P D Siersema and P H Peeters and B Ohlsson and U Ericson and R Palmqvist and H Nystrom and E Weiderpass and G Skeie and H Freisling and S Y Kong and K Tsilidis and D C Muller and E Riboli and M J Gunter}, doi = {10.1371/journal.pmed.1001988}, issn = {1549-1277}, year = {2016}, date = {2016-01-01}, journal = {PLoS Med}, volume = {13}, number = {4}, pages = {e1001988}, abstract = {BACKGROUND: Obesity is positively associated with colorectal cancer. Recently, body size subtypes categorised by the prevalence of hyperinsulinaemia have been defined, and metabolically healthy overweight/obese individuals (without hyperinsulinaemia) have been suggested to be at lower risk of cardiovascular disease than their metabolically unhealthy (hyperinsulinaemic) overweight/obese counterparts. Whether similarly variable relationships exist for metabolically defined body size phenotypes and colorectal cancer risk is unknown. METHODS AND FINDINGS: The association of metabolically defined body size phenotypes with colorectal cancer was investigated in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Metabolic health/body size phenotypes were defined according to hyperinsulinaemia status using serum concentrations of C-peptide, a marker of insulin secretion. A total of 737 incident colorectal cancer cases and 737 matched controls were divided into tertiles based on the distribution of C-peptide concentration amongst the control population, and participants were classified as metabolically healthy if below the first tertile of C-peptide and metabolically unhealthy if above the first tertile. These metabolic health definitions were then combined with body mass index (BMI) measurements to create four metabolic health/body size phenotype categories: (1) metabolically healthy/normal weight (BMI \< 25 kg/m2), (2) metabolically healthy/overweight (BMI \>/= 25 kg/m2), (3) metabolically unhealthy/normal weight (BMI \< 25 kg/m2), and (4) metabolically unhealthy/overweight (BMI \>/= 25 kg/m2). Additionally, in separate models, waist circumference measurements (using the International Diabetes Federation cut-points [\>/=80 cm for women and \>/=94 cm for men]) were used (instead of BMI) to create the four metabolic health/body size phenotype categories. Statistical tests used in the analysis were all two-sided, and a p-value of \<0.05 was considered statistically significant. In multivariable-adjusted conditional logistic regression models with BMI used to define adiposity, compared with metabolically healthy/normal weight individuals, we observed a higher colorectal cancer risk among metabolically unhealthy/normal weight (odds ratio [OR] = 1.59, 95% CI 1.10-2.28) and metabolically unhealthy/overweight (OR = 1.40, 95% CI 1.01-1.94) participants, but not among metabolically healthy/overweight individuals (OR = 0.96, 95% CI 0.65-1.42). Among the overweight individuals, lower colorectal cancer risk was observed for metabolically healthy/overweight individuals compared with metabolically unhealthy/overweight individuals (OR = 0.69, 95% CI 0.49-0.96). These associations were generally consistent when waist circumference was used as the measure of adiposity. To our knowledge, there is no universally accepted clinical definition for using C-peptide level as an indication of hyperinsulinaemia. Therefore, a possible limitation of our analysis was that the classification of individuals as being hyperinsulinaemic-based on their C-peptide level-was arbitrary. However, when we used quartiles or the median of C-peptide, instead of tertiles, as the cut-point of hyperinsulinaemia, a similar pattern of associations was observed. CONCLUSIONS: These results support the idea that individuals with the metabolically healthy/overweight phenotype (with normal insulin levels) are at lower colorectal cancer risk than those with hyperinsulinaemia. The combination of anthropometric measures with metabolic parameters, such as C-peptide, may be useful for defining strata of the population at greater risk of colorectal cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15679, title = {Modifiable causes of premature death in middle-age in Western Europe: results from the EPIC cohort study}, author = {D C Muller and N Murphy and M Johansson and P Ferrari and K K Tsilidis and M C Boutron-Ruault and F Clavel and L Dartois and K Li and R Kaaks and C Weikert and M Bergmann and H Boeing and A Tjonneland and K Overvad and M L Redondo and A Agudo and E Molina-Portillo and J M Altzibar and L Cirera and E Ardanaz and K T Khaw and N J Wareham and T J Key and R C Travis and C Bamia and P Orfanos and A Trichopoulou and D Palli and V Pala and R Tumino and P Vineis and S Panico and H B Bueno-de-Mesquita and W M Verschuren and E A Struijk and P H Peeters and G Engstrom and O Melander and M Sund and E Weiderpass and G Skeie and E Lund and T Norat and M Gunter and E Riboli and P Brennan}, doi = {10.1186/s12916-016-0630-6}, issn = {1741-7015}, year = {2016}, date = {2016-01-01}, journal = {BMC Med}, volume = {14}, pages = {87}, abstract = {BACKGROUND: Life expectancy is increasing in Europe, yet a substantial proportion of adults still die prematurely before the age of 70 years. We sought to estimate the joint and relative contributions of tobacco smoking, hypertension, obesity, physical inactivity, alcohol and poor diet towards risk of premature death. METHODS: We analysed data from 264,906 European adults from the EPIC prospective cohort study, aged between 40 and 70 years at the time of recruitment. Flexible parametric survival models were used to model risk of death conditional on risk factors, and survival functions and attributable fractions (AF) for deaths prior to age 70 years were calculated based on the fitted models. RESULTS: We identified 11,930 deaths which occurred before the age of 70. The AF for premature mortality for smoking was 31 % (95 % confidence interval (CI), 31-32 %) and 14 % (95 % CI, 12-16 %) for poor diet. Important contributions were also observed for overweight and obesity measured by waist-hip ratio (10 %; 95 % CI, 8-12 %) and high blood pressure (9 %; 95 % CI, 7-11 %). AFs for physical inactivity and excessive alcohol intake were 7 % and 4 %, respectively. Collectively, the AF for all six risk factors was 57 % (95 % CI, 55-59 %), being 35 % (95 % CI, 32-37 %) among never smokers and 74 % (95 % CI, 73-75 %) among current smokers. CONCLUSIONS: While smoking remains the predominant risk factor for premature death in Europe, poor diet, overweight and obesity, hypertension, physical inactivity, and excessive alcohol consumption also contribute substantially. Any attempt to minimise premature deaths will ultimately require all six factors to be addressed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15642, title = {Main nutrient patterns and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition study}, author = {A Moskal and H Freisling and G Byrnes and N Assi and M T Fahey and M Jenab and P Ferrari and A Tjonneland and K E Petersen and C C Dahm and C P Hansen and A Affret and M C Boutron-Ruault and C Cadeau and T Kuhn and V Katzke and K Iqbal and H Boeing and A Trichopoulou and C Bamia and A Naska and G Masala and M S Magistris and S Sieri and R Tumino and C Sacerdote and P H Peeters and B H Bueno-de-Mesquita and D Engeset and I Licaj and G Skeie and E Ardanaz and G Buckland and J M Castano and J R Quiros and P Amiano and E Molina-Portillo and A Winkvist and R Myte and U Ericson and E Sonestedt and A Perez-Cornago and N Wareham and K T Khaw and I Huybrechts and K K Tsilidis and H Ward and M J Gunter and N Slimani}, doi = {10.1038/bjc.2016.334}, issn = {0007-0920}, year = {2016}, date = {2016-01-01}, journal = {Br J Cancer}, volume = {115}, number = {11}, pages = {1430-1440}, abstract = {BACKGROUND: Much of the current literature on diet-colorectal cancer (CRC) associations focused on studies of single foods/nutrients, whereas less is known about nutrient patterns. We investigated the association between major nutrient patterns and CRC risk in participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. METHODS: Among 477 312 participants, intakes of 23 nutrients were estimated from validated dietary questionnaires. Using results from a previous principal component (PC) analysis, four major nutrient patterns were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed for the association of each of the four patterns and CRC incidence using multivariate Cox proportional hazards models with adjustment for established CRC risk factors. RESULTS: During an average of 11 years of follow-up, 4517 incident cases of CRC were documented. A nutrient pattern characterised by high intakes of vitamins and minerals was inversely associated with CRC (HR per 1 s.d.=0.94, 95% CI: 0.92-0.98) as was a pattern characterised by total protein, riboflavin, phosphorus and calcium (HR (1 s.d.)=0.96, 95% CI: 0.93-0.99). The remaining two patterns were not significantly associated with CRC risk. CONCLUSIONS: Analysing nutrient patterns may improve our understanding of how groups of nutrients relate to CRC.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15690, title = {Flavonoid and lignan intake and pancreatic cancer risk in the European prospective investigation into cancer and nutrition cohort}, author = {E Molina-Montes and M J Sanchez and R Zamora-Ros and H B Bueno-de-Mesquita and P A Wark and M Obon-Santacana and T Kuhn and V Katzke and R C Travis and W Ye and M Sund and A Naccarati and A Mattiello and V Krogh and C Martorana and G Masala and P Amiano and J M Huerta and A Barricarte and J R Quiros and E Weiderpass and L Angell Asli and G Skeie and U Ericson and E Sonestedt and P H Peeters and I Romieu and A Scalbert and K Overvad and M Clemens and H Boeing and A Trichopoulou and E Peppa and P Vidalis and K T Khaw and N Wareham and A Olsen and A Tjonneland and M C Boutroun-Rualt and F Clavel-Chapelon and A J Cross and Y Lu and E Riboli and E J Duell}, doi = {10.1002/ijc.30190}, issn = {0020-7136}, year = {2016}, date = {2016-01-01}, journal = {Int J Cancer}, volume = {139}, number = {7}, pages = {1480-92}, abstract = {Despite the potential cancer preventive effects of flavonoids and lignans, their ability to reduce pancreatic cancer risk has not been demonstrated in epidemiological studies. Our aim was to examine the association between dietary intakes of flavonoids and lignans and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. A total of 865 exocrine pancreatic cancer cases occurred after 11.3 years of follow-up of 477,309 cohort members. Dietary flavonoid and lignan intake was estimated through validated dietary questionnaires and the US Department of Agriculture (USDA) and Phenol Explorer databases. Hazard ratios (HR) and 95% confidence intervals (CIs) were calculated using age, sex and center-stratified Cox proportional hazards models, adjusted for energy intake, body mass index (BMI), smoking, alcohol and diabetes status. Our results showed that neither overall dietary intake of flavonoids nor of lignans were associated with pancreatic cancer risk (multivariable-adjusted HR for a doubling of intake = 1.03, 95% CI: 0.95-1.11 and 1.02; 95% CI: 0.89-1.17, respectively). Statistically significant associations were also not observed by flavonoid subclasses. An inverse association between intake of flavanones and pancreatic cancer risk was apparent, without reaching statistical significance, in microscopically confirmed cases (HR for a doubling of intake = 0.96, 95% CI: 0.91-1.00). In conclusion, we did not observe an association between intake of flavonoids, flavonoid subclasses or lignans and pancreatic cancer risk in the EPIC cohort.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15699, title = {Association between pain catastrophising and musculoskeletal disorders is modified by past injuries in Malaysian military recruits}, author = {F H Mohd Din and S Rampal and M A Muslan and V C Hoe}, doi = {10.1136/oemed-2015-103140}, issn = {1351-0711}, year = {2016}, date = {2016-01-01}, journal = {Occup Environ Med}, volume = {73}, number = {7}, pages = {429-34}, abstract = {OBJECTIVES: Pain catastrophising is de fi ned as exaggerated negative thoughts, which can occur during an actual or anticipated painful experience, such as musculoskeletal injuries (MSI) or disorders (MSD). The aims of this study are to examine the association between pain catastrophising and MSI and MSD in Malaysian Army male recruits, and evaluate the effects of past injury. METHODS: A cohort of 611 male Malaysian Army recruits were recruited and followed up at 3 and 6 months. Pain catastrophising, MSD, sociodemographic and work factors were measured using a self-administered questionnaire, and MSI incidence was retrieved from the medical records. Multivariable fixed effects regression was used to model the cumulative incidence of MSD and MSI. RESULTS: Approximately 12% of the recruits were diagnosed with incident MSI and 80% reported incident MSD. Higher pain catastrophising at baseline was associated with higher 6 month MSD risk (adjusted OR (aOR) 1.6 per 1 SD increase of Pain Catastrophising Scale (PCS) scores; 95% CI 1.2 to 2.0), and longitudinally associated with MSD incidence (aOR 1.2, 95% CI 1.1 to 1.4). Pain catastrophising was not associated with MSI incidence (aOR 1.0, 95% CI 0.8 to 1.3). The association between pain catastrophising and self-reported MSD was stronger among recruits with self-reported past injury (p for interaction \<0.001). CONCLUSIONS: Pain catastrophising was able to predict symptomatic MSD, and not physician-diagnosed MSI, and these findings are directly related to individual health beliefs. Pain catastrophising has a greater influence on how military recruits perceived their musculoskeletal conditions during training, and efforts to reduce pain catastrophising may be beneficial.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15641, title = {Validation of the CancerMath prognostic tool for breast cancer in Southeast Asia}, author = {H Miao and M Hartman and H M Verkooijen and N A Taib and H S Wong and S Subramaniam and C H Yip and E Y Tan and P Chan and S C Lee and N Bhoo-Pathy}, doi = {10.1186/s12885-016-2841-9}, issn = {1471-2407}, year = {2016}, date = {2016-01-01}, journal = {BMC Cancer}, volume = {16}, number = {1}, pages = {820}, abstract = {BACKGROUND: CancerMath is a set of web-based prognostic tools which predict nodal status and survival up to 15 years after diagnosis of breast cancer. This study validated its performance in a Southeast Asian setting. METHODS: Using Singapore Malaysia Hospital-Based Breast Cancer Registry, clinical information was retrieved from 7064 stage I to III breast cancer patients who were diagnosed between 1990 and 2011 and underwent surgery. Predicted and observed probabilities of positive nodes and survival were compared for each subgroup. Calibration was assessed by plotting observed value against predicted value for each decile of the predicted value. Discrimination was evaluated by area under a receiver operating characteristic curve (AUC) with 95 % confidence interval (CI). RESULTS: The median predicted probability of positive lymph nodes is 40.6 % which was lower than the observed 43.6 % (95 % CI, 42.5 %-44.8 %). The calibration plot showed underestimation for most of the groups. The AUC was 0.71 (95 % CI, 0.70-0.72). Cancermath predicted and observed overall survival probabilities were 87.3 % vs 83.4 % at 5 years after diagnosis and 75.3 % vs 70.4 % at 10 years after diagnosis. The difference was smaller for patients from Singapore, patients diagnosed more recently and patients with favorable tumor characteristics. Calibration plot also illustrated overprediction of survival for patients with poor prognosis. The AUC for 5-year and 10-year overall survival was 0.77 (95 % CI: 0.75-0.79) and 0.74 (95 % CI: 0.71-0.76). CONCLUSIONS: The discrimination and calibration of CancerMath were modest. The results suggest that clinical application of CancerMath should be limited to patients with better prognostic profile.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15732, title = {Nutrient-wide association study of 57 foods/nutrients and epithelial ovarian cancer in the European Prospective Investigation into Cancer and Nutrition study and the Netherlands Cohort Study}, author = {M A Merritt and I Tzoulaki and P A Brandt and L J Schouten and K K Tsilidis and E Weiderpass and C J Patel and A Tjonneland and L Hansen and K Overvad and M His and L Dartois and M C Boutron-Ruault and R T Fortner and R Kaaks and K Aleksandrova and H Boeing and A Trichopoulou and P Lagiou and C Bamia and D Palli and V Krogh and R Tumino and F Ricceri and A Mattiello and H B Bueno-de-Mesquita and N C Onland-Moret and P H Peeters and G Skeie and M Jareid and J R Quiros and M Obon-Santacana and M J Sanchez and S Chamosa and J M Huerta and A Barricarte and J A Dias and E Sonestedt and A Idahl and E Lundin and N J Wareham and K T Khaw and R C Travis and P Ferrari and E Riboli and M J Gunter}, doi = {10.3945/ajcn.115.118588}, issn = {0002-9165}, year = {2016}, date = {2016-01-01}, journal = {Am J Clin Nutr}, volume = {103}, number = {1}, pages = {161-7}, abstract = {BACKGROUND: Studies of the role of dietary factors in epithelial ovarian cancer (EOC) development have been limited, and no specific dietary factors have been consistently associated with EOC risk. OBJECTIVE: We used a nutrient-wide association study approach to systematically test the association between dietary factors and invasive EOC risk while accounting for multiple hypothesis testing by using the false discovery rate and evaluated the findings in an independent cohort. DESIGN: We assessed dietary intake amounts of 28 foods/food groups and 29 nutrients estimated by using dietary questionnaires in the EPIC (European Prospective Investigation into Cancer and Nutrition) study (n = 1095 cases). We selected 4 foods/nutrients that were statistically significantly associated with EOC risk when comparing the extreme quartiles of intake in the EPIC study (false discovery rate = 0.43) and evaluated these factors in the NLCS (Netherlands Cohort Study; n = 383 cases). Cox regression models were used to estimate HRs and 95% CIs. RESULTS: None of the 4 dietary factors that were associated with EOC risk in the EPIC study (cholesterol, polyunsaturated and saturated fat, and bananas) were statistically significantly associated with EOC risk in the NLCS; however, in meta-analysis of the EPIC study and the NLCS, we observed a higher risk of EOC with a high than with a low intake of saturated fat (quartile 4 compared with quartile 1; overall HR: 1.21; 95% CI: 1.04, 1.41). CONCLUSION: In the meta-analysis of both studies, there was a higher risk of EOC with a high than with a low intake of saturated fat.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15718, title = {Victimization After Meeting With Online Acquaintances: A Cross-Sectional Survey of Adolescents in Malaysia}, author = {M J Marret and W Y Choo}, doi = {10.1177/0886260515625502}, issn = {0886-2605}, year = {2016}, date = {2016-01-01}, journal = {J Interpers Violence}, abstract = {This study aimed to determine contact and privacy risks encountered by Malaysian adolescents with access to the Internet and mobile phones and factors associated with face-to-face meetings with online acquaintances as well as to estimate the prevalence of subsequent victimization. Secondary school students from randomly selected public schools in Selangor and Kuala Lumpur responded to an anonymous self-administered questionnaire (78% response rate). Out of 3,349 Internet or mobile phone users, 51% had been invited to meet offline with an online-meeting acquaintance and 30% complied. Of the 1,005 respondents who went to offline meetings, 55% had meetings with more than six people. Male gender, Malay ethnicity, online access at an Internet cafe, viewing pornography on the Internet, the absence of parental restrictions on visiting certain website and chat rooms, not being explicitly forbidden to meet strangers encountered online, and disclosure of personal information were significantly associated with increased odds of face-to-face meetings with online acquaintances. Verbal, physical, or sexual assaults were reported by 5.5% of the 1,005 including 13 males and five females who reported forced sexual intercourse. Similarities as well as differences in factors associated with risk-taking behavior compared with adolescents in Western countries have important implications on policy and intervention.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15670, title = {Are the Poor Dying Younger in Malaysia? An Examination of the Socioeconomic Gradient in Mortality}, author = {J Mariapun and N N Hairi and C W Ng}, doi = {10.1371/journal.pone.0158685}, issn = {1932-6203}, year = {2016}, date = {2016-01-01}, journal = {PLoS One}, volume = {11}, number = {6}, pages = {e0158685}, abstract = {INTRODUCTION: Socioeconomic inequalities in health represent unfairness in the health distribution of a population. Efforts to produce information on mortality distributions in many low and middle income countries (LMICs) are mostly hampered by lack of data disaggregated by socioeconomic groups. In this paper we describe how mortality statistics obtained from multiple data sources were combined to provide an evaluation of the socioeconomic distribution of mortality in Malaysia, a LMIC located in the Asia Pacific region. METHODS: This study has an ecological design. As a measure of socioeconomic status, we used principal component analysis to construct a socioeconomic index using census data. Districts were ranked according to the standardised median index of households and assigned to each individual in the 5-year mortality data. The mortality indicators of interest were potential years of life lost (PYLL), standardised mortality ratio (SMR), infant mortality rate (IMR) and under-5 mortality rate (U5MR). Both socioeconomic status and mortality outcomes were used compute the concentration index which provided the summary measure of the magnitude of inequality. RESULTS: Socially disadvantaged districts were found to have worse mortality outcomes compared to more advantaged districts. The values of the concentration index for the overall population of the Peninsula are C = -0.1334 (95% CI: -0.1605 to -0.1063) for the PYLL}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15660, title = {Physical activity, body composition and lipids changes in adolescents: analysis from the MyHeART Study}, author = {H A Majid and M Amiri and N Mohd Azmi and T T Su and M Y Jalaludin and N Al-Sadat}, doi = {10.1038/srep30544}, issn = {2045-2322}, year = {2016}, date = {2016-01-01}, journal = {Sci Rep}, volume = {6}, pages = {30544}, abstract = {Insufficient physical activity and growing obesity levels among Malaysian adolescents are becoming a public health concern. Our study is to identify the trends of self-reported physical activity (PA) levels, blood lipid profiles, and body composition (BC) indices from a cohort of 820 adolescents. The self-reported PA was assessed using a validated Malay version of the PA Questionnaire for Older Children (PAQ-C). Fasting blood samples were collected to investigate their lipid profiles. Height, weight, waist and hip circumferences as well as body fat percentage were measured. The baseline and the first follow-up were conducted in 2012 and 2014, respectively. A downward trend in the PA level was seen in all categories with a significant reduction among all rural adolescents (P = 0.013) and more specifically, PA among girls residing in rural areas dropped significantly (P = 0.006). Either a significant reduction in high-density lipoprotein (HDL) or a significant increment in BC indices (i.e., body mass index [BMI], waist circumference [WC], hip circumference, and body fat percentage [BF %]) were seen in this group. Female adolescents experienced more body fat increment with the reduction of physical activity. If not intervened early, adolescents from rural areas may increase their risk of developing cardiovascular diseases earlier.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15681, title = {Female chromosome X mosaicism is age-related and preferentially affects the inactivated X chromosome}, author = {M J Machiela and W Zhou and E Karlins and J N Sampson and N D Freedman and Q Yang and B Hicks and C Dagnall and C Hautman and K B Jacobs and C C Abnet and M C Aldrich and C Amos and L T Amundadottir and A A Arslan and L E Beane-Freeman and S I Berndt and A Black and W J Blot and C H Bock and P M Bracci and L A Brinton and H B Bueno-de-Mesquita and L Burdett and J E Buring and M A Butler and F Canzian and T Carreon and K G Chaffee and I S Chang and N Chatterjee and C Chen and C Chen and K Chen and C C Chung and L S Cook and M Crous Bou and M Cullen and F G Davis and I De Vivo and T Ding and J Doherty and E J Duell and C G Epstein and J H Fan and J D Figueroa and J F Fraumeni and C M Friedenreich and C S Fuchs and S Gallinger and Y T Gao and S M Gapstur and M Garcia-Closas and M M Gaudet and J M Gaziano and G G Giles and E M Gillanders and E L Giovannucci and L Goldin and A M Goldstein and C A Haiman and G Hallmans and S E Hankinson and C C Harris and R Henriksson and E A Holly and Y C Hong and R N Hoover and C A Hsiung and N Hu and W Hu and D J Hunter and A Hutchinson and M Jenab and C Johansen and K T Khaw and H N Kim and Y H Kim and Y T Kim and A P Klein and R Klein and W P Koh and L N Kolonel and C Kooperberg and P Kraft and V Krogh and R C Kurtz and A LaCroix and Q Lan and M T Landi and L L Marchand and D Li and X Liang and L M Liao and D Lin and J Liu and J Lissowska and L Lu and A M Magliocco and N Malats and others}, doi = {10.1038/ncomms11843}, issn = {2041-1723}, year = {2016}, date = {2016-01-01}, journal = {Nat Commun}, volume = {7}, pages = {11843}, abstract = {To investigate large structural clonal mosaicism of chromosome X, we analysed the SNP microarray intensity data of 38,303 women from cancer genome-wide association studies (20,878 cases and 17,425 controls) and detected 124 mosaic X events \>2 Mb in 97 (0.25%) women. Here we show rates for X-chromosome mosaicism are four times higher than mean autosomal rates; X mosaic events more often include the entire chromosome and participants with X events more likely harbour autosomal mosaic events. X mosaicism frequency increases with age (0.11% in 50-year olds; 0.45% in 75-year olds), as reported for Y and autosomes. Methylation array analyses of 33 women with X mosaicism indicate events preferentially involve the inactive X chromosome. Our results provide further evidence that the sex chromosomes undergo mosaic events more frequently than autosomes, which could have implications for understanding the underlying mechanisms of mosaic events and their possible contribution to risk for chronic diseases.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15657, title = {Attitudes and factors affecting acceptability of self-administered cervicovaginal sampling for human papillomavirus (HPV) genotyping as an alternative to Pap testing among multiethnic Malaysian women}, author = {M Ma'som and N Bhoo-Pathy and N H Nasir and J Bellinson and S Subramaniam and Y Ma and S H Yap and P P Goh and P Gravitt and Y L Woo}, doi = {10.1136/bmjopen-2015-011022}, issn = {2044-6055}, year = {2016}, date = {2016-01-01}, journal = {BMJ Open}, volume = {6}, number = {8}, pages = {e011022}, abstract = {OBJECTIVE: The objective of this study was to determine the attitudes and acceptability of self-administered cervicovaginal sampling compared with conventional physician-acquired Papanicolaou (Pap) smear among multiethnic Malaysian women. METHOD: A cross-sectional study was carried out via interviewer-administered surveys from August 2013 through August 2015 at five government-run, urban health clinics in the state of Selangor. Subjects were participants from an ongoing community-based human papillomavirus (HPV) prevalence study who answered a standard questionnaire before and after self-sampling. The cervicovaginal self-sampling for HPV genotyping was performed using a simple brush ('Just for Me'; Preventive Oncology International, Hong Kong). Detailed data on sociodemographics, previous Pap smear experience, and attitudes towards self-administered cervicovaginal sampling were collected and analysed. Acceptability was inferred using a five-item Likert scale that included six different subjective descriptives: experience, difficulty, convenience, embarrassment, discomfort or pain, and confidence in collecting one's own sample. RESULTS: Of the 839 participants, 47.9% were Malays, followed by 30.8% Indians, 18.8% Chinese and 2.5% from other ethnicities. The median age of the participants was 38 years (IQR 30-48). Some 68.2% of participants indicated a preference for self-sampling over the Pap test, with 95% indicating willingness to follow-up a positive result at the hospital. Age, ethnicity and previous Pap test experience were significant independent factors associated with preference for self-sampling. The older the individual, the less likely they were to prefer self-sampling (adjusted OR 0.94, 95% CI 0.90 to 0.98). The Chinese were less likely to prefer self-sampling (72.6%) than the Malays (85.1%) (adjusted OR 0.57, 95% CI 0.33 to 0.98}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15644, title = {Menstrual and Reproductive Factors, Hormone Use, and Risk of Pancreatic Cancer: Analysis From the International Pancreatic Cancer Case-Control Consortium (PanC4)}, author = {L Lujan-Barroso and W Zhang and S H Olson and Y T Gao and H Yu and P A Baghurst and P M Bracci and H B Bueno-de-Mesquita and L Foretova and S Gallinger and I Holcatova and V Janout and B T Ji and R C Kurtz and C La Vecchia and P Lagiou and D Li and A B Miller and D Serraino and W Zatonski and H A Risch and E J Duell}, doi = {10.1097/mpa.0000000000000635}, issn = {0885-3177}, year = {2016}, date = {2016-01-01}, journal = {Pancreas}, volume = {45}, number = {10}, pages = {1401-1410}, abstract = {OBJECTIVES: We aimed to evaluate the relation between menstrual and reproductive factors, exogenous hormones, and risk of pancreatic cancer (PC). METHODS: Eleven case-control studies within the International Pancreatic Cancer Case-control Consortium took part in the present study, including in total 2838 case and 4748 control women. Pooled estimates of odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated using a 2-step logistic regression model and adjusting for relevant covariates. RESULTS: An inverse OR was observed in women who reported having had hysterectomy (ORyesvs.no, 0.78; 95% CI, 0.67-0.91), remaining significant in postmenopausal women and never-smoking women, adjusted for potential PC confounders. A mutually adjusted model with the joint effect for hormone replacement therapy (HRT) and hysterectomy showed significant inverse associations with PC in women who reported having had hysterectomy with HRT use (OR, 0.64; 95% CI, 0.48-0.84). CONCLUSIONS: Our large pooled analysis suggests that women who have had a hysterectomy may have reduced risk of PC. However, we cannot rule out that the reduced risk could be due to factors or indications for having had a hysterectomy. Further investigation of risk according to HRT use and reason for hysterectomy may be necessary.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15680, title = {Comparison of abdominal adiposity and overall obesity in relation to risk of small intestinal cancer in a European Prospective Cohort}, author = {Y Lu and A J Cross and N Murphy and H Freisling and R C Travis and P Ferrari and V A Katzke and R Kaaks and A Olsson and I Johansson and F Renstrom and S Panico and V Pala and D Palli and R Tumino and P H Peeters and P D Siersema and H B Bueno-de-Mesquita and A Trichopoulou and E Klinaki and C Tsironis and A Agudo and C Navarro and M J Sanchez and A Barricarte and M C Boutron-Ruault and G Fagherazzi and A Racine and E Weiderpass and M J Gunter and E Riboli}, doi = {10.1007/s10552-016-0772-z}, issn = {0957-5243}, year = {2016}, date = {2016-01-01}, journal = {Cancer Causes Control}, volume = {27}, number = {7}, pages = {919-27}, abstract = {BACKGROUND: The etiology of small intestinal cancer (SIC) is largely unknown, and there are very few epidemiological studies published to date. No studies have investigated abdominal adiposity in relation to SIC. METHODS: We investigated overall obesity and abdominal adiposity in relation to SIC in the European Prospective Investigation into Cancer and Nutrition (EPIC), a large prospective cohort of approximately half a million men and women from ten European countries. Overall obesity and abdominal obesity were assessed by body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Multivariate Cox proportional hazards regression modeling was performed to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs). Stratified analyses were conducted by sex, BMI, and smoking status. RESULTS: During an average of 13.9 years of follow-up, 131 incident cases of SIC (including 41 adenocarcinomas, 44 malignant carcinoid tumors, 15 sarcomas and 10 lymphomas, and 21 unknown histology) were identified. WC was positively associated with SIC in a crude model that also included BMI (HR per 5-cm increase = 1.20, 95 % CI 1.04, 1.39), but this association attenuated in the multivariable model (HR 1.18, 95 % CI 0.98, 1.42). However, the association between WC and SIC was strengthened when the analysis was restricted to adenocarcinoma of the small intestine (multivariable HR adjusted for BMI = 1.56, 95 % CI 1.11, 2.17). There were no other significant associations. CONCLUSION: WC, rather than BMI, may be positively associated with adenocarcinomas but not carcinoid tumors of the small intestine. IMPACT: Abdominal obesity is a potential risk factor for adenocarcinoma in the small intestine.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15702, title = {The Hidden Health and Economic Burden of Rotavirus Gastroenteritis in Malaysia: An Estimation Using Multiple Data Sources}, author = {T Loganathan and C W Ng and W S Lee and M Jit}, doi = {10.1097/inf.0000000000001129}, issn = {0891-3668}, year = {2016}, date = {2016-01-01}, journal = {Pediatr Infect Dis J}, volume = {35}, number = {6}, pages = {601-6}, abstract = {BACKGROUND: Rotavirus gastroenteritis (RVGE) results in substantial mortality and morbidity worldwide. However, an accurate estimation of the health and economic burden of RVGE in Malaysia covering public, private and home treatment is lacking. METHODS: Data from multiple sources were used to estimate diarrheal mortality and morbidity according to health service utilization. The proportion of this burden attributable to rotavirus was estimated from a community-based study and a meta-analysis we conducted of primary hospital-based studies. Rotavirus incidence was determined by multiplying acute gastroenteritis incidence with estimates of the proportion of gastroenteritis attributable to rotavirus. The economic burden of rotavirus disease was estimated from the health systems and societal perspective. RESULTS: Annually, rotavirus results in 27 deaths, 31,000 hospitalizations, 41,000 outpatient visits and 145,000 episodes of home-treated gastroenteritis in Malaysia. We estimate an annual rotavirus incidence of 1 death per 100,000 children and 12 hospitalizations, 16 outpatient clinic visits and 57 home-treated episodes per 1000 children under-5 years. Annually, RVGE is estimated to cost US$ 34 million to the healthcare provider and US$ 50 million to society. Productivity loss contributes almost a third of costs to society. Publicly, privately and home-treated episodes consist of 52%, 27% and 21%, respectively, of the total societal costs. CONCLUSIONS: RVGE represents a considerable health and economic burden in Malaysia. Much of the burden lies in privately or home-treated episodes and is poorly captured in previous studies. This study provides vital information for future evaluation of cost-effectiveness, which are necessary for policy-making regarding universal vaccination.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15634, title = {Rotavirus vaccines contribute towards universal health coverage in a mixed public-private healthcare system}, author = {T Loganathan and M Jit and R Hutubessy and C W Ng and W S Lee and S Verguet}, doi = {10.1111/tmi.12766}, issn = {1360-2276}, year = {2016}, date = {2016-01-01}, journal = {Trop Med Int Health}, volume = {21}, number = {11}, pages = {1458-1467}, abstract = {OBJECTIVES: To evaluate rotavirus vaccination in Malaysia from the household's perspective. The extended cost-effectiveness analysis (ECEA) framework quantifies the broader value of universal vaccination starting with non-health benefits such as financial risk protection and equity. These dimensions better enable decision-makers to evaluate policy on the public finance of health programmes. METHODS: The incidence, health service utilisation and household expenditure related to rotavirus gastroenteritis according to national income quintiles were obtained from local data sources. Multiple birth cohorts were distributed into income quintiles and followed from birth over the first five years of life in a multicohort, static model. RESULTS: We found that the rich pay more out of pocket (OOP) than the poor, as the rich use more expensive private care. OOP payments among the poorest although small are high as a proportion of household income. Rotavirus vaccination results in substantial reduction in rotavirus episodes and expenditure and provides financial risk protection to all income groups. Poverty reduction benefits are concentrated amongst the poorest two income quintiles. CONCLUSION: We propose that universal vaccination complements health financing reforms in strengthening Universal Health Coverage (UHC). ECEA provides an important tool to understand the implications of vaccination for UHC, beyond traditional considerations of economic efficiency.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15632, title = {Determinants of High Fasting Insulin and Insulin Resistance Among Overweight/Obese Adolescents}, author = {J C Ling and M N Mohamed and M Y Jalaludin and S Rampal and N L Zaharan and Z Mohamed}, doi = {10.1038/srep36270}, issn = {2045-2322}, year = {2016}, date = {2016-01-01}, journal = {Sci Rep}, volume = {6}, pages = {36270}, abstract = {Hyperinsulinaemia is the earliest subclinical metabolic abnormality, which precedes insulin resistance in obese children. An investigation was conducted on the potential predictors of fasting insulin and insulin resistance among overweight/obese adolescents in a developing Asian country. A total of 173 overweight/obese (BMI \> 85(th) percentile) multi-ethnic Malaysian adolescents aged 13 were recruited from 23 randomly selected schools in this cross-sectional study. Waist circumference (WC), body fat percentage (BF%), physical fitness score (PFS), fasting glucose and fasting insulin were measured. Insulin resistance was calculated using homeostasis model assessment of insulin resistance (HOMA-IR). Adjusted stepwise multiple regression analysis was performed to predict fasting insulin and HOMA-IR. Covariates included pubertal stage, socioeconomic status, nutritional and physical activity scores. One-third of our adolescents were insulin resistant, with girls having significantly higher fasting insulin and HOMA-IR than boys. Gender, pubertal stage, BMI, WC and BF% had significant, positive moderate correlations with fasting insulin and HOMA-IR while PFS was inversely correlated (p \< 0.05). Fasting insulin was primarily predicted by gender-girls (Beta = 0.305, p \< 0.0001), higher BMI (Beta = -0.254}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15673, title = {Faster onset time of supraclavicular brachial plexus block using local anesthetic diluted with dextrose}, author = {H J Lim and M S Hasan and K Chinna}, doi = {10.1016/j.bjane.2014.11.012}, year = {2016}, date = {2016-01-01}, journal = {Braz J Anesthesiol}, volume = {66}, number = {4}, pages = {341-5}, abstract = {BACKGROUND AND OBJECTIVES: A high sodium concentration is known to antagonize local anesthetics when infiltrated around neural tissue. Thus, we hypothesized that the onset time for sensory and motor blockade, in supraclavicular brachial plexus block using ropivacaine diluted with dextrose would be shorter than with saline. METHODS: Patients scheduled for upper limb surgery were randomized to receive ultrasound guided supraclavicular brachial plexus block with 0.5% ropivacaine. Evaluation of sensory and motor blockade was performed every 5min for 60min. Patients were followed-up on postoperative day 1, and between days 7 and 10 for the presence of any complications. Twenty-five patients in each group were analyzed. RESULTS: Mean time for onset of analgesia for the dextrose group was 37.6+/-12.9min while the mean time for the saline group was 45.2+/-13.9min with a p-value of 0.05. The effect size was 0.567, which was moderate to large. No major complications were observed. CONCLUSION: We conclude that there was a decrease in onset time of analgesia when dextrose was used as a diluent instead of saline for ultrasound guided supraclavicular block.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15676, title = {Dengue in Malaysia: Factors Associated with Dengue Mortality from a National Registry}, author = {S M Liew and E M Khoo and B K Ho and Y K Lee and M Omar and V Ayadurai and F Mohamed Yusoff and Z Suli and R N Mudin and P P Goh and K Chinna}, doi = {10.1371/journal.pone.0157631}, issn = {1932-6203}, year = {2016}, date = {2016-01-01}, journal = {PLoS One}, volume = {11}, number = {6}, pages = {e0157631}, abstract = {BACKGROUND: The increasing incidence and geographical distribution of dengue has had significant impact on global healthcare services and resources. This study aimed to determine the factors associated with dengue-related mortality in a cohort of Malaysian patients. METHODS: This was a retrospective cohort study of patients in the Malaysian National Dengue Registry of 2013. The outcome measure was dengue-related mortality. Associations between sociodemographic and clinical variables with the outcome were analysed using multivariate analysis. RESULTS: There were 43 347 cases of which 13081 were serologically confirmed. The mean age was 30.0 years (SD 15.7); 60.2% were male. The incidence of dengue increased towards the later part of the calendar year. There were 92 probable dengue mortalities, of which 41 were serologically confirmed. Multivariate analysis in those with positive serology showed that increasing age (OR 1.03; CI:1.01-1.05), persistent vomiting (OR 13.34; CI: 1.92-92.95), bleeding (OR 5.84; CI 2.17-15.70) and severe plasma leakage (OR 66.68; CI: 9.13-487.23) were associated with mortality. Factors associated with probable dengue mortality were increasing age (OR 1.04; CI:1.03-1.06), female gender (OR 1.53; CI:1.01-2.33), nausea and/or vomiting (OR 1.80; CI:1.17-2.77), bleeding (OR 3.01; CI:1.29-7.04), lethargy and/or restlessness (OR 5.97; CI:2.26-15.78), severe plasma leakage (OR 14.72; CI:1.54-140.70), and shock (OR 1805.37; CI:125.44-25982.98), in the overall study population. CONCLUSIONS: Older persons and those with persistent vomiting, bleeding or severe plasma leakage, which were associated with mortality, at notification should be monitored closely and referred early if indicated. Doctors and primary care practitioners need to detect patients with dengue early before they develop these severe signs and symptoms.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15635, title = {Genome-wide association analyses identify new susceptibility loci for oral cavity and pharyngeal cancer}, author = {C Lesseur and B Diergaarde and A F Olshan and V Wunsch-Filho and A R Ness and G Liu and M Lacko and J Eluf-Neto and S Franceschi and P Lagiou and G J Macfarlane and L Richiardi and S Boccia and J Polesel and K Kjaerheim and D Zaridze and M Johansson and A M Menezes and M P Curado and M Robinson and W Ahrens and C Canova and A Znaor and X Castellsague and D I Conway and I Holcatova and D Mates and M Vilensky and C M Healy and N Szeszenia-Dabrowska and E Fabianova and J Lissowska and J R Grandis and M C Weissler and E H Tajara and F D Nunes and M B Carvalho and S Thomas and R J Hung and W H Peters and R Herrero and G Cadoni and H B Bueno-de-Mesquita and A Steffen and A Agudo and O Shangina and X Xiao and V Gaborieau and A Chabrier and D Anantharaman and P Boffetta and C I Amos and J D McKay and P Brennan}, doi = {10.1038/ng.3685}, issn = {1061-4036}, year = {2016}, date = {2016-01-01}, journal = {Nat Genet}, volume = {48}, number = {12}, pages = {1544-1550}, abstract = {We conducted a genome-wide association study of oral cavity and pharyngeal cancer in 6,034 cases and 6,585 controls from Europe, North America and South America. We detected eight significantly associated loci (P \< 5 x 10(-8)), seven of which are new for these cancer sites. Oral and pharyngeal cancers combined were associated with loci at 6p21.32 (rs3828805, HLA-DQB1), 10q26.13 (rs201982221, LHPP) and 11p15.4 (rs1453414, OR52N2-TRIM5). Oral cancer was associated with two new regions, 2p23.3 (rs6547741, GPN1) and 9q34.12 (rs928674, LAMC3), and with known cancer-related loci-9p21.3 (rs8181047, CDKN2B-AS1) and 5p15.33 (rs10462706, CLPTM1L). Oropharyngeal cancer associations were limited to the human leukocyte antigen (HLA) region, and classical HLA allele imputation showed a protective association with the class II haplotype HLA-DRB1*1301-HLA-DQA1*0103-HLA-DQB1*0603 (odds ratio (OR) = 0.59}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15763, title = {Test-retest reliability of HeartQoL and its comparability to the MacNew heart disease health-related quality of life questionnaire}, author = {W L Lee and K Chinna and A Bulgiba and K L Abdullah and I Z Abidin and S Hofer}, doi = {10.1007/s11136-015-1097-1}, issn = {0962-9343}, year = {2016}, date = {2016-01-01}, journal = {Qual Life Res}, volume = {25}, number = {2}, pages = {351-7}, abstract = {OBJECTIVES: Heart Quality of Life (HeartQoL) is a new "hybrid" developed from the MacNew and two condition-specific questionnaires measuring health-related quality of life (HRQoL) in patients with ischemic heart disease (IHD). This study investigates test-retest reliability of HeartQoL (English version) according to international criteria (e.g., COSMIN, GRRAS). Findings on HeartQoL are compared to the published data on MacNew in view that both serve as the core IHD-specific HRQoL instrument. METHODS: Out of 105 patients with IHD, 76 completed self-administration of HeartQoL at the clinic followed by at home within a 2-week interval. In retest, patients responded using non-interview methods (phone messaging, email, fax, and post). Phone interviewing was reserved for non-respondents to reminder. RESULTS: Reliability of HeartQoL was good (intraclass correlation coefficients = 0.78-0.82), was supported in the Bland-Altman plot, and was comparable to five studies on MacNew of similar retest interval (MacNew-English = 0.70-0.75; translated MacNew = 0.72-0.91). Applicability of its standard error of measurement (0.20-0.25) and smallest detectable change (0.55-0.70) will depend on availability of normative data in future. CONCLUSION: The reliability of HeartQoL is comparable to its parent instrument, the MacNew. The HeartQoL is a potentially reliable core IHD-specific HRQoL instrument in measuring group change.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15643, title = {The development and validation of the advance care planning questionnaire in Malaysia}, author = {P S Lai and S Mohd Mudri and K Chinna and S Othman}, doi = {10.1186/s12910-016-0147-8}, issn = {1472-6939}, year = {2016}, date = {2016-01-01}, journal = {BMC Med Ethics}, volume = {17}, number = {1}, pages = {61}, abstract = {BACKGROUND: Advance care planning is a voluntary process whereby individual preferences, values and beliefs are used to aid a person in planning for end-of-life care. Currently, there is no local instrument to assess an individual's awareness and attitude towards advance care planning. This study aimed to develop an Advance Care Planning Questionnaire and to determine its validity and reliability among older people in Malaysia. METHODS: The Advance Care Planning Questionnaire was developed based on literature review. Face and content validity was verified by an expert panel, and piloted among 15 participants. Our study was conducted from October 2013 to February 2014, at an urban primary care clinic in Malaysia. Included were those aged \>50 years, who could understand English. A retest was conducted 2 weeks after the first administration. RESULTS: Participants from the pilot study did not encounter any problems in answering the Advance Care Planning Questionnaire. Hence, no further modifications were made. Flesch reading ease was 71. The final version of the Advance Care Planning Questionnaire consists of 66 items: 30 items were measured on a nominal scale, whilst 36 items were measured on a Likert-like scale; of which we were only able to validate 22 items, as the remaining 14 items were descriptive in nature. A total of 245 eligible participants were approached; of which 230 agreed to participate (response rate = 93.9 %). Factor analysis on the 22 items measured on a Likert-scale revealed four domains: "feelings regarding advance care planning", "justifications for advance care planning", "justifications for not having advance care planning: fate and religion", and "justifications for not having advance care planning: avoid thinking about death". The Cronbach's alpha values for items each domain ranged from 0.637-0.915. In test-retest, kappa values ranged from 0.738-0.947. CONCLUSIONS: The final Advance Care Planning Questionnaire consisted of 63 items and 4 domains. It was found to be a valid and reliable instrument to assess the awareness and attitude of older people in Malaysia towards advance care planning.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15714, title = {Serum Endotoxins and Flagellin and Risk of Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) Cohort}, author = {S Y Kong and H Q Tran and A T Gewirtz and G McKeown-Eyssen and V Fedirko and I Romieu and A Tjonneland and A Olsen and K Overvad and M C Boutron-Ruault and N Bastide and A Affret and T Kuhn and R Kaaks and H Boeing and K Aleksandrova and A Trichopoulou and M Kritikou and E Vasilopoulou and D Palli and V Krogh and A Mattiello and R Tumino and A Naccarati and H B Bueno-de-Mesquita and P H Peeters and E Weiderpass and J R Quiros and N Sala and M J Sanchez and J M Castano and A Barricarte and M Dorronsoro and M Werner and N J Wareham and K T Khaw and K E Bradbury and H Freisling and F Stavropoulou and P Ferrari and M J Gunter and A J Cross and E Riboli and W R Bruce and M Jenab}, doi = {10.1158/1055-9965.Epi-15-0798}, issn = {1055-9965}, year = {2016}, date = {2016-01-01}, journal = {Cancer Epidemiol Biomarkers Prev}, volume = {25}, number = {2}, pages = {291-301}, abstract = {BACKGROUND: Chronic inflammation and oxidative stress are thought to be involved in colorectal cancer development. These processes may contribute to leakage of bacterial products, such as lipopolysaccharide (LPS) and flagellin, across the gut barrier. The objective of this study, nested within a prospective cohort, was to examine associations between circulating LPS and flagellin serum antibody levels and colorectal cancer risk. METHODS: A total of 1,065 incident colorectal cancer cases (colon}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15703, title = {Factors affecting Japanese retirees' healthcare service utilisation in Malaysia: a qualitative study}, author = {A Kohno and N D Nik Farid and G Musa and N Abdul Aziz and T Nakayama and M Dahlui}, doi = {10.1136/bmjopen-2015-010668}, issn = {2044-6055}, year = {2016}, date = {2016-01-01}, journal = {BMJ Open}, volume = {6}, number = {3}, pages = {e010668}, abstract = {OBJECTIVE: While living overseas in another culture, retirees need to adapt to a new environment but often this causes difficulties, particularly among those elderly who require healthcare services. This study examines factors affecting healthcare service utilisation among Japanese retirees in Malaysia. DESIGN: We conducted 6 focus group discussions with Japanese retirees and interviewed 8 relevant medical services providers in-depth. Guided by the Andersen Healthcare Utilisation Model, we managed and analysed the data, using QSR NVivo 10 software and the directed content analysis method. SETTING: We interviewed participants at Japan Clubs and their offices. PARTICIPANTS: 30 Japanese retirees who live in Kuala Lumpur and Ipoh, and 8 medical services providers. RESULTS: We identified health beliefs, medical symptoms and health insurance as the 3 most important themes, respectively, representing the 3 dimensions within the Andersen Healthcare Utilisation Model. Additionally, language barriers, voluntary health repatriation to Japan and psychological support were unique themes that influence healthcare service utilisation among Japanese retirees. CONCLUSIONS: The healthcare service utilisation among Japanese retirees in Malaysia could be partially explained by the Andersen Healthcare Utilisation Model, together with some factors that were unique findings to this study. Healthcare service utilisation among Japanese retirees in Malaysia could be improved by alleviating negative health beliefs through awareness programmes for Japanese retirees about the healthcare systems and cultural aspects of medical care in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15691, title = {Issues in healthcare services in Malaysia as experienced by Japanese retirees}, author = {A Kohno and G Musa and N D Nik Farid and N Abdul Aziz and T Nakayama and M Dahlui}, doi = {10.1186/s12913-016-1417-3}, issn = {1472-6963}, year = {2016}, date = {2016-01-01}, journal = {BMC Health Serv Res}, volume = {16}, pages = {167}, abstract = {BACKGROUND: Worldwide, international retirement migration is growing in its popularity and Japanese retirees choose Malaysia as their most preferred destination. This study examines the pertinent issues related to healthcare services as experienced by Japanese retirees in this country. METHODS AND RESULTS: From January to March 2015, we conducted focus group discussions with 30 Japanese retirees who live in Kuala Lumpur and Ipoh. Guided by the social-ecological model, we discovered seven pertinent themes: 'language barriers','healthcare decisions', 'medical check-ups','healthcare insurance', 'nursing and palliative care', 'trust and distrust of healthcare services', and 'word-of-mouth information'. DISCUSSION: We identified seven pertinent issues related to healthcare services among Japanese retirees in Malaysia, of which four are especially important. These issues are explained as integrated themes within the social-ecological model. Language barriers prohibit them from having difficulty accessing to healthcare in Malaysia, but lack of will to improve their language skills exist among them. For that reason, they rely heavily on word-of-mouth information when seeking for healthcare. As a consequence, some develop feelings of trust and distrust of healthcare services. In addition, we have identified the needs for provide nursing and palliative care among Japanese retirees in Malaysia. CONCLUSION: Based on the magnitude of the discussion, we concluded that there are four crucial healthcare issues among Japanese retirees; 'language barriers', 'trust and distrust of healthcare services', 'word-of-mouth information' and 'nursing and palliative care'. We propose that further dialogue by healthcare stakeholders should be carried out to improve further the healthcare service provisions for Japanese retirees in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15654, title = {Comparing effects of soybean oil- and palm olein-based mayonnaise consumption on the plasma lipid and lipoprotein profiles in human subjects: a double-blind randomized controlled trial with cross-over design}, author = {T Karupaiah and K A Chuah and K Chinna and R Matsuoka and Y Masuda and K Sundram and M Sugano}, doi = {10.1186/s12944-016-0301-9}, issn = {1476-511x}, year = {2016}, date = {2016-01-01}, journal = {Lipids Health Dis}, volume = {15}, number = {1}, pages = {131}, abstract = {BACKGROUND: Mayonnaise is used widely in contemporary human diet with widespread use as a salad dressing or spread on breads. Vegetable oils used in its formulation may be a rich source of omega-6 PUFAs and the higher-PUFA content of mayonnaise may be beneficial in mediating a hypocholesterolemic effect. This study, therefore, evaluated the functionality of mayonnaise on cardiometabolic risk within a regular human consumption scenario. METHODS: Subjects underwent a randomized double-blind crossover trial, consuming diets supplemented with 20 g/day of either soybean oil-based mayonnaise (SB-mayo) or palm olein-based mayonnaise (PO-mayo) for 4 weeks each with a 2-week wash-out period. The magnitude of changes for metabolic outcomes between dietary treatments was compared with PO-mayo serving as the control. The data was analyzed by ANCOVA using the GLM model. Analysis was adjusted for weight changes. RESULTS: Treatments resulted in significant reductions in TC (diff = -0.25 mmol/L; P = 0.001), LDL-C (diff = -0.17 mmol/L; P = 0.016) and HDL-C (diff = -0.12 mmol/L; P \< 0.001) in SB-mayo compared to PO-mayo without affecting LDL-C:HDL-C ratio (P \> 0.05). Lipoprotein particle change was significant with large LDL particles increasing after PO-mayo (diff = +63.2 nmol/L; P = 0.007) compared to SB-mayo but small LDL particles remained unaffected. Plasma glucose, apolipoproteins and oxidative stress markers remained unchanged. CONCLUSIONS: Daily use with 20 g of linoleic acid-rich SB-mayo elicited reductions in TC and LDL-C concentrations without significantly changing LDL-C:HDL-C ratio or small LDL particle distributions compared to the PO-mayo diet. TRIAL REGISTRATION: This clinical trial was retrospectively registered with the National Medical Research Register, National Institute of Health, Ministry of Health Malaysia, (NMRR-15-40-24035; registered on 29/01/2015; https://www.nmrr.gov.my/fwbPage.jsp?fwbPageId=ResearchISRForm\&fwbAction=Update\&fw bStep=10\&pk.researchID=24035\&fwbVMenu=3\&fwbResearchAction=Update ). Ethical approval was obtained from the National University of Malaysia's Medical Ethics Committee (UKM 1.5.3.5/244/SPP/NN-054-2011, approved on 25/05/2011).}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15666, title = {Genome-Wide Meta-Analyses of Breast, Ovarian, and Prostate Cancer Association Studies Identify Multiple New Susceptibility Loci Shared by at Least Two Cancer Types}, author = {S P Kar and J Beesley and A Amin Al Olama and K Michailidou and J Tyrer and Z Kote-Jarai and K Lawrenson and S Lindstrom and S J Ramus and D J Thompson and A S Kibel and A Dansonka-Mieszkowska and A Michael and A K Dieffenbach and A Gentry-Maharaj and A S Whittemore and A Wolk and A Monteiro and A Peixoto and A Kierzek and A Cox and A Rudolph and A Gonzalez-Neira and A H Wu and A Lindblom and A Swerdlow and A Ziogas and A B Ekici and B Burwinkel and B Y Karlan and B G Nordestgaard and C Blomqvist and C Phelan and C McLean and C L Pearce and C Vachon and C Cybulski and C Slavov and C Stegmaier and C Maier and C B Ambrosone and C K Hogdall and C C Teerlink and D Kang and D C Tessier and D J Schaid and D O Stram and D W Cramer and D E Neal and D Eccles and D Flesch-Janys and D R Edwards and D Wokozorczyk and D A Levine and D Yannoukakos and E J Sawyer and E V Bandera and E M Poole and E L Goode and E Khusnutdinova and E Hogdall and F Song and F Bruinsma and F Heitz and F Modugno and F C Hamdy and F Wiklund and G G Giles and H Olsson and H Wildiers and H U Ulmer and H Pandha and H A Risch and H Darabi and H B Salvesen and H Nevanlinna and H Gronberg and H Brenner and H Brauch and H Anton-Culver and H Song and H Y Lim and I McNeish and I Campbell and I Vergote and J Gronwald and J Lubinski and J L Stanford and J Benitez and J A Doherty and J B Permuth and J Chang-Claude and J L Donovan and J Dennis and J M Schildkraut and J Schleutker and J L Hopper and J Kupryjanczyk and J Y Park and J Figueroa and others}, doi = {10.1158/2159-8290.Cd-15-1227}, issn = {2159-8274}, year = {2016}, date = {2016-01-01}, journal = {Cancer Discov}, volume = {6}, number = {9}, pages = {1052-67}, abstract = {UNLABELLED: Breast, ovarian, and prostate cancers are hormone-related and may have a shared genetic basis, but this has not been investigated systematically by genome-wide association (GWA) studies. Meta-analyses combining the largest GWA meta-analysis data sets for these cancers totaling 112,349 cases and 116,421 controls of European ancestry, all together and in pairs, identified at P \< 10(-8) seven new cross-cancer loci: three associated with susceptibility to all three cancers (rs17041869/2q13/BCL2L11; rs7937840/11q12/INCENP; rs1469713/19p13/GATAD2A), two breast and ovarian cancer risk loci (rs200182588/9q31/SMC2; rs8037137/15q26/RCCD1), and two breast and prostate cancer risk loci (rs5013329/1p34/NSUN4; rs9375701/6q23/L3MBTL3). Index variants in five additional regions previously associated with only one cancer also showed clear association with a second cancer type. Cell-type-specific expression quantitative trait locus and enhancer-gene interaction annotations suggested target genes with potential cross-cancer roles at the new loci. Pathway analysis revealed significant enrichment of death receptor signaling genes near loci with P \< 10(-5) in the three-cancer meta-analysis. SIGNIFICANCE: We demonstrate that combining large-scale GWA meta-analysis findings across cancer types can identify completely new risk loci common to breast, ovarian, and prostate cancers. We show that the identification of such cross-cancer risk loci has the potential to shed new light on the shared biology underlying these hormone-related cancers. Cancer Discov; 6(9); 1052-67. (c)2016 AACR.This article is highlighted in the In This Issue feature, p. 932.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15682, title = {Work Ability and Its Related Factors Among Workers in Small and Medium Enterprises: Comparison Among Four ASEAN Countries}, author = {O Kaewboonchoo and M Isahak and I Susilowati and T N Phuong and I Morioka and K Harncharoen and W Y Low and P Ratanasiripong}, doi = {10.1177/1010539516651957}, issn = {1010-5395}, year = {2016}, date = {2016-01-01}, journal = {Asia Pac J Public Health}, volume = {28}, number = {5}, pages = {438-49}, abstract = {Work ability is related to many factors that might influence one's capacity to work. This study aimed to examine the work ability and its related factors among small and medium enterprises (SME) workers in 4 Association of Southeast Asian Nations (ASEAN) countries. The participants in this study included 2098 workers from food and textile industries in Indonesia, Malaysia, Thailand, and Vietnam. A cross-sectional survey of anonymous self-administrated questionnaire was designed to collect information on sociodemographic factors, work environment and ergonomic condition, musculoskeletal disorders, and work ability. Bivariate correlation coefficient and multiple linear regression analyses were used to predict the work ability. Results of this study confirm that work ability in 4 ASEAN countries was similar to that in European countries, and that the sociodemographic factors, work environment and ergonomic condition, and musculoskeletal disorder (MSD) were associated with work ability. These factors are important for considering occupational health and safety policy to promote work ability in food, textile, and other SME workers.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15735, title = {Fine mapping of chromosome 5p15.33 based on a targeted deep sequencing and high density genotyping identifies novel lung cancer susceptibility loci}, author = {L Kachuri and C I Amos and J D McKay and M Johansson and P Vineis and H B Bueno-de-Mesquita and M C Boutron-Ruault and M Johansson and J R Quiros and S Sieri and R C Travis and E Weiderpass and L Le Marchand and B E Henderson and L Wilkens and G E Goodman and C Chen and J A Doherty and D C Christiani and Y Wei and L Su and S Tworoger and X Zhang and P Kraft and D Zaridze and J K Field and M W Marcus and M P A Davies and R Hyde and N E Caporaso and M T Landi and G Severi and G G Giles and G Liu and J R McLaughlin and Y Li and X Xiao and G Fehringer and X Zong and R E Denroche and P C Zuzarte and J D McPherson and P Brennan and R J Hung}, doi = {10.1093/carcin/bgv165}, issn = {0143-3334}, year = {2016}, date = {2016-01-01}, journal = {Carcinogenesis}, volume = {37}, number = {1}, pages = {96-105}, abstract = {Chromosome 5p15.33 has been identified as a lung cancer susceptibility locus, however the underlying causal mechanisms were not fully elucidated. Previous fine-mapping studies of this locus have relied on imputation or investigated a small number of known, common variants. This study represents a significant advance over previous research by investigating a large number of novel, rare variants, as well as their underlying mechanisms through telomere length. Variants for this fine-mapping study were identified through a targeted deep sequencing (average depth of coverage greater than 4000x) of 576 individuals. Subsequently, 4652 SNPs, including 1108 novel SNPs, were genotyped in 5164 cases and 5716 controls of European ancestry. After adjusting for known risk loci, rs2736100 and rs401681, we identified a new, independent lung cancer susceptibility variant in LPCAT1: rs139852726 (OR = 0.46}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15624, title = {Effects of a Community-Based Healthy Lifestyle Intervention Program (Co-HELP) among Adults with Prediabetes in a Developing Country: A Quasi-Experimental Study}, author = {N Ibrahim and F Ming Moy and I A Awalludin and Z Mohd Ali and I S Ismail}, doi = {10.1371/journal.pone.0167123}, issn = {1932-6203}, year = {2016}, date = {2016-01-01}, journal = {PLoS One}, volume = {11}, number = {12}, pages = {e0167123}, abstract = {BACKGROUND: The prevalence of type 2 diabetes among Malaysian adults has increased by more than two folds over the past two decades. Strategies to collaborate with the existing community partners may become a promising channel for wide-scale dissemination of diabetes prevention in the country. The objectives of this study were to determine the effects of community-based lifestyle interventions delivered to adults with prediabetes and their health-related quality of life as compared to the usual care group. METHODS: This was a quasi-experimental study conducted in two sub-urban communities in Seremban, Malaysia. A total of 268 participants with prediabetes aged between 18 to 65 years old were assigned to either the community-based lifestyle intervention (Co-HELP) (n = 122) or the usual care (n = 146) groups. The Co-HELP program was delivered in partnership with the existing community volunteers to incorporate diet, physical activity, and behaviour modification strategies. Participants in the Co-HELP group received twelve group-based sessions and two individual counselling to reinforce behavioural change. Participants in the usual care group received standard health education from primary health providers in the clinic setting. Primary outcomes were fasting blood glucose, 2-hour plasma glucose, and HbA1C. Secondary outcomes included weight, BMI, waist circumference, total cholesterol, triglyceride, LDL cholesterol, HDL cholesterol, systolic and diastolic blood pressure, physical activity, diet, and health-related quality of life (HRQOL). RESULTS: An intention-to-treat analysis of between-groups at 12-month (mean difference, 95% CI) revealed that the Co-HELP participants' mean fasting plasma glucose reduced by -0.40 mmol/l (-0.51 to -0.28, p\<0.001), 2-hour post glucose by -0.58 mmol/l (-0.91 to -0.24, p\<0.001), HbA1C by -0.24% (-0.34 to -0.15, p\<0.001), diastolic blood pressure by -2.63 mmHg (-3.79 to -1.48, p\<0.01), and waist circumference by -2.44 cm (-4.75 to -0.12, p\<0.05) whereas HDL cholesterol increased by 0.12 mmol/l (0.05 to 0.13, p\<0.01), compared to the usual care group. Significant improvements were also found in HRQOL for both physical component (PCS) by 6.51 points (5.21 to 7.80, p\<0.001) and mental component (MCS) by 7.79 points (6.44 to 9.14, p\<0.001). Greater proportion of participants from the Co-HELP group met the clinical recommended target of 5% or more weight loss from the initial weight (24.6% vs 3.4%, p\<0.001) and physical activity of \>600 METS/min/wk (60.7% vs 32.2%, p\<0.001) compared to the usual care group. CONCLUSIONS: This study provides evidence that a culturally adapted diabetes prevention program can be implemented in the community setting, with reduction of several diabetes risk factors and improvement of HRQOL. Collaboration with existing community partners demonstrated a promising channel for the wide-scale dissemination of diabetes prevention at the community level. Further studies are required to determine whether similar outcomes could be achieved in communities with different socioeconomic backgrounds and geographical areas. TRIAL REGISTRATION: IRCT201104106163N1.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15671, title = {Health-care providers' perceptions, attitudes towards and recommendation practice of cervical cancer screening}, author = {N A Hweissa and J N Lim and T T Su}, doi = {10.1111/ecc.12537}, issn = {0961-5423}, year = {2016}, date = {2016-01-01}, journal = {Eur J Cancer Care (Engl)}, volume = {25}, number = {5}, pages = {864-70}, abstract = {In Libya, cervical cancer is ranked third as the most frequent cancer among women with early diagnosis being shown to reduce morbidity and mortality. Health-care providers can influence women's screening behaviours, and their lack of recommendations for screening can be one of the barriers that affect women's participation in screening programmes. This study aims to assess the health-care provider's perception around cervical cancer screening. In-depth, face-to-face interviews were conducted with 16 health-care providers, from both public and private sectors in Az-Zawiya city, Libya, between February and July of 2014. The interviews were recorded and transcribed, then analysed using thematic analysis. Our findings suggest that health-care providers did not provide sufficient information regarding cervical cancer screening for women who attend health-care facilities. The results highlight the role played by health-care professionals in motivating women to attend cervical cancer screening programs, and the need for health education of health-care providers to offer a precious advice regarding the screening. On the other hand, health-care providers highlighted that implementation of reminding system of cervical cancer screening will support them to improve screening attendance. In addition, health-care providers stressed the necessity for educational and awareness campaigns of cervical cancer screening among Libyan women.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15707, title = {Research on Climate and Dengue in Malaysia: A Systematic Review}, author = {Y L Hii and R A Zaki and N Aghamohammadi and J Rocklov}, doi = {10.1007/s40572-016-0078-z}, issn = {2196-5412}, year = {2016}, date = {2016-01-01}, journal = {Curr Environ Health Rep}, volume = {3}, number = {1}, pages = {81-90}, abstract = {BACKGROUND \& OBJECTIVES: Dengue is a climate-sensitive infectious disease. Climate-based dengue early warning may be a simple, low-cost, and effective tool for enhancing surveillance and control. Scientific studies on climate and dengue in local context form the basis for advancing the development of a climate-based early warning system. This study aims to review the current status of scientific studies in climate and dengue and the prospect or challenges of such research on a climate-based dengue early warning system in a dengue-endemic country, taking Malaysia as a case study. METHOD: We reviewed the relationship between climate and dengue derived from statistical modeling, laboratory tests, and field studies. We searched electronic databases including PubMed, Scopus, EBSCO (MEDLINE), Web of Science, and the World Health Organization publications, and assessed climate factors and their influence on dengue cases, mosquitoes, and virus and recent development in the field of climate and dengue. RESULTS \& DISCUSSION: Few studies in Malaysia have emphasized the relationship between climate and dengue. Climatic factors such as temperature, rainfall, and humidity are associated with dengue; however, these relationships were not consistent. Climate change projections for Malaysia show a mounting risk for dengue in the future. Scientific studies on climate and dengue enhance dengue surveillance in the long run. CONCLUSION: It is essential for institutions in Malaysia to promote research on climate and vector-borne diseases to advance the development of climate-based early warning systems. Together, effective strategies that improve existing research capacity, maximize the use of limited resources, and promote local-international partnership are crucial for sustaining research on climate and health.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15669, title = {Depression and Associated Factors in Patients with Type 2 Diabetes Mellitus}, author = {N A Hashim and S Ariaratnam and M R Salleh and M A Said and A H Sulaiman}, issn = {2078-9947}, year = {2016}, date = {2016-01-01}, journal = {East Asian Arch Psychiatry}, volume = {26}, number = {2}, pages = {77-82}, abstract = {OBJECTIVES: To determine the prevalence of major depressive disorder and its association with socio-demographic and clinical factors in patients with type 2 diabetes mellitus. METHODS: This was a cross-sectional study of patients with type 2 diabetes mellitus who attended the hospital-based primary care clinics at the University Malaya Medical Centre, Kuala Lumpur, Malaysia. The patients were interviewed using the Mini-International Neuropsychiatric Interview to diagnose depression based on the DSM-IV criteria. The socio-demographic and clinical data were obtained by interviewing the patients and subsequently verified against their respective case notes. RESULTS: A total of 204 patients were recruited. The prevalence of major depressive disorder was 15.7%. Major depressive disorder was significantly associated with younger age of patients (mean +/- standard deviation, 57.8 +/- 15.1 years}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15705, title = {Dialysis Malnutrition and Malnutrition Inflammation Scores: screening tools for prediction of dialysis-related protein-energy wasting in Malaysia}, author = {G S Harvinder and W C Swee and T Karupaiah and S Sahathevan and K Chinna and G Ahmad and S Bavanandan and B L Goh}, doi = {10.6133/apjcn.2016.25.1.01}, issn = {0964-7058 (Print) 0964-7058}, year = {2016}, date = {2016-01-01}, journal = {Asia Pac J Clin Nutr}, volume = {25}, number = {1}, pages = {26-33}, abstract = {BACKGROUND AND OBJECTIVES: Malnutrition is highly prevalent in Malaysian dialysis patients and there is a need for a valid screening tool for early identification and management. This cross-sectional study aims to examine the sensitivity of the Dialysis Malnutrition Score (DMS) and Malnutrition Inflammation Score (MIS) tools in predicting protein-energy wasting (PEW) among Malaysian dialysis patients. METHODS AND STUDY DESIGN: A total of 155 haemodialysis (HD) and 90 peritoneal dialysis (PD) patients were screened for risk of malnutrition using DMS and MIS and comparisons were made with established guidelines by International Society of Renal Nutrition and Metabolism (ISRNM) for PEW. RESULTS: MIS cut-off score of \>=5 indicated presence of malnutrition in all patients. A total of 59% of HD and 83% of PD patients had PEW by ISRNM criteria. Based on DMS, 73% of HD and 71% of PD patients exhibited moderate malnutrition, whilst using MIS, 88% and 90%, respectively were malnourished. DMS and MIS correlated significantly in HD (r2=0.552, p\<0.001) and PD (r2=0.466, p\<0.001) patients. DMS and MIS had higher sensitivity values in PD (81% and 82%, respectively) compared to HD (59% and 60%, respectively) patients. CONCLUSIONS: The MIS cut-off scores for malnutrition classification were established (score \>=5) for use amongst Malaysian dialysis patients. Both DMS and MIS are valid tools to be used for nutrition screening of dialysis patients especially those undergoing peritoneal dialysis. The DMS may be a more practical and simpler tool to be utilized in the Malaysian dialysis settings as it does not require laboratory markers.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15667, title = {International pooled study on diet and bladder cancer: the bladder cancer, epidemiology and nutritional determinants (BLEND) study: design and baseline characteristics}, author = {M E Goossens and F Isa and M Brinkman and D Mak and R Reulen and A Wesselius and S Benhamou and C Bosetti and B Bueno-de-Mesquita and A Carta and M F Allam and K Golka and E J Grant and X Jiang and K C Johnson and M R Karagas and E Kellen and C La Vecchia and C M Lu and J Marshall and K Moysich and H Pohlabeln and S Porru and G Steineck and M C Stern and L Tang and J A Taylor and P Brandt and P J Villeneuve and K Wakai and E Weiderpass and E White and A Wolk and Z F Zhang and F Buntinx and M P Zeegers}, doi = {10.1186/s13690-016-0140-1}, issn = {0778-7367 (Print) 0778-7367}, year = {2016}, date = {2016-01-01}, journal = {Arch Public Health}, volume = {74}, pages = {30}, abstract = {BACKGROUND: In 2012, more than 400,000 urinary bladder cancer cases occurred worldwide, making it the 7(th) most common type of cancer. Although many previous studies focused on the relationship between diet and bladder cancer, the evidence related to specific food items or nutrients that could be involved in the development of bladder cancer remains inconclusive. Dietary components can either be, or be activated into, potential carcinogens through metabolism, or act to prevent carcinogen damage. METHODS/DESIGN: The BLadder cancer, Epidemiology and Nutritional Determinants (BLEND) study was set up with the purpose of collecting individual patient data from observational studies on diet and bladder cancer. In total, data from 11,261 bladder cancer cases and 675,532 non-cases from 18 case-control and 6 cohort studies from all over the world were included with the aim to investigate the association between individual food items, nutrients and dietary patterns and risk of developing bladder cancer. DISCUSSION: The substantial number of cases included in this study will enable us to provide evidence with large statistical power, for dietary recommendations on the prevention of bladder cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15652, title = {An overview of biological processes and their potential for CO2 capture}, author = {A Goli and A Shamiri and A Talaiekhozani and N Eshtiaghi and N Aghamohammadi and M K Aroua}, doi = {10.1016/j.jenvman.2016.08.054}, issn = {0301-4797}, year = {2016}, date = {2016-01-01}, journal = {J Environ Manage}, volume = {183}, pages = {41-58}, abstract = {The extensive amount of available information on global warming suggests that this issue has become prevalent worldwide. Majority of countries have issued laws and policies in response to this concern by requiring their industrial sectors to reduce greenhouse gas emissions, such as CO2. Thus, introducing new and more effective treatment methods, such as biological techniques, is crucial to control the emission of greenhouse gases. Many studies have demonstrated CO2 fixation using photo-bioreactors and raceway ponds, but a comprehensive review is yet to be published on biological CO2 fixation. A comprehensive review of CO2 fixation through biological process is presented in this paper as biological processes are ideal to control both organic and inorganic pollutants. This process can also cover the classification of methods, functional mechanisms, designs, and their operational parameters, which are crucial for efficient CO2 fixation. This review also suggests the bio-trickling filter process as an appropriate approach in CO2 fixation to assist in creating a pollution-free environment. Finally, this paper introduces optimum designs, growth rate models, and CO2 fixation of microalgae, functions, and operations in biological CO2 fixation.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15674, title = {Factors Associated with Tick Bite Preventive Practices among Farmworkers in Malaysia}, author = {M Ghane Kisomi and L P Wong and S T Tay and A Bulgiba and K Zandi and K L Kho and F X Koh and B L Ong and T Jaafar and Q N Hassan Nizam}, doi = {10.1371/journal.pone.0157987}, issn = {1932-6203}, year = {2016}, date = {2016-01-01}, journal = {PLoS One}, volume = {11}, number = {6}, pages = {e0157987}, abstract = {BACKGROUND: Farmworkers are at high-risk for tick bites, which potentially transmit various tick-borne diseases. Previous studies show that personal prevention against tick bites is key, and certain factors namely, knowledge, experience of tick bites, and health beliefs influence compliance with tick bites preventive behaviour. This study aimed to assess these factors and their associations with tick bite preventive practices among Malaysian farmworkers. METHODS: A total of eight cattle, goat and sheep farms in six states in Peninsular Malaysia participated in a cross-sectional survey between August and October 2013. RESULTS: A total of 151 (72.2%) out of 209 farmworkers answered the questionnaire. More than half of the farmworkers (n = 91) reported an experience of tick bites. Farms with monthly acaricide treatment had significantly (P\<0.05) a low report of tick bites. Tick bite exposure rates did not differ significantly among field workers and administrative workers. The mean total knowledge score of ticks for the overall farmworkers was 13.6 (SD+/-3.2) from 20. The mean total tick bite preventive practices score for all farmworkers was 8.3 (SD+/-3.1) from 15. Fixed effect model showed the effects of four factors on tick bite prevention: (1) farms, (2) job categories (administrative workers vs. field workers), (3) perceived severity of tick bites, and (4) perceived barriers to tick bite prevention. CONCLUSIONS: A high proportion of farmworkers, including administrative workers, reported an experience of tick bites. The effectiveness of monthly acaricide treatment was declared by low reports of tick bites on these farms. Tick bite preventive practices were insufficient, particularly in certain farms and for administrative workers. Our findings emphasise the need to have education programmes for all farmworkers and targeting farms with low prevention practices. Education and health programmes should increase the perception of the risk of tick bites and remove perceived barriers of tick bite prevention.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15759, title = {Main nutrient patterns are associated with prospective weight change in adults from 10 European countries}, author = {H Freisling and P T Pisa and P Ferrari and G Byrnes and A Moskal and C C Dahm and A C Vergnaud and M C Boutron-Ruault and G Fagherazzi and C Cadeau and T Kuhn and J Neamat-Allah and B Buijsse and H Boeing and J Halkjaer and A Tjonneland and C P Hansen and J R Quiros and N Travier and E Molina-Montes and P Amiano and J M Huerta and A Barricarte and K T Khaw and N Wareham and T J Key and D Romaguera and Y Lu and C M Lassale and A Naska and P Orfanos and A Trichopoulou and G Masala and V Pala and F Berrino and R Tumino and F Ricceri and M S Magistris and H B Bueno-de-Mesquita and M C Ocke and E Sonestedt and U Ericson and M Johansson and G Skeie and E Weiderpass and T Braaten and P H Peeters and N Slimani}, doi = {10.1007/s00394-015-1023-x}, issn = {1436-6207}, year = {2016}, date = {2016-01-01}, journal = {Eur J Nutr}, volume = {55}, number = {6}, pages = {2093-104}, abstract = {PURPOSE: Various food patterns have been associated with weight change in adults, but it is unknown which combinations of nutrients may account for such observations. We investigated associations between main nutrient patterns and prospective weight change in adults. METHODS: This study includes 235,880 participants, 25-70 years old, recruited between 1992 and 2000 in 10 European countries. Intakes of 23 nutrients were estimated from country-specific validated dietary questionnaires using the harmonized EPIC Nutrient DataBase. Four nutrient patterns, explaining 67 % of the total variance of nutrient intakes, were previously identified from principal component analysis. Body weight was measured at recruitment and self-reported 5 years later. The relationship between nutrient patterns and annual weight change was examined separately for men and women using linear mixed models with random effect according to center controlling for confounders. RESULTS: Mean weight gain was 460 g/year (SD 950) and 420 g/year (SD 940) for men and women, respectively. The annual differences in weight gain per one SD increase in the pattern scores were as follows: principal component (PC) 1, characterized by nutrients from plant food sources, was inversely associated with weight gain in men (-22 g/year; 95 % CI -33 to -10) and women (-18 g/year; 95 % CI -26 to -11). In contrast, PC4, characterized by protein, vitamin B2, phosphorus, and calcium, was associated with a weight gain of +41 g/year (95 % CI +2 to +80) and +88 g/year (95 % CI +36 to +140) in men and women, respectively. Associations with PC2, a pattern driven by many micro-nutrients, and with PC3, a pattern driven by vitamin D, were less consistent and/or non-significant. CONCLUSIONS: We identified two main nutrient patterns that are associated with moderate but significant long-term differences in weight gain in adults.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15683, title = {Exposure to Famine at a Young Age and Unhealthy Lifestyle Behavior Later in Life}, author = {H P Fransen and P H Peeters and J W Beulens and J M Boer and G A Wit and N C Onland-Moret and Y T Schouw and H B Bueno-de-Mesquita and J Hoekstra and S G Elias and A M May}, doi = {10.1371/journal.pone.0156609}, issn = {1932-6203}, year = {2016}, date = {2016-01-01}, journal = {PLoS One}, volume = {11}, number = {5}, pages = {e0156609}, abstract = {BACKGROUND: A healthy diet is important for normal growth and development. Exposure to undernutrition during important developmental periods such as childhood and adolescence can have effects later in life. Inhabitants of the west of the Netherlands were exposed to severe undernutrition during the famine in the last winter of the second World War (1944-1945). OBJECTIVE: We investigated if exposure of women to the Dutch famine during childhood and adolescence was associated with an unhealthy lifestyle later in life. DESIGN: We studied 7,525 women from the Prospect-EPIC cohort, recruited in 1993-97 and aged 0-18 years during the Dutch famine. An individual famine score was calculated based on self-reported information about experience of hunger and weight loss. We investigated the association between famine exposure in early life and four lifestyle factors in adulthood: smoking, alcohol consumption, physical activity level and a Mediterranean-style diet. RESULTS: Of the 7,525 included women, 46% were unexposed, 38% moderately exposed and 16% severely exposed to the Dutch famine. Moderately and severely exposed women were more often former or current smokers compared to women that did not suffer from the famine: adjusted prevalence ratio 1.10 (95% CI: 1.05; 1.14) and 1.18 (1.12; 1.25), respectively. They also smoked more pack years than unexposed women. Severely exposed women were more often physically inactive than unexposed women, adjusted prevalence ratio 1.32 (1.06; 1.64). Results did not differ between exposure age categories (0-9 and 10-17 years). We found no associations of famine exposure with alcohol consumption and no dose-dependent relations with diet. CONCLUSIONS: Exposure to famine early in female life may be associated with higher prevalence of smoking and physical inactivity later in life, but not with unhealthy diet and alcohol consumption.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15723, title = {Identification of a novel susceptibility locus at 13q34 and refinement of the 20p12.2 region as a multi-signal locus associated with bladder cancer risk in individuals of European ancestry}, author = {J D Figueroa and C D Middlebrooks and A R Banday and Y Ye and M Garcia-Closas and N Chatterjee and S Koutros and L A Kiemeney and T Rafnar and T Bishop and H Furberg and G Matullo and K Golka and M Gago-Dominguez and J A Taylor and T Fletcher and A Siddiq and V K Cortessis and C Kooperberg and O Cussenot and S Benhamou and J Prescott and S Porru and C P Dinney and N Malats and D Baris and M P Purdue and E J Jacobs and D Albanes and Z Wang and C C Chung and S H Vermeulen and K K Aben and T E Galesloot and G Thorleifsson and P Sulem and K Stefansson and A E Kiltie and M Harland and M Teo and K Offit and J Vijai and D Bajorin and R Kopp and G Fiorito and S Guarrera and C Sacerdote and S Selinski and J G Hengstler and H Gerullis and D Ovsiannikov and M Blaszkewicz and J E Castelao and M Calaza and M E Martinez and P Cordeiro and Z Xu and V Panduri and R Kumar and E Gurzau and K Koppova and H B Bueno-De-Mesquita and B Ljungberg and F Clavel-Chapelon and E Weiderpass and V Krogh and M Dorronsoro and R C Travis and A Tjonneland and P Brennan and J Chang-Claude and E Riboli and D Conti and M C Stern and M C Pike and D Van Den Berg and J M Yuan and C Hohensee and R P Jeppson and G Cancel-Tassin and M Roupret and E Comperat and C Turman and I De Vivo and E Giovannucci and D J Hunter and P Kraft and S Lindstrom and A Carta and S Pavanello and C Arici and G Mastrangelo and A M Kamat and L Zhang and Y Gong and X Pu and A Hutchinson and L Burdett and W A Wheeler and M R Karagas and others}, doi = {10.1093/hmg/ddv492}, issn = {0964-6906}, year = {2016}, date = {2016-01-01}, journal = {Hum Mol Genet}, volume = {25}, number = {6}, pages = {1203-14}, abstract = {Candidate gene and genome-wide association studies (GWAS) have identified 15 independent genomic regions associated with bladder cancer risk. In search for additional susceptibility variants, we followed up on four promising single-nucleotide polymorphisms (SNPs) that had not achieved genome-wide significance in 6911 cases and 11 814 controls (rs6104690, rs4510656, rs5003154 and rs4907479, P \< 1 x 10(-6)), using additional data from existing GWAS datasets and targeted genotyping for studies that did not have GWAS data. In a combined analysis, which included data on up to 15 058 cases and 286 270 controls, two SNPs achieved genome-wide statistical significance: rs6104690 in a gene desert at 20p12.2 (P = 2.19 x 10(-11)) and rs4907479 within the MCF2L gene at 13q34 (P = 3.3 x 10(-10)). Imputation and fine-mapping analyses were performed in these two regions for a subset of 5551 bladder cancer cases and 10 242 controls. Analyses at the 13q34 region suggest a single signal marked by rs4907479. In contrast, we detected two signals in the 20p12.2 region-the first signal is marked by rs6104690, and the second signal is marked by two moderately correlated SNPs (r(2) = 0.53), rs6108803 and the previously reported rs62185668. The second 20p12.2 signal is more strongly associated with the risk of muscle-invasive (T2-T4 stage) compared with non-muscle-invasive (Ta, T1 stage) bladder cancer (case-case P \</= 0.02 for both rs62185668 and rs6108803). Functional analyses are needed to explore the biological mechanisms underlying these novel genetic associations with risk for bladder cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15649, title = {Ten-year survival in women with primary stage IV breast cancer}, author = {L G Eng and S Dawood and V Sopik and B Haaland and P S Tan and N Bhoo-Pathy and E Warner and J Iqbal and S A Narod and R Dent}, doi = {10.1007/s10549-016-3974-x}, issn = {0167-6806}, year = {2016}, date = {2016-01-01}, journal = {Breast Cancer Res Treat}, volume = {160}, number = {1}, pages = {145-152}, abstract = {PURPOSE: To evaluate breast cancer-specific survival at 10 years in patients who present with primary stage IV breast cancer, and to determine whether survival varies with age of diagnosis. METHODS: We retrieved the records of 25,323 women diagnosed with primary stage IV breast cancer in the surveillance, epidemiology, and end results 18 registries database from 1990 to 2012. For each case, we extracted information on age at diagnosis, tumour size, nodal status, oestrogen receptor status, progesterone receptor status, ethnicity, cause of death and date of death. The Cox proportional hazards model was used to estimate the unadjusted and adjusted hazard ratio (HR) of death due to stage IV breast cancer, according to age group. RESULTS: Among 25,323 women with stage IV breast cancer, 2542 (10.0 %) were diagnosed at age 40 or below, 5562 (22.0 %) were diagnosed between ages 41 and 50 and 17,219 (68.0 %) were diagnosed between ages 51 and 70. After a mean follow-up of 2.2 years, 16,387 (64.7 %) women died of breast cancer (median survival 2.3 years). The ten-year actuarial breast cancer-specific survival rate was 15.7 % for women ages 40 and below, 14.9 % for women ages 41-50 and 11.7 % for women ages 51 to 70 (p \< 0.0001). In an adjusted analysis, the risk of death from breast cancer at 10 years was significantly lower for women ages 40 and below (HR 0.78; 95 % CI 0.74-0.82; p \< 0.0001) and for women ages 41-50 (HR 0.82; 95 % CI 0.79-0.85; p \< 0.0001), compared to women ages 51-70. CONCLUSIONS: Approximately 13 % of women with primary stage IV breast cancer survive 10 years after diagnosis. Women diagnosed with stage IV breast cancer before age 50 have better survival at 10 years compared to older women.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15713, title = {Impact of a Workplace Health Promotion Program on Employees' Blood Pressure in a Public University}, author = {J Y Eng and F M Moy and A Bulgiba}, doi = {10.1371/journal.pone.0148307}, issn = {1932-6203}, year = {2016}, date = {2016-01-01}, journal = {PLoS One}, volume = {11}, number = {2}, pages = {e0148307}, abstract = {INTRODUCTION: Workplace health promotion is important in the prevention of non-communicable diseases among employees. Previous workplace health programs have shown benefits such as lowered disease prevalence, reduced medical costs and improved productivity. This study aims to evaluate the impact of a 6-year workplace health promotion program on employees' blood pressure in a public university. METHODS: In this prospective cohort study, we included 1,365 employees enrolled in the university's workplace health promotion program, a program conducted since 2008 and using data from the 2008-2013 follow-up period. Participants were permanent employees aged 35 years and above, with at least one follow up measurements and no change in antihypertensive medication during the study period. Baseline socio-demographic information was collected using a questionnaire while anthropometry measurements and resting blood pressure were collected during annual health screening. Changes in blood pressure over time were analyzed using a linear mixed model. RESULTS: The systolic blood pressure in the hypertension subgroup decreased 2.36 mmHg per year (p\<0.0001). There was also significant improvement in systolic blood pressure among the participants who were at risk of hypertension (-0.75 mmHg, p\<0.001). The diastolic blood pressure among the hypertensive and at risk subgroups improved 1.76 mmHg/year (p\<0.001) and 0.56 mmHg/year (p\<0.001), respectively. However, there was no change in both systolic and diastolic blood pressure among participants in the healthy subgroup over the 6-year period. CONCLUSION: This study shows that continuing participation in workplace health promotion program has the potential to improve blood pressure levels among employees.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15733, title = {Vegetable and fruit consumption and the risk of hormone receptor-defined breast cancer in the EPIC cohort}, author = {M J Emaus and P H Peeters and M F Bakker and K Overvad and A Tjonneland and A Olsen and I Romieu and P Ferrari and L Dossus and M C Boutron-Ruault and L Baglietto and R T Fortner and R Kaaks and H Boeing and A Trichopoulou and P Lagiou and D Trichopoulos and G Masala and V Pala and S Panico and R Tumino and S Polidoro and G Skeie and E Lund and E Weiderpass and J R Quiros and N Travier and M J Sanchez and M D Chirlaque and E Ardanaz and M Dorronsoro and A Winkvist and M Wennberg and H B Bueno-de-Mesquita and K T Khaw and R C Travis and T J Key and D Aune and M Gunter and E Riboli and C H Gils}, doi = {10.3945/ajcn.114.101436}, issn = {0002-9165}, year = {2016}, date = {2016-01-01}, journal = {Am J Clin Nutr}, volume = {103}, number = {1}, pages = {168-77}, abstract = {BACKGROUND: The recent literature indicates that a high vegetable intake and not a high fruit intake could be associated with decreased steroid hormone receptor-negative breast cancer risk. OBJECTIVE: This study aimed to investigate the association between vegetable and fruit intake and steroid hormone receptor-defined breast cancer risk. DESIGN: A total of 335,054 female participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort were included in this study (mean +/- SD age: 50.8 +/- 9.8 y). Vegetable and fruit intake was measured by country-specific questionnaires filled out at recruitment between 1992 and 2000 with the use of standardized procedures. Cox proportional hazards models were stratified by age at recruitment and study center and were adjusted for breast cancer risk factors. RESULTS: After a median follow-up of 11.5 y (IQR: 10.1-12.3 y), 10,197 incident invasive breast cancers were diagnosed [3479 estrogen and progesterone receptor positive (ER+PR+); 1021 ER and PR negative (ER-PR-)]. Compared with the lowest quintile, the highest quintile of vegetable intake was associated with a lower risk of overall breast cancer (HRquintile 5-quintile 1: 0.87; 95% CI: 0.80, 0.94). Although the inverse association was most apparent for ER-PR- breast cancer (ER-PR-: HRquintile 5-quintile 1: 0.74; 95% CI: 0.57, 0.96; P-trend = 0.03; ER+PR+: HRquintile 5-quintile 1: 0.91; 95% CI: 0.79, 1.05; P-trend = 0.14), the test for heterogeneity by hormone receptor status was not significant (P-heterogeneity = 0.09). Fruit intake was not significantly associated with total and hormone receptor-defined breast cancer risk. CONCLUSION: This study supports evidence that a high vegetable intake is associated with lower (mainly hormone receptor-negative) breast cancer risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15754, title = {Cross-Cultural Adaptation and Psychometric Properties of the Malay Version of the Short Sensory Profile}, author = {S I Ee and S Y Loh and K Chinna and M J Marret}, doi = {10.3109/01942638.2015.1040574}, issn = {0194-2638}, year = {2016}, date = {2016-01-01}, journal = {Phys Occup Ther Pediatr}, volume = {36}, number = {2}, pages = {117-30}, abstract = {AIMS: To translate, culturally adapt, and examine psychometric properties of the Malay version Short Sensory Profile (SSP-M). METHODS: Pretesting (n = 30) of the original English SSP established its applicability for use with Malaysian children aged 3-10 years. This was followed by the translation and cross-cultural adaptation of the SSP-M. Two forward and two back translations were compared and reviewed by a committee of 10 experts who validated the content of the SSP-M, before pilot testing (n = 30). The final SSP-M questionnaire was completed by 419 parents of typically developing children aged 3-10 years. RESULTS: Cronbach's alpha of each section of the SSP-M ranged from 0.73 to 0.93 and the intraclass correlation coefficient (ICC) indicated good reliability (0.62-0.93). The seven factor model of the SSP-M had an adequate fit with evidence of convergent and discriminant validity. CONCLUSIONS: We conclude that the SSP-M is a valid and reliable screening tool for use in Malaysia with Malay-speaking parents of children aged 3-10 years. The SSP-M enables Malay-speaking parents to answer the questionnaire with better reliability, and provides occupational therapists with a valid tool to screen for sensory processing difficulties.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15675, title = {Circulating Osteopontin and Prediction of Hepatocellular Carcinoma Development in a Large European Population}, author = {T Duarte-Salles and S Misra and M Stepien and A Plymoth and D Muller and K Overvad and A Olsen and A Tjonneland and L Baglietto and G Severi and M C Boutron-Ruault and R Turzanski-Fortner and R Kaaks and H Boeing and K Aleksandrova and A Trichopoulou and P Lagiou and C Bamia and V Pala and D Palli and A Mattiello and R Tumino and A Naccarati and H B Bueno-de-Mesquita and P H Peeters and E Weiderpass and J R Quiros and A Agudo and E Sanchez-Cantalejo and E Ardanaz and D Gavrila and M Dorronsoro and M Werner and O Hemmingsson and B Ohlsson and K Sjoberg and N J Wareham and K T Khaw and K E Bradbury and M J Gunter and A J Cross and E Riboli and M Jenab and P Hainaut and L Beretta}, doi = {10.1158/1940-6207.Capr-15-0434}, issn = {1940-6215}, year = {2016}, date = {2016-01-01}, journal = {Cancer Prev Res (Phila)}, volume = {9}, number = {9}, pages = {758-65}, abstract = {We previously identified osteopontin (OPN) as a promising marker for the early detection of hepatocellular carcinoma (HCC). In this study, we investigated the association between prediagnostic circulating OPN levels and HCC incidence in a large population-based cohort. A nested case-control study was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. During a mean follow-up of 4.8 years, 100 HCC cases were identified. Each case was matched to two controls and OPN levels were measured in baseline plasma samples. Viral hepatitis, liver function, and alpha-fetoprotein (AFP) tests were also conducted. Conditional logistic regression models were used to calculate multivariable odds ratio (OR) and 95% confidence intervals (95% CI) for OPN levels in relation to HCC. Receiver operating characteristics curves were constructed to determine the discriminatory accuracy of OPN alone or in combination with other liver biomarkers in the prediction of HCC. OPN levels were positively associated with HCC risk (per 10% increment}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15717, title = {Risk factors for low birth weight in Nigeria: evidence from the 2013 Nigeria Demographic and Health Survey}, author = {M Dahlui and N Azahar and O M Oche and N A Aziz}, doi = {10.3402/gha.v9.28822}, issn = {1654-9880}, year = {2016}, date = {2016-01-01}, journal = {Glob Health Action}, volume = {9}, pages = {28822}, abstract = {BACKGROUND: Low birth weight (LBW) continues to be the primary cause of infant morbidity and mortality. OBJECTIVE: This study was undertaken to identify the predictors of LBW in Nigeria. DESIGN: The data for this study was extracted from the 2013 Nigeria Demographic and Health Survey conducted by the National Population Commission. Several questionnaires were used in the survey, some covering questions on pregnancy characteristics. The inclusion criteria include mothers who gave birth to a child 5 years before the interview and aged 15-49 years who were either permanent residents or visitors present in the household on the night before the survey conducted. The birth weight of the infants was recorded from written records from the hospital cards or the mothers' recall. RESULTS: The prevalence of LBW in this study was 7.3%. Multiple logistic regression analysis showed an adjusted significant odds ratio for mothers from North West region (aOR 10.67; 95% CI [5.83-19.5]), twin pregnancy (aOR 5.11; 95% CI [3.11-8.39]), primiparous mother (aOR 2.08; 95% CI [1.15-3.77]), maternal weight of less than 70 kg (aOR 1.92; 95% CI [1.32-2.78]), and manual paternal employment (aOR 1.91; 95% CI [1.08-3.37]). CONCLUSIONS: The risk factors for LBW identified in this study are modifiable. In order to reduce this menace in Nigeria, holistic approaches such as health education, maternal nutrition, improvement in socio-economic indices, and increasing the quality and quantity of the antenatal care services are of paramount importance.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15678, title = {Sugar-sweetened carbonated beverage consumption and coronary artery calcification in asymptomatic men and women}, author = {S Chun and Y Choi and Y Chang and J Cho and Y Zhang and S Rampal and D Zhao and J Ahn and B S Suh and R Pastor-Barriuso and J A Lima and E C Chung and H Shin and E Guallar and S Ryu}, doi = {10.1016/j.ahj.2016.03.018}, issn = {0002-8703}, year = {2016}, date = {2016-01-01}, journal = {Am Heart J}, volume = {177}, pages = {17-24}, abstract = {BACKGROUND: Sugar-sweetened carbonated beverage consumption has been linked to obesity, metabolic syndrome, type 2 diabetes, and clinically manifest coronary heart disease, but its association with subclinical coronary heart disease remains unclear. We investigated the relationship between sugar-sweetened carbonated beverage consumption and coronary artery calcium (CAC) in a large study of asymptomatic men and women. METHODS: This was a cross-sectional study of 22,210 adult men and women who underwent a comprehensive health screening examination between 2011 and 2013 (median age 40 years). Sugar-sweetened carbonated beverage consumption was assessed using a validated food frequency questionnaire, and CAC was measured by cardiac computed tomography. Multivariable-adjusted CAC score ratios and 95% CIs were estimated from robust Tobit regression models for the natural logarithm (CAC score +1). RESULTS: The prevalence of detectable CAC (CAC score \>0) was 11.7% (n = 2,604). After adjustment for age; sex; center; year of screening examination; education level; physical activity; smoking; alcohol intake; family history of cardiovascular disease; history of hypertension; history of hypercholesterolemia; and intake of total energy, fruits, vegetables, and red and processed meats, only the highest category of sugar-sweetened carbonated beverage consumption was associated with an increased CAC score compared with the lowest consumption category. The multivariable-adjusted CAC ratio comparing participants who consumed \>/=5 sugar-sweetened carbonated beverages per week with nondrinkers was 1.70 (95% CI, 1.03-2.81). This association did not differ by clinical subgroup, including participants at low cardiovascular risk. CONCLUSION: Our findings suggest that high levels of sugar-sweetened carbonated beverage consumption are associated with a higher prevalence and degree of CAC in asymptomatic adults without a history of cardiovascular disease, cancer, or diabetes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15709, title = {Cellular immune activity biomarker neopterin is associated hyperlipidemia: results from a large population-based study}, author = {S C Chuang and H Boeing and S E Vollset and O Midttun and P M Ueland and B Bueno-de-Mesquita and M Lajous and G Fagherazzi and M C Boutron-Ruault and R Kaaks and T Kuehn and T Pischon and D Drogan and A Tjonneland and K Overvad and J R Quiros and A Agudo and E Molina-Montes and M Dorronsoro and J M Huerta and A Barricarte and K T Khaw and N J Wareham and R C Travis and A Trichopoulou and P Lagiou and D Trichopoulos and G Masala and C Agnoli and R Tumino and A Mattiello and P H Peeters and E Weiderpass and R Palmqvist and I Ljuslinder and M Gunter and Y Lu and A J Cross and E Riboli and P Vineis and K Aleksandrova}, doi = {10.1186/s12979-016-0059-y}, issn = {1742-4933 (Print) 1742-4933}, year = {2016}, date = {2016-01-01}, journal = {Immun Ageing}, volume = {13}, pages = {5}, abstract = {BACKGROUND: Increased serum neopterin had been described in older age two decades ago. Neopterin is a biomarker of systemic adaptive immune activation that could be potentially implicated in metabolic syndrome (MetS). Measurements of waist circumference, triglycerides, high-density lipoprotein cholesterol (HDLC), systolic and diastolic blood pressure, glycated hemoglobin as components of MetS definition, and plasma total neopterin concentrations were performed in 594 participants recruited in the European Prospective Investigation into Cancer and Nutrition (EPIC). RESULTS: Higher total neopterin concentrations were associated with reduced HDLC (9.7 %, p \< 0.01 for men and 9.2 %, p \< 0.01 for women), whereas no association was observed with the rest of the MetS components as well as with MetS overall (per 10 nmol/L: OR = 1.42, 95 % CI = 0.85-2.39 for men and OR = 1.38, 95 % CI = 0.79-2.43). CONCLUSIONS: These data suggest that high total neopterin concentrations are cross-sectionally associated with reduced HDLC, but not with overall MetS.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15684, title = {Elder mistreatment in a community dwelling population: the Malaysian Elder Mistreatment Project (MAESTRO) cohort study protocol}, author = {W Y Choo and N N Hairi and R Sooryanarayana and R M Yunus and F M Hairi and N Ismail and S Kandiben and Z Mohd Ali and S N Ahmad and I Abdul Razak and S Othman and M P Tan and F H Mydin and D Peramalah and P Brownell and A Bulgiba}, doi = {10.1136/bmjopen-2016-011057}, issn = {2044-6055}, year = {2016}, date = {2016-01-01}, journal = {BMJ Open}, volume = {6}, number = {5}, pages = {e011057}, abstract = {INTRODUCTION: Despite being now recognised as a global health concern, there is still an inadequate amount of research into elder mistreatment, especially in low and middle-income regions. The purpose of this paper is to report on the design and methodology of a population-based cohort study on elder mistreatment among the older Malaysian population. The study aims at gathering data and evidence to estimate the prevalence and incidence of elder mistreatment, identify its individual, familial and social determinants, and quantify its health consequences. METHODS AND ANALYSIS: This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression. ETHICS AND DISSEMINATION: The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments, and published in appropriate scientific journals and presented at conferences.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15627, title = {Ethnic differences in the prevalence of knee pain among adults of a community in a cross-sectional study}, author = {Y C Chia and H C Beh and C J Ng and C L Teng and N S Hanafi and W Y Choo and S M Ching}, doi = {10.1136/bmjopen-2016-011925}, issn = {2044-6055}, year = {2016}, date = {2016-01-01}, journal = {BMJ Open}, volume = {6}, number = {12}, pages = {e011925}, abstract = {OBJECTIVE: To determine the prevalence of knee pain among 3 major ethnic groups in Malaysia. By identifying high-risk groups, preventive measures can be targeted at these populations. DESIGN AND SETTING: A cross-sectional survey was carried out in rural and urban areas in a state in Malaysia. Secondary schools were randomly selected and used as sampling units. PARTICIPANTS: Adults aged \>/=18 years old were invited to answer a self-administered questionnaire on pain experienced over the previous 6 months. Out of 9300 questionnaires distributed, 5206 were returned and 150 participants who did not fall into the 3 ethnic groups were excluded, yielding a total of 5056 questionnaires for analysis. 58.2% (n=2926) were women. 50% (n=2512) were Malays, 41.4% (n=2079) were Chinese and 8.6% (n=434) were Indians. RESULTS: 21.1% (n=1069) had knee pain during the previous 6 months. More Indians (31.8%) experienced knee pain compared with Malays (24.3%) and Chinese (15%) (p\<0.001). The odds of Indian women reporting knee pain was twofold higher compared with Malay women. There was a rising trend in the prevalence of knee pain with increasing age (p\<0.001). The association between age and knee pain appeared to be stronger in women than men. 68.1% of Indians used analgesia for knee pain while 75.4% of Malays and 52.1% of Chinese did so (p\<0.001). The most common analgesic used for knee pain across all groups was topical medicated oil (43.7%). CONCLUSIONS: The prevalence of knee pain in adults was more common in Indian women and older women age groups and Chinese men had the lowest prevalence of knee pain. Further studies should investigate the reasons for these differences.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15689, title = {Metabolically Healthy Obesity and the Development of Nonalcoholic Fatty Liver Disease}, author = {Y Chang and H S Jung and J Cho and Y Zhang and K E Yun and M Lazo and R Pastor-Barriuso and J Ahn and C W Kim and S Rampal and M Cainzos-Achirica and D Zhao and E C Chung and H Shin and E Guallar and S Ryu}, doi = {10.1038/ajg.2016.178}, issn = {0002-9270}, year = {2016}, date = {2016-01-01}, journal = {Am J Gastroenterol}, volume = {111}, number = {8}, pages = {1133-40}, abstract = {OBJECTIVES: The risk of nonalcoholic fatty liver disease (NAFLD) among obese individuals without obesity-related metabolic abnormalities, a condition referred to as metabolically healthy obese (MHO), is largely unexplored. Therefore, we examined the association between body mass index (BMI) categories and the development of NAFLD in a large cohort of metabolically healthy men and women. METHODS: A cohort study was conducted in 77,425 men and women free of NAFLD and metabolic abnormalities at baseline, who were followed-up annually or biennially for an average of 4.5 years. Being metabolically healthy was defined as not having any metabolic syndrome component and having a homeostasis model assessment of insulin resistance \<2.5. The presence of fatty liver was determined using ultrasound. RESULTS: During 348,193.5 person-years of follow-up, 10,340 participants developed NAFLD (incidence rate, 29.7 per 1,000 person-years). The multivariable adjusted hazard ratios (95% confidence intervals) for incident NAFLD comparing overweight and obese with normal-weight participants were 2.15 (2.06-2.26) and 3.55 (3.37-3.74), respectively. In detailed dose-response analyses, increasing baseline BMI showed a strong and approximately linear relationship with the incidence of NAFLD, with no threshold at no risk. This association was present in both men and women, although it was stronger in women (P for interaction \<0.001), and it was evident in all clinically relevant subgroups evaluated, including participants with low inflammation status. CONCLUSIONS: In a large cohort of strictly defined metabolically healthy men and women, overweight and obesity were strongly and progressively associated with an increased incidence of NAFLD, suggesting that the obese phenotype per se, regardless of metabolic abnormalities, can increase the risk of NAFLD.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15658, title = {Functional single nucleotide polymorphisms within the cyclin-dependent kinase inhibitor 2A/2B region affect pancreatic cancer risk}, author = {D Campa and M Pastore and M Gentiluomo and R Talar-Wojnarowska and J Kupcinskas and E Malecka-Panas and J P Neoptolemos and W Niesen and P Vodicka and G Delle Fave and H B Bueno-de-Mesquita and M Gazouli and P Pacetti and M Di Leo and H Ito and H Kluter and P Soucek and V Corbo and K Yamao and S Hosono and R Kaaks and Y Vashist and D Gioffreda and O Strobel and Y Shimizu and F Dijk and A Andriulli and A Ivanauskas and P Bugert and F Tavano and L Vodickova and C F Zambon and M Lovecek and S Landi and T J Key and U Boggi and R Pezzilli and K Jamroziak and B Mohelnikova-Duchonova and A Mambrini and F Bambi and O Busch and V Pazienza and R Valente and G E Theodoropoulos and T Hackert and G Capurso and G M Cavestro and C Pasquali and D Basso and C Sperti and K Matsuo and M Buchler and K T Khaw and J Izbicki and E Costello and V Katzke and C Michalski and A Stepien and C Rizzato and F Canzian}, doi = {10.18632/oncotarget.10935}, issn = {1949-2553}, year = {2016}, date = {2016-01-01}, journal = {Oncotarget}, volume = {7}, number = {35}, pages = {57011-57020}, abstract = {The CDKN2A (p16) gene plays a key role in pancreatic cancer etiology. It is one of the most commonly somatically mutated genes in pancreatic cancer, rare germline mutations have been found to be associated with increased risk of developing familiar pancreatic cancer and CDKN2A promoter hyper-methylation has been suggested to play a critical role both in pancreatic cancer onset and prognosis. In addition several unrelated SNPs in the 9p21.3 region, that includes the CDNK2A, CDNK2B and the CDNK2B-AS1 genes, are associated with the development of cancer in various organs. However, association between the common genetic variability in this region and pancreatic cancer risk is not clearly understood. We sought to fill this gap in a case-control study genotyping 13 single nucleotide polymorphisms (SNPs) in 2,857 pancreatic ductal adenocarcinoma (PDAC) patients and 6,111 controls in the context of the Pancreatic Disease Research (PANDoRA) consortium. We found that the A allele of the rs3217992 SNP was associated with an increased pancreatic cancer risk (ORhet=1.14, 95% CI 1.01-1.27}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14161, title = {Energy and macronutrient intake and risk of differentiated thyroid carcinoma in the European Prospective Investigation into Cancer and Nutrition study}, author = {R Zamora-Ros and S Rinaldi and K K Tsilidis and E Weiderpass and M C Boutron-Ruault and A L Rostgaard-Hansen and A Tjonneland and F Clavel-Chapelon and S Mesrine and V A Katzke and T Kuhn and J Forster and H Boeing and A Trichopoulou and P Lagiou and E Klinaki and G Masala and S Sieri and F Ricceri and R Tumino and A Mattiello and P H Peeters and H B Bueno-de-Mesquita and D Engeset and G Skeie and M Arguelles and A Agudo and M J Sanchez and M D Chirlaque and A Barricarte and S Chamosa and M Almquist and A Tosovic and J Hennings and M Sandstrom and J A Schmidt and K T Khaw and N J Wareham and A J Cross and N Slimani and G Byrnes and I Romieu and E Riboli and S Franceschi}, url = {http://onlinelibrary.wiley.com/doi/10.1002/ijc.29693/abstract}, doi = {10.1002/ijc.29693}, issn = {0020-7136}, year = {2015}, date = {2015-01-01}, journal = {Int J Cancer}, abstract = {Incidence rates of differentiated thyroid carcinoma (TC) have increased in many countries. Adiposity and dietary risk factors may play a role, but little is known on the influence of energy intake and macronutrient composition. The aim of this study was to investigate the associations between TC and the intake of energy, macronutrients, glycemic index (GI) and glycemic load in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 477,274 middle-age participants (70.2% women) from ten European countries. Dietary data were collected using country-specific validated dietary questionnaires. Total carbohydrates, proteins, fats, saturated, monounsaturated and polyunsaturated fats (PUFA), starch, sugar, and fiber were computed as g/1,000 kcal. Multivariable Cox regression was used to calculate multivariable adjusted hazard ratios (HR) and 95% confidence interval (CI) by intake quartile (Q). After a mean follow-up time of 11 years, differentiated TC was diagnosed in 556 participants (90% women). Overall, we found significant associations only with total energy (HRQ4 vs .Q1 , 1.29; 95% CI, 1.00-1.68) and PUFA intakes (HRQ4 vs .Q1 , 0.74; 95% CI, 0.57-0.95). However, the associations with starch and sugar intake and GI were significantly heterogeneous across body mass index (BMI) groups, i.e., positive associations with starch and GI were found in participants with a BMI \>/= 25 and with sugar intake in those with BMI \< 25. Moreover, inverse associations with starch and GI were observed in subjects with BMI \< 25. In conclusion, our results suggest that high total energy and low PUFA intakes may increase the risk of differentiated TC. Positive associations with starch intake and GI in participants with BMI \>/= 25 suggest that those persons may have a greater insulin response to high starch intake and GI than lean people.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14346, title = {Assessing the Extent of Adherence to the Recommended Antenatal Care Content in Malaysia: Room for Improvement}, author = {P L Yeoh and K Hornetz and N I Ahmad Shauki and M Dahlui}, doi = {10.1371/journal.pone.0135301}, issn = {1932-6203}, year = {2015}, date = {2015-01-01}, journal = {PLoS One}, volume = {10}, number = {8}, pages = {e0135301}, abstract = {BACKGROUND: Recent papers on monitoring of health services affirmed that while antenatal care (ANC) is an effective measure, quality is still a problem. Quality in maternal services "...involves providing a minimum level of care to all pregnant women..." Yet adherence to a minimum level of recommended ANC content appears to be unmet. Comprehensive review of ANC content rendered in environments with rapid changes in demographic, socio-economic, lifestyle and morbidity was sparse. Malaysia is such a country that has undergone these transitions with tremendous progress in health. However, recent progress in pregnancy outcomes is stagnating. This study aims to analyse adherence to recommended ANC; specifically, to examine the extent of adherence to recommended ANC content and to determine the factors influencing ANC content score. METHODS: A retrospective cohort study of 522 randomly selected women who used ANC was conducted. Data were extracted from individual records. The study examined adherence to essential ANC guidelines using weighted scoring for physical examination, health screening, case management, and health education. GLM Univariate analysis procedure was used to determine the factors associated with ANC content score. Binary logistic regression was used to assess ANC content level and pregnancy outcomes, controlled for ANC utilisation. RESULTS: Around half of the women had \<80% of recommended ANC content documented. Health education had the lowest mean score, at around 35%. The low-risk pregnancies had a higher ANC content score than the high-risk pregnancies (78% vs. 75%; P = 0.002). The smallest clinics had a higher ANC content score than the bigger clinics (78% vs. 74-76%; P\<0.001). ANC content score among the women with "adequate" ANC utilisation, as defined by the modified Adequacy of Prenatal Care Utilisation Index, was lower than the women with "adequate-plus" ANC utilisation (75% vs. 78%, P\<0.001). Assessment of symphysis-fundal height, foetal presentation and foetal heart auscultation were initiated earlier than recommended. Inadequate ANC content was associated with higher prevalence of preterm birth. CONCLUSIONS: Our findings indicate the presence of issues related to delivery of recommended ANC content. We advocate for all pregnant women to be ensured of adherence to the recommended ANC content. We also recommend monitoring the delivery of health advice. Conforming to recommended timing of initiation for ANC practices is essential due to resource implication and possible implication on maternal wellbeing. The association of inadequate ANC content and preterm birth may be due to lesser opportunities to receive some of the care because of lower number of ANC visits among preterm birth; this may also indicate the importance of having adequate ANC content.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15980, title = {Does change in perception following counseling result in improved quitting outcome among Malaysian smokers?}, author = {S M Yasin and R Masilamani and M F Ming and D Koh}, doi = {10.1177/1010539511426472}, issn = {1010-5395}, year = {2015}, date = {2015-01-01}, journal = {Asia Pac J Public Health}, volume = {27}, number = {2}, pages = {Np143-53}, abstract = {OBJECTIVE: The authors examined the effects that change in perception about the advantages and disadvantages of smoking and quitting had on quitting outcome among smokers enrolled in a program for smoking cessation. METHODS: A total of 185 smokers from 2 public universities who were interested in quitting received smoking cessation counseling on understanding the risks and benefits of quitting (or smoking) in addition to a course of free nicotine replacement therapy (NRT). A decisional balance questionnaire (DBQ) was administered at baseline and at 2 months postcounseling to determine and assess changes in smoking perception. RESULTS: After counseling, 72.3% of smokers had reduced their perceptions about the advantages of smoking, and 66.4% had increased perceptions of disadvantages of smoking. At the eighth week, 51 participants (27%) had quit. Smokers who had reduced perceptions of the advantages of smoking had significantly higher quit rates compared with those with no improvement in perception (82.6% vs 17.4%; odds ratio = 2.47; 95% confidence interval = 1.00-6.10). CONCLUSION: After counseling, smokers did change their perception of the advantages and disadvantages of smoking during the quitting process. These changes are associated with a higher likelihood of smoking cessation.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14194, title = {Alcohol consumption and the risk of renal cancers in the European prospective investigation into cancer and nutrition (EPIC)}, author = {M B Wozniak and P Brennan and D R Brenner and K Overvad and A Olsen and A Tjonneland and M C Boutron-Ruault and F Clavel-Chapelon and G Fagherazzi and V Katzke and T Kuhn and H Boeing and M M Bergmann and A Steffen and A Naska and A Trichopoulou and D Trichopoulos and C Saieva and S Grioni and S Panico and R Tumino and P Vineis and H B Bueno-de-Mesquita and P H Peeters and A Hjartaker and E Weiderpass and L Arriola and E Molina-Montes and E J Duell and C Santiuste and R Alonso Torre and A Barricarte Gurrea and T Stocks and M Johansson and B Ljungberg and N Wareham and K T Khaw and R C Travis and A J Cross and N Murphy and E Riboli and G Scelo}, url = {http://onlinelibrary.wiley.com/doi/10.1002/ijc.29559/abstract}, doi = {10.1002/ijc.29559}, issn = {0020-7136}, year = {2015}, date = {2015-01-01}, journal = {Int J Cancer}, volume = {137}, number = {8}, pages = {1953-66}, abstract = {Epidemiologic studies have reported that moderate alcohol consumption is inversely associated with the risk of renal cancer. However, there is no information available on the associations in renal cancer subsites. From 1992 through to 2010, 477,325 men and women in the European Prospective Investigation into Cancer and Nutrition cohort were followed for incident renal cancers (n = 931). Baseline and lifetime alcohol consumption was assessed by country-specific, validated dietary questionnaires. Information on past alcohol consumption was collected by lifestyle questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from Cox proportional hazard models. In multivariate analysis, total alcohol consumption at baseline was inversely associated with renal cancer; the HR and 95% CI for the increasing categories of total alcohol consumption at recruitment versus the light drinkers category were 0.78 (0.62-0.99), 0.82 (0.64-1.04), 0.70 (0.55-0.90), 0.91 (0.63-1.30), respectively, (ptrend = 0.001). A similar relationship was observed for average lifetime alcohol consumption and for all renal cancer subsites combined or for renal parenchyma subsite. The trend was not observed in hypertensive individuals and not significant in smokers. In conclusion, moderate alcohol consumption was associated with a decreased risk of renal cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15768, title = {Arboridinine, a Pentacyclic Indole Alkaloid with a New Cage Carbon-Nitrogen Skeleton Derived from a Pericine Precursor}, author = {S P Wong and C Y Gan and K H Lim and K N Ting and Y Y Low and T S Kam}, doi = {10.1021/acs.orglett.5b01757}, issn = {1523-7052}, year = {2015}, date = {2015-01-01}, journal = {Org Lett}, volume = {17}, number = {14}, pages = {3628-31}, abstract = {A new monoterpene indole alkaloid characterized by an unprecedented pentacyclic cage skeleton, arboridinine (1), was isolated from a Malaysian Kopsia species. The structure and absolute configuration of the alkaloid were determined based on NMR, MS, and X-ray diffraction analysis. A possible biogenetic pathway from a pericine precursor is presented.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14389, title = {Factors affecting dengue prevention practices: nationwide survey of the Malaysian public}, author = {L P Wong and S M Shakir and N Atefi and S AbuBakar}, doi = {10.1371/journal.pone.0122890}, issn = {1932-6203}, year = {2015}, date = {2015-01-01}, journal = {PLoS One}, volume = {10}, number = {4}, pages = {e0122890}, abstract = {BACKGROUND: Efforts to stamp dengue in many dengue endemic countries has met little success. There is a need to re-examine and understand how the public at large view the dengue prevention efforts. This study aimed to examine the demographic factors, theoretical constructs of the Health Belief Model and knowledge about dengue and how these influence the practice of dengue prevention. METHODS: A national telephone survey was carried out with 2,512 individuals of the Malaysian public aged 18-60 years. RESULTS: The majority (73%) of the Malaysian public had a total dengue prevention score of 51-100 (of a possible score of 1-100). Multivariate analysis suggests significant correlates of higher dengue prevention practices with demographic background, perception of susceptibility to dengue, perceived density of mosquitoes in the neighbourhood and knowledge about dengue. Households of lower income of which the majority (40.7%) were from the rural areas, were associated with the highest odds [OR = 1.33; 95%CI = 1.09-1.67; p = 0.004] of dengue prevention. Dengue prevention practices were also less likely to be undertaken in neighbourhoods where the responders perceived there is no and/or low density of mosquitoes. Dengue prevention practices are also less likely to be practiced by skilled workers [OR = 0.78; 95%CI = 0.63-0.95; p = 0.029] compared to those unemployed. Higher perceived susceptibility to dengue was associated with higher dengue prevention practices and participants with higher dengue knowledge were found to have a higher level of involvement in dengue prevention practices. CONCLUSION: Results from the study suggest that in formulating approaches to contain dengue, strategies should be developed to cultivate dengue prevention practices among urban population and target areas with low density of mosquitoes where public perceived a less likely chance of getting dengue. Dengue prevention campaigns should focus on messages highlighting the risk of contracting dengue and education to increase knowledge about dengue.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14618, title = {The predictive accuracy of PREDICT: a personalized decision-making tool for Southeast Asian women with breast cancer}, author = {H S Wong and S Subramaniam and Z Alias and N A Taib and G F Ho and C H Ng and C H Yip and H M Verkooijen and M Hartman and N Bhoo-Pathy}, url = {http://graphics.tx.ovid.com/ovftpdfs/FPDDNCMCCDLBCB00/fs046/ovft/live/gv025/00005792/00005792-201502040-00019.pdf}, doi = {10.1097/md.0000000000000593}, issn = {0025-7974}, year = {2015}, date = {2015-01-01}, journal = {Medicine (Baltimore)}, volume = {94}, number = {8}, pages = {e593}, abstract = {Web-based prognostication tools may provide a simple and economically feasible option to aid prognostication and selection of chemotherapy in early breast cancers. We validated PREDICT, a free online breast cancer prognostication and treatment benefit tool, in a resource-limited setting. All 1480 patients who underwent complete surgical treatment for stages I to III breast cancer from 1998 to 2006 were identified from the prospective breast cancer registry of University Malaya Medical Centre, Kuala Lumpur, Malaysia. Calibration was evaluated by comparing the model-predicted overall survival (OS) with patients' actual OS. Model discrimination was tested using receiver-operating characteristic (ROC) analysis. Median age at diagnosis was 50 years. The median tumor size at presentation was 3 cm and 54% of patients had lymph node-negative disease. About 55% of women had estrogen receptor-positive breast cancer. Overall, the model-predicted 5 and 10-year OS was 86.3% and 77.5%, respectively, whereas the observed 5 and 10-year OS was 87.6% (difference: -1.3%) and 74.2% (difference: 3.3%), respectively; P values for goodness-of-fit test were 0.18 and 0.12, respectively. The program was accurate in most subgroups of patients, but significantly overestimated survival in patients aged \<40 years, and in those receiving neoadjuvant chemotherapy. PREDICT performed well in terms of discrimination; areas under ROC curve were 0.78 (95% confidence interval [CI]: 0.74-0.81) and 0.73 (95% CI: 0.68-0.78) for 5 and 10-year OS, respectively. Based on its accurate performance in this study, PREDICT may be clinically useful in prognosticating women with breast cancer and personalizing breast cancer treatment in resource-limited settings.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14391, title = {Employability among people with uncontrolled seizures: An interpretative phenomenological approach}, author = {M C Wo and K S Lim and W Y Choo and C T Tan}, doi = {10.1016/j.yebeh.2015.02.016}, issn = {1525-5050}, year = {2015}, date = {2015-01-01}, journal = {Epilepsy Behav}, volume = {45}, pages = {21-30}, abstract = {PURPOSE: This study aimed to explore positive and negative factors affecting the employability in patients with uncontrolled seizures. METHOD: Semistructured interviews with 21 patients with uncontrolled seizures were analyzed using interpretative phenomenological analysis. RESULT: Eleven (52.4%) of the participants interviewed were employed; 7 were holding full-time position with more than 4years of working experience. The mean age was 34.6years, 71.4% were female, 38% were married, 71.4% had at least 11years of education, 38% had a driving license, 19% received government monetary aid, 66.7% had seizure onset before reaching 17years of age, 66.7% experienced monthly seizures, and 76% were on polytherapy. A total of 6 main themes were found to be affecting the employability among people with uncontrolled seizures: (a) ability to work; (b) intention to work; (c) support and stigma at workplace; (d) family support, overdependence, and protection; (e) life event; and (f) government and welfare support. Subthemes under the main theme ability to work included education, cognitive and physical functions, ability to continue working after seizures, ability to travel to work, self-perceived ability to work, and ability to cope with stress. Many shared the same idea that employment is important, but their intention to work varied. The employed group tended to work for a future goal and self-satisfaction, and the unemployed group tended to have no or lack intention to work. Positive factors were noted in the following themes: ability to work; intention to work; support and stigma at workplace; and family support, overdependence, and protection. CONCLUSION: There were internal and external factors affecting the employability among people with uncontrolled seizures both positively and negatively. Positive internal factors such as ability and intention to work require further exploration.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14342, title = {Employability in people with epilepsy: A systematic review}, author = {M C Wo and K S Lim and W Y Choo and C T Tan}, doi = {10.1016/j.eplepsyres.2015.06.016}, issn = {0920-1211}, year = {2015}, date = {2015-01-01}, journal = {Epilepsy Res}, volume = {116}, pages = {67-78}, abstract = {OBJECTIVES: People with epilepsy were (PWE) reported to have poorer employment rate. However, the methodologies used differ greatly from one study to another, making global comparison difficult. We aimed to determine the employment rate of PWE globally using a unified definition of employment rate and to summarize the reported positive and negative factors affecting employability in PWE, using a systematic review. METHODS: All studies reporting employment rate of PWE were independently assessed. Employment rate was recalculated according to the standard definition by the Bureau of Labor statistics (BLS) of United States and the International Labour Organization i.e. employment rate is the percentage of employed person over the labor force. RESULTS: Of 95 papers reported on employment status of PWE, adjusted employment rate (aER) was shown to be as low as 14% to as high as 89% with a mean adjusted employment rate of 58%. No significant differences in mean of aER was found between continents, or among Asian countries. Employment rate of people with uncontrolled seizures were reported in 16 papers, with a mean adjusted employed rate of 58%. Psychological factors were less frequently reported as compared to clinical and socio-demographical factors, seen in a total of 25 (26%) out of 97 studies. The positive factors leading to successful career in PWE were understudied and needed to be further explored. CONCLUSION: Employability is multifactorial, including clinical, psychological and social factors. The adjusted employment rate of people with uncontrolled seizures is comparable to those with controlled seizures, supporting the need to explore non-clinical factors.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14381, title = {Should the threshold for expired-air carbon monoxide concentration as a means of verifying self-reported smoking abstinence be reduced in clinical treatment programmes? Evidence from a Malaysian smokers' clinic}, author = {L H Wee and R West and J Mariapun and C M Chan and A Bulgiba and D Peramalah and S Jit}, doi = {10.1016/j.addbeh.2015.03.021}, issn = {0306-4603}, year = {2015}, date = {2015-01-01}, journal = {Addict Behav}, volume = {47}, pages = {74-9}, abstract = {BACKGROUND: It has been proposed that the expired-air carbon monoxide (CO) threshold for confirming smoking abstinence in clinical practice be reduced below 10 ppm. Optimal thresholds may vary across regions. Data are needed to assess the impact of such a change on claimed success. METHODS: A total of 253 smokers who attended the Tanglin quit smoking clinic in Malaysia were followed-up 1, 3 and 6 months after the target quit date. All participants received a standard behavioural support programme and were prescribed either varenicline or nicotine replacement therapy. Expired-air CO was measured at every visit. Respondents' smoking status was assessed using a range of different CO thresholds (3, 5 and 10 ppm) and the impact on quit rates was calculated. Predictors of success as defined using the different thresholds were assessed. RESULTS: The 6-month abstinence rates were: 1 month - 54.9% at 10 ppm, 54.9% at 5 ppm and 48.6% at 3 ppm; 3 months - 36.0% at 10 ppm, 35.2% at 5 ppm and 30.4% at 3 ppm; 6 months - 24.1% at 10 ppm, 24.1% at 5 ppm and 20.6% at 3 ppm. Older smokers were more likely to be recorded as abstinent at 6 months regardless of the threshold used. CONCLUSIONS: Reducing the threshold for expired-air carbon monoxide concentrations to verify claimed smoking abstinence from 10 ppm to 5 ppm makes minimal difference to documented success rates in Malaysian smoker's clinic patients. Reducing to 3 ppm decreases success rates slightly. Predictors of success at stopping appear to be unaffected by the threshold used.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14374, title = {Diffusion Tensor Imaging Parameters in Mild Traumatic Brain Injury and Its Correlation with Early Neuropsychological Impairment: A Longitudinal Study}, author = {V Veeramuthu and V Narayanan and T L Kuo and L Delano-Wood and K Chinna and M W Bondi and V Waran and D Ganesan and N Ramli}, doi = {10.1089/neu.2014.3750}, issn = {0897-7151}, year = {2015}, date = {2015-01-01}, journal = {J Neurotrauma}, volume = {32}, number = {19}, pages = {1497-509}, abstract = {We explored the prognostic value of diffusion tensor imaging (DTI) parameters of selected white matter (WM) tracts in predicting neuropsychological outcome, both at baseline and 6 months later, among well-characterized patients diagnosed with mild traumatic brain injury (mTBI). Sixty-one patients with mTBI (mean age=27.08; standard deviation [SD], 8.55) underwent scanning at an average of 10 h (SD, 4.26) post-trauma along with assessment of their neuropsychological performance at an average of 4.35 h (SD, 7.08) upon full Glasgow Coma Scale recovery. Results were then compared to 19 healthy control participants (mean age=29.05; SD, 5.84), both in the acute stage and 6 months post-trauma. DTI and neuropsychological measures between acute and chronic phases were compared, and significant differences emerged. Specifically, chronic-phase fractional anisotropy and radial diffusivity values showed significant group differences in the corona radiata, anterior limb of internal capsule, cingulum, superior longitudinal fasciculus, optic radiation, and genu of corpus callosum. Findings also demonstrated associations between DTI indices and neuropsychological outcome across two time points. Our results provide new evidence for the use of DTI as an imaging biomarker and indicator of WM damage occurring in the context of mTBI, and they underscore the dynamic nature of brain injury and possible biological basis of chronic neurocognitive alterations.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14382, title = {Circulating prolactin and in situ breast cancer risk in the European EPIC cohort: a case-control study}, author = {K Tikk and D Sookthai and R T Fortner and T Johnson and S Rinaldi and I Romieu and A Tjonneland and A Olsen and K Overvad and F Clavel-Chapelon and L Baglietto and H Boeing and A Trichopoulou and P Lagiou and D Trichopoulos and G Masala and V Krogh and R Tumino and F Ricceri and A Mattiello and A Agudo and V Menendez and M J Sanchez and P Amiano and M D Chirlaque and A Barricarte and H B Bueno-de-Mesquita and E M Monninkhof and N C Onland-Moret and A Andresson and M Sund and E Weiderpass and K T Khaw and T J Key and R C Travis and M A Merritt and E Riboli and L Dossus and R Kaaks}, doi = {10.1186/s13058-015-0563-6}, issn = {1465-5411}, year = {2015}, date = {2015-01-01}, journal = {Breast Cancer Res}, volume = {17}, pages = {49}, abstract = {INTRODUCTION: The relationship between circulating prolactin and invasive breast cancer has been investigated previously, but the association between prolactin levels and in situ breast cancer risk has received less attention. METHODS: We analysed the relationship between pre-diagnostic prolactin levels and the risk of in situ breast cancer overall, and by menopausal status and use of postmenopausal hormone therapy (HT) at blood donation. Conditional logistic regression was used to assess this association in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, including 307 in situ breast cancer cases and their matched control subjects. RESULTS: We found a significant positive association between higher circulating prolactin levels and risk of in situ breast cancer among all women [pre-and postmenopausal combined}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15696, title = {Factors Associated with Complications and Postoperative Visual Outcomes of Cataract Surgery; a Study of 1,632 Cases}, author = {T Thanigasalam and S C Reddy and R A Zaki}, doi = {10.4103/2008-322x.158892}, issn = {2008-2010 (Print) 2008-322x}, year = {2015}, date = {2015-01-01}, journal = {J Ophthalmic Vis Res}, volume = {10}, number = {4}, pages = {375-84}, abstract = {PURPOSE: Cataract surgery is the most common intraocular surgery performed all over the world and has advanced technically in recent years. As in all surgeries, complications are unavoidable. Herein we report factors associated with complications and visual outcomes of cataract surgery. METHODS: This retrospective cohort study included data of 1,632 cataract surgeries performed from 2007 to 2010 which was obtained from the cataract registry of the Malaysian National Eye Database. Demographic features, ocular and systemic comorbidites, grade of surgeon expertise and duration of surgery, type of anesthesia, intraoperative and postoperative complications, and the type of intraocular lens were recorded. Best corrected visual acuities were compared before and after the operation. RESULTS: Mean patient age was 66.9 years with equal gender distribution. The majority of subjects had age related cataracts. Phacoemulsification was done faster than other surgeries, especially by specialist surgeons. History of prior ocular surgery and operations performed under general anesthesia were associated with greater complications. Phacoemulsification was associated with less complications and better visual outcomes. The age and etiology of cataract did not affect complications. Malays, absence of ocular comorbidities, left eyes and eyes operated under local anesthesia were more likely to experience more visual improvement. Gender, age, cause of cataract, systemic comorbidities and surgeon expertise as well as intra-and postoperative complications did not affect the visual outcomes. CONCLUSION: Phacoemulsification had good visual outcomes in cataract surgery. Duration of surgery, expertise of the surgeon and complications did not affect the visual outcomes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14213, title = {Development and psychometric properties of a scale assessing the needs of caregivers of children with disabilities}, author = {S H Tan}, url = {http://ac.els-cdn.com/S1936657414001927/1-s2.0-S1936657414001927-main.pdf?_tid=cf99c840-66a9-11e5-84b8-00000aacb361\&acdnat=1443531702_58f5b75925ec38297230f764abc879c0}, doi = {10.1016/j.dhjo.2014.11.003}, issn = {1936-6574 (Print)}, year = {2015}, date = {2015-01-01}, journal = {Disabil Health J}, volume = {8}, number = {3}, pages = {414-23}, abstract = {BACKGROUND: Planning and evaluation of health care services for children with disabilities requires information on their caregivers' needs. OBJECTIVE: This paper aims to present the development and psychometric properties of the Caregiver Needs Scale (CNS), a scale assessing the needs of caregivers of children with disabilities aged 0-12 years in Malaysia. METHODS: Development of the scale went through a multistage process of literature review, modification of an existing instrument, input from experts and feedback from service users. Literature review identified content domains and response options. An exploratory factor analysis (EFA) was undertaken to identify subscales of caregiver needs. The internal consistency reliability, convergent validity and discriminant validity of the new scale were examined. RESULTS: 273 caregivers of children with disabilities completed the fielded questionnaire. EFA revealed 4 subscales of caregiver needs: need for 'Help getting information and services for the child,' 'Help coping with the child,' 'Help getting child care' and 'Help with finances.' Three items with factor loading \<0.4 were dropped. Cronbach's alpha coefficients of the subscales ranged from 0.813 to 0.903. Total CNS score correlated with number of child's needs and unmet needs. The score was also higher in families with financial and employment problems. CONCLUSION: A new instrument was developed to assess the needs of caregivers of children with disabilities for use in the Malaysian population. The CNS showed satisfactory psychometric properties but further examination is warranted to confirm its validity.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14413, title = {The Will Rogers phenomenon in the staging of breast cancer - does it matter?}, author = {G H Tan and N Bhoo-Pathy and N A Taib and M H See and S Jamaris and C H Yip}, doi = {10.1016/j.canep.2014.11.005}, issn = {1877-7821}, year = {2015}, date = {2015-01-01}, journal = {Cancer Epidemiol}, volume = {39}, number = {1}, pages = {115-7}, abstract = {INTRODUCTION: Changes in the American Joint Commission on Cancer staging for breast cancer occurred when the 5th Edition was updated to the 6th Edition. OBJECTIVE: To investigate how these changes affected stage and survival. METHODS: 3127 cases of breast cancer were restaged. RESULTS: Late stages increased from 27.7% to 38.1%. The five-year survival improved in Stage 2 (82.9-86.1%) and Stage 3 (50.6-59%). DISCUSSION: Stage shift leads to an erroneous impression that women are presenting with later stages and stage-specific survival is improving. CONCLUSION: Standardizing cancer staging is important when reporting stage and survival in different time periods.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14403, title = {The impact of dyspepsia on symptom severity and quality of life in adults with headache}, author = {M L Tai and N Norhatta and K J Goh and F M Moy and R Sujarita and A A Asraff and Q Z Lee and J H Ng and E C Tan and S Mahadeva}, doi = {10.1371/journal.pone.0115838}, issn = {1932-6203}, year = {2015}, date = {2015-01-01}, journal = {PLoS One}, volume = {10}, number = {1}, pages = {e0115838}, abstract = {BACKGROUND: Dyspepsia and headache frequently co-exist, but the clinical implication of this association is uncertain. We planned to examine the prevalence and impact of dyspepsia in adults with headache. METHODS: A cross-sectional study was conducted in a secondary care setting. Clinical, psychological and health-related quality of life (HRQOL) data were compared between subjects with headache and controls (non-headache subjects). The impact of dyspepsia was analysed further in subjects with headache alone. RESULTS: 280 subjects (93 cases with headache and 187 matched controls) were recruited. The following baseline characteristics of subjects were as follows: mean age 45.0 +/- 17.3 years, 57.0% females and ethnic distribution-Malaysian = 45 (48.4%), Chinese n = 24 (25.8%) and Indians n = 24 (25.8%). Headache sub-types among cases with headache were as follows: tension-type headache (TTH) n = 53 (57.0%) and migraine n = 40 (43.0%). Dyspepsia was more prevalent in cases with headache compared to controls (25.8% vs 12.8%}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15757, title = {Genome-wide association study of prostate cancer-specific survival}, author = {R Szulkin and R Karlsson and T Whitington and M Aly and H Gronberg and R A Eeles and D F Easton and Z Kote-Jarai and A A Al Olama and S Benlloch and K Muir and G G Giles and M C Southey and L M FitzGerald and B E Henderson and F R Schumacher and C A Haiman and C Sipeky and T L Tammela and B G Nordestgaard and T J Key and R C Travis and D E Neal and J L Donovan and F C Hamdy and P D Pharoah and N Pashayan and K T Khaw and J L Stanford and S N Thibodeau and S K McDonnell and D J Schaid and C Maier and W Vogel and M Luedeke and K Herkommer and A S Kibel and C Cybulski and J Lubinski and W Kluzniak and L Cannon-Albright and H Brenner and V Herrmann and B Holleczek and J Y Park and T A Sellers and H Y Lim and C Slavov and R P Kaneva and V I Mitev and A Spurdle and M R Teixeira and P Paulo and S Maia and H Pandha and A Michael and A Kierzek and J Batra and J A Clements and D Albanes and G L Andriole and S I Berndt and S Chanock and S M Gapstur and E L Giovannucci and D J Hunter and P Kraft and L Le Marchand and J Ma and A M Mondul and K L Penney and M J Stampfer and V L Stevens and S J Weinstein and A Trichopoulou and B H Bueno-de-Mesquita and A Tjonneland and D G Cox and L Maehle and J Schleutker and S Lindstrom and F Wiklund}, doi = {10.1158/1055-9965.Epi-15-0543}, issn = {1055-9965}, year = {2015}, date = {2015-01-01}, journal = {Cancer Epidemiol Biomarkers Prev}, volume = {24}, number = {11}, pages = {1796-800}, abstract = {BACKGROUND: Unnecessary intervention and overtreatment of indolent disease are common challenges in clinical management of prostate cancer. Improved tools to distinguish lethal from indolent disease are critical. METHODS: We performed a genome-wide survival analysis of cause-specific death in 24,023 prostate cancer patients (3,513 disease-specific deaths) from the PRACTICAL and BPC3 consortia. Top findings were assessed for replication in a Norwegian cohort (CONOR). RESULTS: We observed no significant association between genetic variants and prostate cancer survival. CONCLUSIONS: Common genetic variants with large impact on prostate cancer survival were not observed in this study. IMPACT: Future studies should be designed for identification of rare variants with large effect sizes or common variants with small effect sizes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15801, title = {Assessing Quality of Working Life Among Malaysian Workers}, author = {N S Sulaiman and W Y Choo and A R Mat Yassim and D Van Laar and K Chinna and H A Majid}, doi = {10.1177/1010539515583331}, issn = {1010-5395}, year = {2015}, date = {2015-01-01}, journal = {Asia Pac J Public Health}, volume = {27}, number = {8 Suppl}, pages = {94s-100s}, abstract = {The Work-Related Quality of Life Scale-2 (WRQLS-2) has been used to measure quality of working life (QOWL) in the United Kingdom. In this study, the scale was translated and normalized into Malay. The scale was translated using the back-translation method, pretesting, and pilot testing. It was conducted among health care and office workers. It was tested in 3 stages; confirmatory factor analysis at stages 1 and 3 and exploratory factor analysis at stage 2. The Malaysian WRQLS-2 had 5 factors: "General Well-Being," "Job and Career Satisfaction," "Employee Engagement," "Home-Work Interface," and "Stress at Work." The scale showed good convergent and construct validity and also reliability. Perception of good QOWL may differ because of cultural influences and varying work environments. The validated Malaysian WRQLS-2 can be used to determine the QOWL of Malaysian office and health care workers.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14397, title = {Body composition indices and predicted cardiovascular disease risk profile among urban dwellers in Malaysia}, author = {T T Su and M Amiri and F Mohd Hairi and N Thangiah and M Dahlui and H A Majid}, doi = {10.1155/2015/174821}, year = {2015}, date = {2015-01-01}, journal = {Biomed Res Int}, volume = {2015}, pages = {174821}, abstract = {OBJECTIVES: This study aims to compare various body composition indices and their association with a predicted cardiovascular disease (CVD) risk profile in an urban population in Kuala Lumpur, Malaysia. METHODS: A cross-sectional survey was conducted in metropolitan Kuala Lumpur, Malaysia, in 2012. Households were selected using a simple random-sampling method, and adult members were invited for medical screening. The Framingham Risk Scoring algorithm was used to predict CVD risk, which was then analyzed in association with body composition measurements, including waist circumference, waist-hip ratio, waist-height ratio, body fat percentage, and body mass index. RESULTS: Altogether, 882 individuals were included in our analyses. Indices that included waist-related measurements had the strongest association with CVD risk in both genders. After adjusting for demographic and socioeconomic variables, waist-related measurements retained the strongest correlations with predicted CVD risk in males. However, body mass index, waist-height ratio, and waist circumference had the strongest correlation with CVD risk in females. CONCLUSIONS: The waist-related indicators of abdominal obesity are important components of CVD risk profiles. As waist-related parameters can quickly and easily be measured, they should be routinely obtained in primary care settings and population health screens in order to assess future CVD risk profiles and design appropriate interventions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14390, title = {Prediction of cardiovascular disease risk among low-income urban dwellers in metropolitan Kuala Lumpur, Malaysia}, author = {T T Su and M Amiri and F Mohd Hairi and N Thangiah and A Bulgiba and H A Majid}, doi = {10.1155/2015/516984}, year = {2015}, date = {2015-01-01}, journal = {Biomed Res Int}, volume = {2015}, pages = {516984}, abstract = {We aimed to predict the ten-year cardiovascular disease (CVD) risk among low-income urban dwellers of metropolitan Malaysia. Participants were selected from a cross-sectional survey conducted in Kuala Lumpur. To assess the 10-year CVD risk, we employed the Framingham risk scoring (FRS) models. Significant determinants of the ten-year CVD risk were identified using General Linear Model (GLM). Altogether 882 adults (\>/=30 years old with no CVD history) were randomly selected. The classic FRS model (figures in parentheses are from the modified model) revealed that 20.5% (21.8%) and 38.46% (38.9%) of respondents were at high and moderate risk of CVD. The GLM models identified the importance of education, occupation, and marital status in predicting the future CVD risk. Our study indicated that one out of five low-income urban dwellers has high chance of having CVD within ten years. Health care expenditure, other illness related costs and loss of productivity due to CVD would worsen the current situation of low-income urban population. As such, the public health professionals and policy makers should establish substantial effort to formulate the public health policy and community-based intervention to minimize the upcoming possible high mortality and morbidity due to CVD among the low-income urban dwellers.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14349, title = {Alteration of amino acid and biogenic amine metabolism in hepatobiliary cancers: Findings from a prospective cohort study}, author = {M Stepien and T Duarte-Salles and V Fedirko and A Floegel and D K Barupal and S Rinaldi and D Achaintre and N Assi and A Tjonneland and K Overvad and N Bastide and M C Boutron-Ruault and G Severi and T Kuhn and R Kaaks and K Aleksandrova and H Boeing and A Trichopoulou and C Bamia and P Lagiou and C Saieva and C Agnoli and S Panico and R Tumino and A Naccarati and H B Bueno-de-Mesquita and P H Peeters and E Weiderpass and J R Quiros and A Agudo and M J Sanchez and M Dorronsoro and D Gavrila and A Barricarte and B Ohlsson and K Sjoberg and M Werner and M Sund and N Wareham and K T Khaw and R C Travis and J A Schmidt and M Gunter and A Cross and P Vineis and I Romieu and A Scalbert and M Jenab}, doi = {10.1002/ijc.29718}, issn = {0020-7136}, year = {2015}, date = {2015-01-01}, journal = {Int J Cancer}, abstract = {Perturbations in levels of amino acids (AA) and their derivatives are observed in hepatocellular carcinoma (HCC). Yet, it is unclear whether these alterations precede or are a consequence of the disease, nor whether they pertain to anatomically related cancers of the intrahepatic bile duct (IHBC), and gallbladder and extrahepatic biliary tract (GBTC). Circulating standard AA, biogenic amines and hexoses were measured (Biocrates AbsoluteIDQ-p180Kit) in a case-control study nested within a large prospective cohort (147 HCC, 43 IHBC and 134 GBTC cases). Liver function and hepatitis status biomarkers were determined separately. Multivariable conditional logistic regression was used to calculate odds ratios and 95% confidence intervals (OR; 95%CI) for log-transformed standardised (mean = 0}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14405, title = {General and abdominal obesity and risk of esophageal and gastric adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition}, author = {A Steffen and J M Huerta and E Weiderpass and H B Bueno-de-Mesquita and A M May and P D Siersema and R Kaaks and J Neamat-Allah and V Pala and S Panico and C Saieva and R Tumino and A Naccarati and M Dorronsoro and E Sanchez-Cantalejo and E Ardanaz and J R Quiros and B Ohlsson and M Johansson and B Wallner and K Overvad and J Halkjaer and A Tjonneland and G Fagherazzi and A Racine and F Clavel-Chapelon and T J Key and K T Khaw and N Wareham and P Lagiou and C Bamia and A Trichopoulou and P Ferrari and H Freisling and Y Lu and E Riboli and A J Cross and C A Gonzalez and H Boeing}, doi = {10.1002/ijc.29432}, issn = {0020-7136}, year = {2015}, date = {2015-01-01}, journal = {Int J Cancer}, volume = {137}, number = {3}, pages = {646-57}, abstract = {General obesity, as reflected by BMI, is an established risk factor for esophageal adenocarcinoma (EAC), a suspected risk factor for gastric cardia adenocarcinoma (GCC) and appears unrelated to gastric non-cardia adenocarcinoma (GNCC). How abdominal obesity, as commonly measured by waist circumference (WC), relates to these cancers remains largely unexplored. Using measured anthropometric data from 391,456 individuals from the European Prospective Investigation into Cancer and Nutrition (EPIC) study and 11 years of follow-up, we comprehensively assessed the association of anthropometric measures with risk of EAC, GCC and GNCC using multivariable proportional hazards regression. One hundred twenty-four incident EAC, 193 GCC and 224 GNCC were accrued. After mutual adjustment, BMI was unrelated to EAC, while WC showed a strong positive association (highest vs. lowest quintile HR = 1.19; 95% CI, 0.63-2.22 and HR = 3.76; 1.72-8.22, respectively). Hip circumference (HC) was inversely related to EAC after controlling for WC, while WC remained positively associated (HR = 0.35; 0.18-0.68, and HR=4.10; 1.94-8.63, respectively). BMI was not associated with GCC or GNCC. WC was related to higher risks of GCC after adjustment for BMI and more strongly after adjustment for HC (highest vs. lowest quintile HR = 1.91; 1.09-3.37, and HR = 2.23; 1.28-3.90, respectively). Our study demonstrates that abdominal, rather than general, obesity is an indisputable risk factor for EAC and also provides evidence for a protective effect of gluteofemoral (subcutaneous) adipose tissue in EAC. Our study further shows that general obesity is not a risk factor for GCC and GNCC, while the role of abdominal obesity in GCC needs further investigation.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14406, title = {Insight into elder abuse among urban poor of Kuala Lumpur, Malaysia-a middle-income developing country}, author = {R Sooryanarayana and W Y Choo and N N Hairi and K Chinna and A Bulgiba}, doi = {10.1111/jgs.13217}, issn = {0002-8614}, year = {2015}, date = {2015-01-01}, journal = {J Am Geriatr Soc}, volume = {63}, number = {1}, pages = {180-2}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14407, title = {Cinderella's lifetime abuse}, author = {R Sooryanarayana}, doi = {10.1111/jgs.13179}, issn = {0002-8614}, year = {2015}, date = {2015-01-01}, journal = {J Am Geriatr Soc}, volume = {63}, number = {1}, pages = {175}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15722, title = {Psychometric Properties and Validation of the Positive and Negative Suicide Ideation (PANSI) Inventory in an Outpatient Clinical Population in Malaysia}, author = {A Sinniah and T P Oei and K Chinna and S A Shah and T Maniam and P Subramaniam}, doi = {10.3389/fpsyg.2015.01934}, issn = {1664-1078 (Print) 1664-1078}, year = {2015}, date = {2015-01-01}, journal = {Front Psychol}, volume = {6}, pages = {1934}, abstract = {The PANSI is a measure designed to assess the risk and protective factors related to suicidal behaviors. The present study evaluated the psychometric properties and factor structure of the Positive and Negative Suicide Ideation (PANSI) Inventory in a sample of clinical outpatients at a major hospital in Malaysia. In this study, 283 psychiatric patients and 200 medical (non-psychiatric) patients participated. All the patients completed the PANSI and seven other self-report instruments. Confirmative factor analysis supported the 2-factor oblique model. The internal consistency of the two subscales of PANSI-Negative and the PANSI-Positive were 0.93 and 0.84, respectively. In testing construct validity, PANSI showed sizable correlation with the other seven scales. Criterion validity was supported by scores on PANSI which differentiated psychiatric patients from medical patients. Logistic regression analyses showed PANSI can be used to classify the patients into suicidal or non-suicidal. The PANSI is a reliable and valid instrument to measure the severity of suicidal ideation among clinical outpatients in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14379, title = {The 11-item Medication Adherence Reasons Scale: reliability and factorial validity among patients with hypertension in Malaysian primary healthcare settings}, author = {R Shima and H Farizah and H A Majid}, doi = {10.11622/smedj.2015069}, issn = {0037-5675 (Print) 0037-5675}, year = {2015}, date = {2015-01-01}, journal = {Singapore Med J}, volume = {56}, number = {8}, pages = {460-7}, abstract = {INTRODUCTION: The aim of this study was to assess the reliability and validity of a modified Malaysian version of the Medication Adherence Reasons Scale (MAR-Scale). METHODS: In this cross-sectional study, the 15-item MAR-Scale was administered to 665 patients with hypertension who attended one of the four government primary healthcare clinics in the Hulu Langat and Klang districts of Selangor, Malaysia, between early December 2012 and end-March 2013. The construct validity was examined in two phases. Phase I consisted of translation of the MAR-Scale from English to Malay, a content validity check by an expert panel, a face validity check via a small preliminary test among patients with hypertension, and exploratory factor analysis (EFA). Phase II involved internal consistency reliability calculations and confirmatory factor analysis (CFA). RESULTS: EFA verified five existing factors that were previously identified (i.e. issues with medication management, multiple medications, belief in medication, medication availability, and the patient's forgetfulness and convenience), while CFA extracted four factors (medication availability issues were not extracted). The final modified MAR-Scale model, which had 11 items and a four-factor structure, provided good evidence of convergent and discriminant validities. Cronbach's alpha coefficient was \> 0.7, indicating good internal consistency of the items in the construct. The results suggest that the modified MAR-Scale has good internal consistencies and construct validity. CONCLUSION: The validated modified MAR-Scale (Malaysian version) was found to be suitable for use among patients with hypertension receiving treatment in primary healthcare settings. However, the comprehensive measurement of other factors that can also lead to non-adherence requires further exploration.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14345, title = {Baseline and lifetime alcohol consumption and risk of differentiated thyroid carcinoma in the EPIC study}, author = {A Sen and K K Tsilidis and N E Allen and S Rinaldi and P N Appleby and M Almquist and J A Schmidt and C C Dahm and K Overvad and A Tjonneland and A L Rostgaard-Hansen and F Clavel-Chapelon and L Baglietto and M C Boutron-Ruault and T Kuhn and V A Katze and H Boeing and A Trichopoulou and C Tsironis and P Lagiou and D Palli and V Pala and S Panico and R Tumino and P Vineis and H A Bueno-de-Mesquita and P H Peeters and A Hjartaker and E Lund and E Weiderpass and J R Quiros and A Agudo and M J Sanchez and L Arriola and D Gavrila and A B Gurrea and A Tosovic and J Hennings and M Sandstrom and I Romieu and P Ferrari and R Zamora-Ros and K T Khaw and N J Wareham and E Riboli and M Gunter and S Franceschi}, doi = {10.1038/bjc.2015.280}, issn = {0007-0920}, year = {2015}, date = {2015-01-01}, journal = {Br J Cancer}, volume = {113}, number = {5}, pages = {840-7}, abstract = {BACKGROUND: Results from several cohort and case-control studies suggest a protective association between current alcohol intake and risk of thyroid carcinoma, but the epidemiological evidence is not completely consistent and several questions remain unanswered. METHODS: The association between alcohol consumption at recruitment and over the lifetime and risk of differentiated thyroid carcinoma was examined in the European Prospective Investigation into Cancer and Nutrition. Among 477 263 eligible participants (70% women), 556 (90% women) were diagnosed with differentiated thyroid carcinoma over a mean follow-up of 11 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards models. RESULTS: Compared with participants consuming 0.1-4.9 g of alcohol per day at recruitment, participants consuming 15 or more grams (approximately 1-1.5 drinks) had a 23% lower risk of differentiated thyroid carcinoma (HR=0.77; 95% CI=0.60-0.98). These findings did not differ greatly when analyses were conducted for lifetime alcohol consumption, although the risk estimates were attenuated and not statistically significant anymore. Similar results were observed by type of alcoholic beverage, by differentiated thyroid carcinoma histology or according to age, sex, smoking status, body mass index and diabetes. CONCLUSIONS: Our study provides some support to the hypothesis that moderate alcohol consumption may be associated with a lower risk of papillary and follicular thyroid carcinomas.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15772, title = {Equitable Distribution of Public Hospitals According to Health Needs in Malaysia: Does It Exist or Not?}, author = {G Saw Chien and C Chee-Khoon and V H Wai and C W Ng}, doi = {10.1177/1010539515591847}, issn = {1010-5395}, year = {2015}, date = {2015-01-01}, journal = {Asia Pac J Public Health}, volume = {27}, number = {8 Suppl}, pages = {79s-85s}, abstract = {The goal of ensuring geographic equity of health care can be achieved if the geographic distribution of health care services is according to the health needs. This study aims to examine whether acute Ministry of Health hospital beds are distributed according to population health needs in various states within Peninsular Malaysia. The health needs of each state are indicated by the crude death rate. Comparisons of the share of hospital beds to that of population with differential health needs were assessed using concentration curve and index. In most years between 1995 and 2010, the distribution of hospital beds in Peninsular Malaysia were concentrated among states with higher health needs. This is in line with the principle of vertical equity and could be one advantage of a central federal government that can allocate health care resources to prioritize states with higher health care needs.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15803, title = {Frail Elders in an Urban District Setting in Malaysia: Multidimensional Frailty and Its Correlates}, author = {J Sathasivam and S B Kamaruzzaman and F Hairi and C W Ng and K Chinna}, doi = {10.1177/1010539515583332}, issn = {1010-5395}, year = {2015}, date = {2015-01-01}, journal = {Asia Pac J Public Health}, volume = {27}, number = {8 Suppl}, pages = {52s-61s}, abstract = {In the past decade, the population in Malaysia has been rapidly ageing. This poses new challenges and issues that threaten the ability of the elderly to independently age in place. A multistage cross-sectional study on 789 community-dwelling elderly individuals aged 60 years and above was conducted in an urban district in Malaysia to assess the geriatric syndrome of frailty. Using a multidimensional frailty index, we detected 67.7% prefrail and 5.7% frail elders. Cognitive status was a significant correlate for frailty status among the respondents as well as those who perceived their health status as very poor or quite poor; but self-rated health was no longer significant when controlled for sociodemographic variables. Lower-body weakness and history of falls were associated with increasing frailty levels, and this association persisted in the multivariate model. This study offers support that physical disability, falls, and cognition are important determinants for frailty. This initial work on frailty among urban elders in Malaysia provides important correlations and identifies potential risk factors that can form the basis of information for targeted preventive measures for this vulnerable group in their prefrail state.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14409, title = {High producing tumor necrosis factor alpha gene alleles in protection against severe manifestations of dengue}, author = {S S Sam and B T Teoh and K Chinna and S AbuBakar}, doi = {10.7150/ijms.8988}, issn = {1449-1907}, year = {2015}, date = {2015-01-01}, journal = {Int J Med Sci}, volume = {12}, number = {2}, pages = {177-86}, abstract = {Dengue virus (DENV) infection usually presents with mild self-limiting dengue fever (DF). Few however, would present with the more severe form of the disease, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). In the present study, the association between IL-12B, IL-10 and TNF-alpha gene polymorphisms and dengue severity was investigated. METHODS: A case-control study was performed on a total of 120 unrelated controls, 86 DF patients and 196 DHF/DSS patients. The polymorphisms in IL-12B, IL-10 and TNF-alpha genes were genotyped using PCR-RFLP and PCR-sequencing methods. RESULTS: A protective association of TNF-alpha -308A allele and -308GA genotype against DHF/DSS was observed, while TNF-alpha -238A allele and -238GA genotype were associated with DHF/DSS. A combination of TNF-alpha -308GA+AA genotype and IL-10 non-GCC haplotypes, IL-12B pro homozygotes (pro1/pro1, pro2/pro2) and IL-12B 3'UTR AC were significantly correlated with protective effects against DHF/DSS. An association between the cytokine gene polymorphisms and protection against the clinical features of severe dengue including thrombocytopenia and increased liver enzymes was observed in this study. CONCLUSION: The overall findings of the study support the correlation of high-producer TNF-alpha genotypes combined with low-producer IL-10 haplotypes and IL-12B genotypes in reduced risk of DHF/DSS.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15805, title = {Physical Activity Among Adolescents in an East Malaysian Rural Indigenous Community: Exploring the Influence of Neighborhood Environmental Factors}, author = {R Saimon and W Y Choo and K H Chang and C J Ng and A Bulgiba}, doi = {10.1177/1010539515582220}, issn = {1010-5395}, year = {2015}, date = {2015-01-01}, journal = {Asia Pac J Public Health}, volume = {27}, number = {8 Suppl}, pages = {33s-40s}, abstract = {This study explores the rural environmental factors that influence adolescents' participation in physical activities (PA). Thirty-six indigenous adolescents, aged 13 to 17 years from rural communities of East Malaysia were involved in the photovoice procedures: photo-taking, selecting, contextualizing, and codifying themes. Despite being endowed with natural resources such as river, forest, hills, and so on, the adolescents and the community did not capitalize on these rich resources to promote and engage in PA. Poor maintenance of natural resources, the lack of pedestrian infrastructures and road safety, the lack of PA facilities, and negative perception of ancestors' agricultural activities were among factors that constrained adolescents' PA. Although basic amenities such as play spaces and pedestrian infrastructures are necessary to increase adolescents' PA, any intervention should make the most of the natural resources, which are cheaper, environment friendly, and sustainable.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14631, title = {"Feeling unsafe": a photovoice analysis of factors influencing physical activity behavior among Malaysian adolescents}, author = {R Saimon and W Y Choo and A Bulgiba}, url = {http://aph.sagepub.com/content/27/2/NP2079.full.pdf}, doi = {10.1177/1010539513480229}, issn = {1010-5395}, year = {2015}, date = {2015-01-01}, journal = {Asia Pac J Public Health}, volume = {27}, number = {2}, pages = {Np2079-92}, abstract = {Understanding the factors influencing physical activity (PA) in the Asia-Pacific region is critical, given the high prevalence of inactivity in this area. The photovoice technique explores the types of PA and factors influencing PA among adolescents in Kuching, Sarawak. A total of 160 photographs were collected from participants (adolescents}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14354, title = {Assessing protein energy wasting in a Malaysian haemodialysis population using self-reported appetite rating: a cross-sectional study}, author = {S Sahathevan and C H Se and S H Ng and K Chinna and G S Harvinder and W S Chee and B L Goh and H A Gafor and S Bavanandan and G Ahmad and T Karupaiah}, doi = {10.1186/s12882-015-0073-x}, issn = {1471-2369}, year = {2015}, date = {2015-01-01}, journal = {BMC Nephrol}, volume = {16}, pages = {99}, abstract = {BACKGROUND: Poor appetite could be indicative of protein energy wasting (PEW) and experts recommend assessing appetite in dialysis patients. Our study aims to determine the relationship between PEW and appetite in haemodialysis (HD) patients. METHODS: HD patients (n=205) self-rated their appetite on a scale of 1 to 5 as very good (1), good (2), fair (3), poor (4) or very poor (5). Nutritional markers were compared against appetite ratings. Using logistic regression analysis associations between dichotomized appetite with PEW diagnosis were determined as per the International Society of Renal Nutrition and Metabolism (ISRNM) criteria and alternate objective measures. Data was adjusted for socioeconomic and demographic characteristics. RESULTS: Poorer appetite ratings were significantly associated with lower income (P = 0.021), lower measurements (P \< 0.05) for mid-arm muscle circumference, mid-arm muscle area and lean tissue mass (LTM), serum urea (P = 0.007) and creatinine (P = 0.005). The highest hsCRP (P = 0.016) levels occurred in patients reporting the poorest appetite. Serum albumin did not differ significantly across appetite ratings. Poor oral intake represented by underreporting (EI/BMR \< 1.2) was evident for all appetite ratings. PEW was prevalent irrespective of appetite ratings (very good: 17.6 %, good: 40.2 %, fair: 42.3 % and poor: 83.3 %). After dichotomizing appetite ratings into normal and diminished categories, there was a marginal positive association between diminished appetite and overall PEW diagnosis (OR adj: 1.71; 95 % CI: 0.94-3.10}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14375, title = {Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients: a cohort study}, author = {D Romaguera and H Ward and P A Wark and A C Vergnaud and P H Peeters and C H Gils and P Ferrari and V Fedirko and M Jenab and M C Boutron-Ruault and L Dossus and L Dartois and C P Hansen and C C Dahm and G Buckland and M J Sanchez and M Dorronsoro and C Navarro and A Barricarte and T J Key and A Trichopoulou and C Tsironis and P Lagiou and G Masala and V Pala and R Tumino and P Vineis and S Panico and H B Bueno-de-Mesquita and P D Siersema and B Ohlsson and K Jirstrom and M Wennberg and L M Nilsson and E Weiderpass and T Kuhn and V Katzke and K T Khaw and N J Wareham and A Tjonneland and H Boeing and J R Quiros and M J Gunter and E Riboli and T Norat}, doi = {10.1186/s12916-015-0332-5}, issn = {1741-7015}, year = {2015}, date = {2015-01-01}, journal = {BMC Med}, volume = {13}, pages = {107}, abstract = {BACKGROUND: Cancer survivors are advised to follow lifestyle recommendations on diet, physical activity, and body fatness proposed by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) for cancer prevention. Previous studies have demonstrated that higher concordance with these recommendations measured using an index score (the WCRF/AICR score) was associated with lower cancer incidence and mortality. The aim of this study was to evaluate the association between pre-diagnostic concordance with WCRF/AICR recommendations and mortality in colorectal cancer (CRC) patients. METHODS: The association between the WCRF/AICR score (score range 0-6 in men and 0-7 in women; higher scores indicate greater concordance) assessed on average 6.4 years before diagnosis and CRC-specific (n = 872) and overall mortality (n = 1,113) was prospectively examined among 3,292 participants diagnosed with CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (mean follow-up time after diagnosis 4.2 years). Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. RESULTS: The HRs (95% CIs) for CRC-specific mortality among participants in the second (score range in men/women: 2.25-2.75/3.25-3.75), third (3-3.75/4-4.75), and fourth (4-6/5-7) categories of the score were 0.87 (0.72-1.06), 0.74 (0.61-0.90), and 0.70 (0.56-0.89), respectively (P for trend \<0.0001), compared to participants with the lowest concordance with the recommendations (category 1 of the score: 0-2/0-3). Similar HRs for overall mortality were observed (P for trend 0.004). Meeting the recommendations on body fatness and plant food consumption were associated with improved survival among CRC cases in mutually adjusted models. CONCLUSIONS: Greater concordance with the WCRF/AICR recommendations on diet, physical activity, and body fatness prior to CRC diagnosis is associated with improved survival among CRC patients.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14385, title = {Improvement in binge eating in non-diabetic obese individuals after 3 months of treatment with liraglutide - A pilot study}, author = {S A Robert and A G Rohana and S A Shah and K Chinna and W N Wan Mohamud and N A Kamaruddin}, doi = {10.1016/j.orcp.2015.03.005}, issn = {1871-403X (Print) 1871-403x}, year = {2015}, date = {2015-01-01}, journal = {Obes Res Clin Pract}, volume = {9}, number = {3}, pages = {301-4}, abstract = {We examined the effects of liraglutide, a glucagon-like peptide-1 analogue on appetite and plasma ghrelin in non-diabetic obese participants with subclinical binge eating (BE). Forty-four obese BE participants (mean age: 34+/-9 years, BMI: 35.9+/-4.2kg/m(2)) were randomly assigned to intervention or control groups for 12 weeks. All participants received standard advice for diet and exercise. Binge eating score, ghrelin levels and other anthropometric variables were evaluated at baseline and at the end of the study. Participants who received liraglutide showed significant improvement in binge eating, accompanied by reduction in body weight, BMI, waist circumference, systolic blood pressure, fasting glucose and total cholesterol. Ghrelin levels were significantly increased which may potentially diminish the weight loss effects of liraglutide beyond the intervention.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14401, title = {Risk of second primary malignancies in women with breast cancer: Results from the European prospective investigation into cancer and nutrition (EPIC)}, author = {F Ricceri and F Fasanelli and M T Giraudo and S Sieri and R Tumino and A Mattiello and L Vagliano and G Masala and J R Quiros and N Travier and M J Sanchez and N Larranaga and M D Chirlaque and E Ardanaz and A Tjonneland and A Olsen and K Overvad and J Chang-Claude and R Kaaks and H Boeing and F Clavel-Chapelon and M Kvaskoff and L Dossus and A Trichopoulou and V Benetou and G Adarakis and H B Bueno-de-Mesquita and P H Peeters and M Sund and A Andersson and S Borgquist and S Butt and E Weiderpass and G Skeie and K T Khaw and R C Travis and S Rinaldi and I Romieu and M Gunter and M Kadi and E Riboli and P Vineis and C Sacerdote}, doi = {10.1002/ijc.29462}, issn = {0020-7136}, year = {2015}, date = {2015-01-01}, journal = {Int J Cancer}, volume = {137}, number = {4}, pages = {940-8}, abstract = {Women with a diagnosis of breast cancer are at increased risk of second primary cancers, and the identification of risk factors for the latter may have clinical implications. We have followed-up for 11 years 10,045 women with invasive breast cancer from a European cohort, and identified 492 second primary cancers, including 140 contralateral breast cancers. Expected and observed cases and Standardized Incidence Ratios (SIR) were estimated using Aalen-Johansen Markovian methods. Information on various risk factors was obtained from detailed questionnaires and anthropometric measurements. Cox proportional hazards regression models were used to estimate the role of risk factors. Women with breast cancer had a 30% excess risk for second malignancies (95% confidence interval-CI 18-42) after excluding contralateral breast cancers. Risk was particularly elevated for colorectal cancer (SIR, 1.71, 95% CI 1.43-2.00), lymphoma (SIR 1.80, 95% CI 1.31-2.40), melanoma (2.12; 1.63-2.70), endometrium (2.18; 1.75-2.70) and kidney cancers (2.40; 1.57-3.52). Risk of second malignancies was positively associated with age at first cancer, body mass index and smoking status, while it was inversely associated with education, post-menopausal status and a history of full-term pregnancy. We describe in a large cohort of women with breast cancer a 30% excess of second primaries. Among risk factors for breast cancer, a history of full-term pregnancy was inversely associated with the risk of second primary cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15830, title = {The CD14 C-260T single nucleotide polymorphism (SNP) modulates monocyte/macrophage activation in treated HIV-infected individuals}, author = {R Rajasuriar and Y Y Kong and R Nadarajah and N K Abdullah and T Spelman and M Y Yuhana and S Ponampalavanar and A Kamarulzaman and S R Lewin}, doi = {10.1186/s12967-015-0391-6}, issn = {1479-5876}, year = {2015}, date = {2015-01-01}, journal = {J Transl Med}, volume = {13}, pages = {30}, abstract = {BACKGROUND: HIV-infected individuals have an increased risk of cardiovascular disease (CVD). T-allele carriers of the CD14 C-260T single-nucleotide polymorphism (SNP) have reported increased expression of the LPS-binding receptor, CD14 and inflammation in the general population. Our aim was to explore the relationship of this SNP with monocyte/macrophage activation and inflammation and its association with sub-clinical atherosclerosis in HIV-infected individuals. METHODS: Patients with no pre-existing CVD risk factors on suppressive antiretroviral therapy were recruited from University Malaya Medical Centre, Malaysia (n = 84). The CD14 C-260T and TLR4 SNPs, Asp299Gly and Thr399Ile were genotyped and soluble(s) CD14 and sCD163 and high-sensitivity C-reactive protein, hsCRP were measured in plasma. Subclinical atherosclerosis was assessed by measuring carotid intima media thickness (cIMT). The association between CD14 C-260T SNP carriage and cIMT was assessed in a multivariable quantile regression model where a p-value of \<0.05 was considered significant. RESULTS: We found the CD14 C-260T T-allele in 56% of the cohort and evidence of subclinical atherosclerosis in 27%. TT genotype was associated with higher sCD163 (p = 0.009) but only marginally higher sCD14 (p = 0.209) and no difference in hsCRP (p = 0.296) compared to CC/CT. In multivariable analysis, only Framingham risk score was independently associated with higher cIMT while lower sCD163 was trending towards significance. No association was found in TT-genotype carriers and cIMT measurements. CONCLUSION: The CD14 C-260T SNP was associated with increased monocyte activation but not systemic inflammation or cIMT in this HIV-infected cohort with low CVD risk profile.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14425, title = {A genome-wide pleiotropy scan for prostate cancer risk}, author = {O A Panagiotou and R C Travis and D Campa and S I Berndt and S Lindstrom and P Kraft and F R Schumacher and A Siddiq and S I Papatheodorou and J L Stanford and D Albanes and J Virtamo and S J Weinstein and W R Diver and S M Gapstur and V L Stevens and H Boeing and H B Bueno-de-Mesquita and A Barricarte Gurrea and R Kaaks and K T Khaw and V Krogh and K Overvad and E Riboli and D Trichopoulos and E Giovannucci and M Stampfer and C Haiman and B Henderson and L Le Marchand and J M Gaziano and D J Hunter and S Koutros and M Yeager and R N Hoover and S J Chanock and S Wacholder and T J Key and K K Tsilidis}, doi = {10.1016/j.eururo.2014.09.020}, issn = {0302-2838}, year = {2015}, date = {2015-01-01}, journal = {Eur Urol}, volume = {67}, number = {4}, pages = {649-57}, abstract = {BACKGROUND: No single-nucleotide polymorphisms (SNPs) specific for aggressive prostate cancer have been identified in genome-wide association studies (GWAS). OBJECTIVE: To test if SNPs associated with other traits may also affect the risk of aggressive prostate cancer. DESIGN, SETTING, AND PARTICIPANTS: SNPs implicated in any phenotype other than prostate cancer (p\</=10(-7)) were identified through the catalog of published GWAS and tested in 2891 aggressive prostate cancer cases and 4592 controls from the Breast and Prostate Cancer Cohort Consortium (BPC3). The 40 most significant SNPs were followed up in 4872 aggressive prostate cancer cases and 24,534 controls from the Prostate Cancer Association Group to Investigate Cancer Associated Alterations in the Genome (PRACTICAL) consortium. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Odds ratios (ORs) and 95% confidence intervals (CIs) for aggressive prostate cancer were estimated. RESULTS AND LIMITATIONS: A total of 4666 SNPs were evaluated by the BPC3. Two signals were seen in regions already reported for prostate cancer risk. rs7014346 at 8q24.21 was marginally associated with aggressive prostate cancer in the BPC3 trial (p=1.6x10(-6)), whereas after meta-analysis by PRACTICAL the summary OR was 1.21 (95% CI 1.16-1.27; p=3.22x10(-18)). rs9900242 at 17q24.3 was also marginally associated with aggressive disease in the meta-analysis (OR 0.90, 95% CI 0.86-0.94; p=2.5x10(-6)). Neither of these SNPs remained statistically significant when conditioning on correlated known prostate cancer SNPs. The meta-analysis by BPC3 and PRACTICAL identified a third promising signal, marked by rs16844874 at 2q34, independent of known prostate cancer loci (OR 1.12, 95% CI 1.06-1.19; p=4.67x10(-5)); it has been shown that SNPs correlated with this signal affect glycine concentrations. The main limitation is the heterogeneity in the definition of aggressive prostate cancer between BPC3 and PRACTICAL. CONCLUSIONS: We did not identify new SNPs for aggressive prostate cancer. However, rs16844874 may provide preliminary genetic evidence on the role of the glycine pathway in prostate cancer etiology. PATIENT SUMMARY: We evaluated whether genetic variants associated with several traits are linked to the risk of aggressive prostate cancer. No new such variants were identified.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14368, title = {The Cost of Dengue Vector Control Activities in Malaysia by Different Service Providers}, author = {P R Packierisamy and C W Ng and M Dahlui and B Venugopalan and Y A Halasa and D S Shepard}, doi = {10.1177/1010539515589339}, issn = {1010-5395}, year = {2015}, date = {2015-01-01}, journal = {Asia Pac J Public Health}, abstract = {We examined variations in dengue vector control costs and resource consumption between the District Health Departments (DHDs) and Local Authorities (LAs) to assist informed decision making as to the future roles of these agencies in the delivery of dengue vector control services in Malaysia. Data were collected from the vector control units of DHDs and LAs in 8 selected districts. We captured costs and resource consumption in 2010 for premise inspection for mosquito breeding sites, fogging to destroy adult mosquitoes and larviciding of potential breeding sites. Overall, DHDs spent US$5.62 million or US$679 per case and LAs spent US$2.61 million or US$499 per case. The highest expenditure for both agencies was for fogging, 51.0% and 45.8% of costs for DHDs and LAs, respectively. The DHDs had higher resource costs for human personnel, vehicles, pesticides, and equipment. The findings provide some evidence to rationalize delivery of dengue vector control services in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15747, title = {Cost of Dengue Vector Control Activities in Malaysia}, author = {P R Packierisamy and C W Ng and M Dahlui and J Inbaraj and V K Balan and Y A Halasa and D S Shepard}, doi = {10.4269/ajtmh.14-0667}, issn = {0002-9637}, year = {2015}, date = {2015-01-01}, journal = {Am J Trop Med Hyg}, volume = {93}, number = {5}, pages = {1020-7}, abstract = {Dengue fever, an arbovirus disease transmitted by Aedes mosquitoes, has recently spread rapidly, especially in the tropical countries of the Americas and Asia-Pacific regions. It is endemic in Malaysia, with an annual average of 37,937 reported dengue cases from 2007 to 2012. This study measured the overall economic impact of dengue in Malaysia, and estimated the costs of dengue prevention. In 2010, Malaysia spent US$73.5 million or 0.03% of the country's GDP on its National Dengue Vector Control Program. This spending represented US$1,591 per reported dengue case and US$2.68 per capita population. Most (92.2%) of this spending occurred in districts, primarily for fogging. A previous paper estimated the annual cost of dengue illness in the country at US$102.2 million. Thus, the inclusion of preventive activities increases the substantial estimated cost of dengue to US$175.7 million, or 72% above illness costs alone. If innovative technologies for dengue vector control prove efficacious, and a dengue vaccine was introduced, substantial existing spending could be rechanneled to fund them.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14387, title = {Inflammatory Markers and Risk of Epithelial Ovarian Cancer by Tumor Subtypes: The EPIC Cohort}, author = {J Ose and H Schock and A Tjonneland and L Hansen and K Overvad and L Dossus and F Clavel-Chapelon and L Baglietto and H Boeing and A Trichopolou and V Benetou and P Lagiou and G Masala and G Tagliabue and R Tumino and C Sacerdote and A Mattiello and H B Bueno-de-Mesquita and P H Peeters and N C Onland-Moret and E Weiderpass and I T Gram and S Sanchez and M Obon-Santacana and M J Sanchez-Perez and N Larranaga and J M Castano and E Ardanaz and J Brandstedt and E Lundin and A Idahl and R C Travis and K T Khaw and S Rinaldi and I Romieu and M A Merritt and M J Gunter and E Riboli and R Kaaks and R T Fortner}, doi = {10.1158/1055-9965.epi-14-1279-t}, issn = {1055-9965}, year = {2015}, date = {2015-01-01}, journal = {Cancer Epidemiol Biomarkers Prev}, volume = {24}, number = {6}, pages = {951-61}, abstract = {BACKGROUND: Evidence suggests an etiologic role for inflammation in ovarian carcinogenesis and heterogeneity between tumor subtypes and anthropometric indices. Prospective studies on circulating inflammatory markers and epithelial invasive ovarian cancer (EOC) have predominantly investigated overall risk; data characterizing risk by tumor characteristics (histology, grade, stage, dualistic model of ovarian carcinogenesis) and anthropometric indices are sparse. METHODS: We conducted a nested case-control study in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort to evaluate C-reactive protein (CRP), IL6, and EOC risk by tumor characteristics. A total of 754 eligible EOC cases were identified; two controls (n = 1,497) were matched per case. We used multivariable conditional logistic regression to assess associations. RESULTS: CRP and IL6 were not associated with overall EOC risk. However, consistent with prior research, CRP \>10 versus CRP \</=1 mg/L was associated with higher overall EOC risk [OR, 1.67 (1.03-2.70)]. We did not observe significant associations or heterogeneity in analyses by tumor characteristics. In analyses stratified by waist circumference, inflammatory markers were associated with higher risk among women with higher waist circumference; no association was observed for women with normal waist circumference [e.g., IL6: waist \</=80: ORlog2, 0.97 (0.81-1.16); waist \>88: ORlog2, 1.78 (1.28-2.48), Pheterogeneity \</= 0.01]. CONCLUSIONS: Our data suggest that high CRP is associated with increased risk of overall EOC, and that IL6 and CRP may be associated with EOC risk among women with higher adiposity. IMPACT: Our data add to global evidence that ovarian carcinogenesis may be promoted by an inflammatory milieu.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14240, title = {Dietary intake of acrylamide and epithelial ovarian cancer risk in the european prospective investigation into cancer and nutrition (EPIC) cohort}, author = {M Obon-Santacana and P H Peeters and H Freisling and L Dossus and F Clavel-Chapelon and L Baglietto and H Schock and R T Fortner and H Boeing and A Tjonneland and A Olsen and K Overvad and V Menendez and M J Sanchez and N Larranaga and J M Huerta Castano and A Barricarte and K T Khaw and N Wareham and R C Travis and M A Merritt and A Trichopoulou and D Trichopoulos and P Orfanos and G Masala and S Sieri and R Tumino and P Vineis and A Mattiello and H B Bueno-de-Mesquita and N C Onland-Moret and E Wirfalt and T Stocks and A Idahl and E Lundin and G Skeie and I T Gram and E Weiderpass and E Riboli and E J Duell}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295892/pdf/emss-60655.pdf}, doi = {10.1158/1055-9965.epi-14-0636}, issn = {1055-9965}, year = {2015}, date = {2015-01-01}, journal = {Cancer Epidemiol Biomarkers Prev}, volume = {24}, number = {1}, pages = {291-7}, abstract = {Acrylamide, classified in 1994 by the International Agency for Research on Cancer (IARC) as "probably carcinogenic" to humans, was discovered in 2002 in some heat-treated, carbohydrate-rich foods. The association between dietary acrylamide intake and epithelial ovarian cancer risk (EOC) has been previously studied in one case-control and three prospective cohort studies which obtained inconsistent results and could not further examine histologic subtypes other than serous EOC. The present study was carried out in the European Prospective Investigation into Cancer and Nutrition (EPIC) subcohort of women (n = 325,006). Multivariate Cox proportional hazards models were used to assess the association between questionnaire-based acrylamide intake and EOC risk. Acrylamide was energy-adjusted using the residual method and was evaluated both as a continuous variable (per 10 mug/d) and in quintiles; when subgroups by histologic EOC subtypes were analyzed, acrylamide intake was evaluated in quartiles. During a mean follow-up of 11 years, 1,191 incident EOC cases were diagnosed. At baseline, the median acrylamide intake in EPIC was 21.3 mug/d. No associations and no evidence for a dose-response were observed between energy-adjusted acrylamide intake and EOC risk (HR10mug/d,1.02; 95% CI, 0.96-1.09; HRQ5vsQ1, 0.97; 95% CI, 0.76-1.23). No differences were seen when invasive EOC subtypes (582 serous, 118 endometrioid, and 79 mucinous tumors) were analyzed separately. This study did not provide evidence that acrylamide intake, based on food intake questionnaires, was associated with risk for EOC in EPIC. Additional studies with more reliable estimates of exposure based on biomarkers may be needed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14339, title = {Acrylamide and glycidamide hemoglobin adduct levels and endometrial cancer risk: A nested case-control study in non-smoking postmenopausal women from the EPIC cohort}, author = {M Obon-Santacana and H Freisling and P H Peeters and L Lujan-Barroso and P Ferrari and M C Boutron-Ruault and S Mesrine and L Baglietto and R Turzanski-Fortner and V A Katzke and H Boeing and J R Quiros and E Molina-Portillo and N Larranaga and M D Chirlaque and A Barricarte and K T Khaw and N Wareham and R C Travis and M A Merritt and M J Gunter and A Trichopoulou and P Lagiou and A Naska and D Palli and S Sieri and R Tumino and V Fiano and R Galassom and H B Bueno-de-Mesquita and N C Onland-Moret and A Idahl and E Lundin and E Weiderpass and H Vesper and E Riboli and E J Duell}, doi = {10.1002/ijc.29853}, issn = {0020-7136}, year = {2015}, date = {2015-01-01}, journal = {Int J Cancer}, abstract = {Acrylamide, classified in 1994 by IARC as 'probably carcinogenic to humans', was discovered in 2002 in some heat-treated, carbohydrate-rich foods. Four prospective studies have evaluated the association between dietary acrylamide intake and endometrial cancer (EC) risk with inconsistent results. The purpose of this nested case-control study, based on the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, was to evaluate, for the first time, the association between hemoglobin adducts of acrylamide (HbAA) and glycidamide (HbGA) and the risk of developing EC in non-smoking postmenopausal women. Hemoglobin adducts were measured in red blood cells by HPLC/MS/MS. Four exposure variables were evaluated: HbAA, HbGA, their sum (HbAA+HbGA), and their ratio (HbGA/HbAA). The association between hemoglobin adducts and EC was evaluated using unconditional multivariable logistic regression models, and included 383 EC cases (171 were type-I EC), and 385 controls. Exposure variables were analyzed in quintiles based on control distributions. None of the biomarker variables had an effect on overall EC (HRHbAA;Q5vsQ1 : 0.84, 95%CI: 0.49-1.48; HRHbGA;Q5vsQ1 : 0.94, 95%CI: 0.54-1.63) or type-I EC risk. Additionally, none of the subgroups investigated (BMI \<25 vs \>/=25 kg/m2 , alcohol drinkers vs never drinkers, oral contraceptive users vs non-users) demonstrated effect measure modification. Hemoglobin adducts of acrylamide or glycidamide were not associated with EC or type-I EC risk in 768 non-smoking postmenopausal women from the EPIC cohort. This article is protected by copyright. All rights reserved.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15745, title = {Reading the mind of children in response to food advertising: a cross-sectional study of Malaysian schoolchildren's attitudes towards food and beverages advertising on television}, author = {S H Ng and B Kelly and C H Se and S Sahathevan and K Chinna and M N Ismail and T Karupaiah}, doi = {10.1186/s12889-015-2392-z}, issn = {1471-2458}, year = {2015}, date = {2015-01-01}, journal = {BMC Public Health}, volume = {15}, pages = {1047}, abstract = {BACKGROUND: Television food advertising (TVFA) is the most dominant medium in the obesogenic environment promoting unhealthy food choices in children. METHODS: This cross-sectional study investigated children's attitudes towards TVFA by examining four well-cited induction factors namely advertisement recognition, favourite advertisement, purchase request, and product preference. Malaysian urban schoolchildren (7 to 12 years) of equal ethnic distribution were voluntarily recruited (n = 402). Questionnaire administration was facilitated using a food album of 24 advertised food products. RESULTS: Majority of children were older (66.2 %), girls (56.7 %) with one-third either overweight or obese. TV viewing time for weekend was greater than weekdays (4.77 +/- 2.60 vs 2.35 +/- 1.40 h/day) and Malay children spent more time watching TV compared to Chinese (p \< 0.001) and Indian (p \< 0.05) children. Chinese children spent significantly more time surfing the internet compared to either Malay or Indian (p \< 0.01). Median score trend was advertisement recognition \> favourite advertisement and product preference \> purchase request, and significantly greater (p \< 0.001) for non-core than core food advertisements. TV viewing time and ethnicity significantly influenced all induction factors for non-core foods. After correcting for all influencing factors, 'favourite advertisement' (IRRfinal adj: 1.06; 95 % CI: 1.04 to 1.08), 'purchase request' (IRRfinal adj: 1.06; 95 % CI: 1.04 to 1.08) and 'product preference' (IRRfinal adj: 1.04; 95 % CI: 1.02 to 1.07) still were significantly associated with TV viewing time. For every additional hour of TV viewing, the incidence rates increased significantly by 1.04 to 1.06 for 'favourite advertisement', 'purchase request' and 'product preference' related to non-core foods amongst Malay and Indian children. However, Chinese children only demonstrated a significant association between TV viewing time and 'favourite advertisement' (IRRadj: 1.06; 95 % CI: 1.01 to 1.10). CONCLUSION: This study highlights TVFA as a powerful medium predisposing the mind of children to non-core foods through appealing TV commercials, promoting purchase request and generating unhealthy food preferences in early childhood.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15727, title = {Anxiety, depression, perceived social support and quality of life in Malaysian breast cancer patients: a 1-year prospective study}, author = {C G Ng and S Mohamed and M H See and F Harun and M Dahlui and A H Sulaiman and N Z Zainal and N A Taib}, doi = {10.1186/s12955-015-0401-7}, issn = {1477-7525}, year = {2015}, date = {2015-01-01}, journal = {Health Qual Life Outcomes}, volume = {13}, pages = {205}, abstract = {BACKGROUND: Depression and anxiety are common psychiatric morbidity among breast cancer patient. There is a lack of study examining the correlation between depression, anxiety and quality of life (QoL) with perceived social support (PSS) among breast cancer patients. This study aims to study the level of depression, anxiety, QoL and PSS among Malaysian breast cancer women over a period of 12 months and their associations at baseline, 6 and 12 months. METHODS: It is a 12 months prospective cohort study. Two hundred and twenty one female patients were included in the study. They were assessed at the time of diagnosis, 6 months and 12 month using Hospital Anxiety and Depression Scale (HADS), Quality-of-Life Questionnaire (QLQ-C30), Version 3.0 of the EORTC Study Group and Multidimensional Scale of Perceived Social Support (MSPSS). The information of age, ethnicity, types of treatment, and staging of cancer were collected. RESULTS: The HADS anxiety and depression subscales scores of the subjects were relatively low. The level of anxiety reduced significantly at 6 and 12 months (Baseline - 6 months}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14142, title = {Cross cultural translation, adaptation and reliability of the Malay version of the Canadian Acute Respiratory Illness and Flu Scale (CARIFS)}, author = {A M Nathan and R Zaki and R Rozario and N Dhania and S N Mohd Hamirudin and K P Eg and S Y Kee and C Teh and K A Jabar and C Westerhout and S Thavagnanam and J Bruyne}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4559942/pdf/12955_2015_Article_336.pdf}, doi = {10.1186/s12955-015-0336-z}, issn = {1477-7525}, year = {2015}, date = {2015-01-01}, journal = {Health Qual Life Outcomes}, volume = {13}, pages = {139}, abstract = {BACKGROUND: The Canadian Acute Respiratory Illness and Flu Scale (CARIFS) is a parent-proxy questionnaire that assesses severity of acute respiratory infections in children. The aim was to (a) perform a cross-cultural adaptation and (b) prove that the Malay CARIFS is a reliable tool. FINDINGS: The CARIFS underwent forward and backward translations as recommended by international guidelines. A pilot study was performed on the harmonised version and the final version of the Malay version of CARIFS was produced. A test-retest, 1 h apart, was then performed on parents with children less than 13 years old, admitted with a respiratory tract infection. Parents of children with asthma and who were not eloquent in Malay, were excluded. The data was analysed for consistency (Cronbach's alpha) and reliability (test-retest co-efficient). Thirty-three parents were recruited. Children were aged median (IQR) 6 (2.8, 13.3) months with a male: female ratio of 22:11 and 88% were Malays. Parents were interviewed at median (IQR) 6 (3, 11.5) days of admission. The Cronbach's alpha coefficient was 0.70 for all items. The test-retest reliability analysis had a minimum and maximum intraclass correlation coefficient of 0.63 and 0.97 respectively. Clinically, the longer patients were admitted, the lower the severity score (r = -0.35, p \< 0.05), indicating that they were getting better. CONCLUSION: The Malay version of CARIFS is a valid and reliable tool to determine severity of respiratory illness in children. Parent-centred questionnaires are useful and should be an adjunct to other methods, in monitoring response to treatment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15767, title = {Smoking and All-cause Mortality in Older Adults: Results From the CHANCES Consortium}, author = {A Muezzinler and U Mons and C Gellert and B Schottker and E Jansen and F Kee and M G O'Doherty and K Kuulasmaa and N D Freedman and C C Abnet and A Wolk and N Hakansson and N Orsini and T Wilsgaard and B Bueno-de-Mesquita and Y T Schouw and P H M Peeters and Lcpgm Groot and A Peters and P Orfanos and A Linneberg and C Pisinger and A Tamosiunas and M Baceviciene and D Luksiene and G Bernotiene and P Jousilahti and U Petterson-Kymmer and J H Jansson and S Soderberg and S Eriksson and N Jankovic and M J Sanchez and G Veronesi and S Sans and W Drygas and A Trichopoulou and P Boffetta and H Brenner}, doi = {10.1016/j.amepre.2015.04.004}, issn = {0749-3797}, year = {2015}, date = {2015-01-01}, journal = {Am J Prev Med}, volume = {49}, number = {5}, pages = {e53-e63}, abstract = {INTRODUCTION: Smoking is known to be a major cause of death among middle-aged adults, but evidence on its impact and the benefits of smoking cessation among older adults has remained limited. Therefore, we aimed to estimate the influence of smoking and smoking cessation on all-cause mortality in people aged \>/=60 years. METHODS: Relative mortality and mortality rate advancement periods (RAPs) were estimated by Cox proportional hazards models for the population-based prospective cohort studies from Europe and the U.S. (CHANCES [Consortium on Health and Ageing: Network of Cohorts in Europe and the U.S.]), and subsequently pooled by individual participant meta-analysis. Statistical analyses were performed from June 2013 to March 2014. RESULTS: A total of 489,056 participants aged \>/=60 years at baseline from 22 population-based cohort studies were included. Overall, 99,298 deaths were recorded. Current smokers had 2-fold and former smokers had 1.3-fold increased mortality compared with never smokers. These increases in mortality translated to RAPs of 6.4 (95% CI=4.8, 7.9) and 2.4 (95% CI=1.5, 3.4) years, respectively. A clear positive dose-response relationship was observed between number of currently smoked cigarettes and mortality. For former smokers, excess mortality and RAPs decreased with time since cessation, with RAPs of 3.9 (95% CI=3.0, 4.7), 2.7 (95% CI=1.8, 3.6), and 0.7 (95% CI=0.2, 1.1) for those who had quit \<10, 10 to 19, and \>/=20 years ago, respectively. CONCLUSIONS: Smoking remains as a strong risk factor for premature mortality in older individuals and cessation remains beneficial even at advanced ages. Efforts to support smoking abstinence at all ages should be a public health priority.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14352, title = {Smoking and All-cause Mortality in Older Adults: Results From the CHANCES Consortium}, author = {A Muezzinler and U Mons and C Gellert and B Schottker and E Jansen and F Kee and M G O'Doherty and K Kuulasmaa and N D Freedman and C C Abnet and A Wolk and N Hakansson and N Orsini and T Wilsgaard and B Bueno-de-Mesquita and Y T Schouw and P H Peeters and L C Groot and A Peters and P Orfanos and A Linneberg and C Pisinger and A Tamosiunas and M Baceviciene and D Luksiene and G Bernotiene and P Jousilahti and U Petterson-Kymmer and J H Jansson and S Soderberg and S Eriksson and N Jankovic and M J Sanchez and G Veronesi and S Sans and W Drygas and A Trichopoulou and P Boffetta and H Brenner}, doi = {10.1016/j.amepre.2015.04.004}, issn = {0749-3797}, year = {2015}, date = {2015-01-01}, journal = {Am J Prev Med}, abstract = {INTRODUCTION: Smoking is known to be a major cause of death among middle-aged adults, but evidence on its impact and the benefits of smoking cessation among older adults has remained limited. Therefore, we aimed to estimate the influence of smoking and smoking cessation on all-cause mortality in people aged \>/=60 years. METHODS: Relative mortality and mortality rate advancement periods (RAPs) were estimated by Cox proportional hazards models for the population-based prospective cohort studies from Europe and the U.S. (CHANCES [Consortium on Health and Ageing: Network of Cohorts in Europe and the U.S.]), and subsequently pooled by individual participant meta-analysis. Statistical analyses were performed from June 2013 to March 2014. RESULTS: A total of 489,056 participants aged \>/=60 years at baseline from 22 population-based cohort studies were included. Overall, 99,298 deaths were recorded. Current smokers had 2-fold and former smokers had 1.3-fold increased mortality compared with never smokers. These increases in mortality translated to RAPs of 6.4 (95% CI=4.8, 7.9) and 2.4 (95% CI=1.5, 3.4) years, respectively. A clear positive dose-response relationship was observed between number of currently smoked cigarettes and mortality. For former smokers, excess mortality and RAPs decreased with time since cessation, with RAPs of 3.9 (95% CI=3.0, 4.7), 2.7 (95% CI=1.8, 3.6), and 0.7 (95% CI=0.2, 1.1) for those who had quit \<10, 10 to 19, and \>/=20 years ago, respectively. CONCLUSIONS: Smoking remains as a strong risk factor for premature mortality in older individuals and cessation remains beneficial even at advanced ages. Efforts to support smoking abstinence at all ages should be a public health priority.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14372, title = {Cardiometabolic risks profile of normal weight obese and multi-ethnic women in a developing country}, author = {F M Moy and D A Loh}, doi = {10.1016/j.maturitas.2015.04.011}, issn = {0378-5122}, year = {2015}, date = {2015-01-01}, journal = {Maturitas}, volume = {81}, number = {3}, pages = {389-93}, abstract = {OBJECTIVES: To determine the prevalence of normal weight obesity among multi-ethnic women in Peninsular Malaysia and examine its associations with cardiometabolic risks and lifestyle behaviours. METHODS: This was a cross-sectional study involving women recruited via multi-stage sampling from six states in Malaysia. Anthropometric and body composition analysis were performed. Normal weight obese (NWO) was defined as normal body mass index for Asians and the highest tertile of % body fat (BF). Biochemical measurements included fasting lipid and blood glucose levels. Metabolic syndrome was diagnosed based on the Harmonization criteria. Participants completed self-reported questionnaires that included physical activity, smoking, alcohol consumption, fruit and vegetable intake and sleep duration. MAIN OUTCOME MEASURE: Body mass index, %BF, cardiometabolic risk factors, lifestyle behaviours. RESULTS: A total of 6854 women were recruited and the prevalence of NWO was 19.8% (95% CI: 17.3-22.5). NWO was more prevalent among the Indians and older women. NWO women had higher odds for abdominal obesity (OR: 2.64, 95% CI: 1.73-4.04), hypertriglyceridemia (2.51, 1.47-4.29) and hypertension (1.63, 1.15-2.31) compared to women with lower % body fat after adjusted for age and ethnicity. The prevalence of metabolic syndrome among NWO women was 5.4% (95% CI: 3.0-9.8). None of the lifestyle behaviours were significantly associated with NWO. CONCLUSIONS: Women with NWO had cardiometabolic abnormalities including abdominal obesity, dyslipidaemia and increased blood pressure. Health promotion efforts should include NWO women who may be oblivious of their deleterious health risks.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15738, title = {Determinants and Effects of Voice Disorders among Secondary School Teachers in Peninsular Malaysia Using a Validated Malay Version of VHI-10}, author = {F M Moy and V C Hoe and N N Hairi and A H Chu and A Bulgiba and D Koh}, doi = {10.1371/journal.pone.0141963}, issn = {1932-6203}, year = {2015}, date = {2015-01-01}, journal = {PLoS One}, volume = {10}, number = {11}, pages = {e0141963}, abstract = {OBJECTIVES: To establish the prevalence of voice disorder using the Malay-Voice Handicap Index 10 (Malay-VHI-10) and to study the determinants, quality of life, depression, anxiety and stress associated with voice disorder among secondary school teachers in Peninsular Malaysia. METHODS: This study was divided into two phases. Phase I tested the reliability of the Malay-VHI-10 while Phase II was a cross-sectional study with two-stage sampling. In Phase II, a self-administered questionnaire was used to collect socio-demographic and teaching characteristics, depression, anxiety and stress scale (Malay version of DASS-21); and health-related quality of life (Malay version of SF12-v2). Complex sample analysis was conducted using multivariate Poisson regression with robust variance. RESULTS: In Phase I, the Spearman correlation coefficient and Cronbach alpha for total VHI-10 score was 0.72 (p \< 0.001) and 0.77 respectively; showing good correlation and internal consistency. The ICCs ranged from 0.65 to 0.78 showing fair to good reliability and demonstrating the subscales to be reliable and stable. A total of 6039 teachers participated in Phase II. They were primarily Malays, females, married, had completed tertiary education and aged between 30 to 50 years. A total of 10.4% (95% CI 7.1, 14.9) of the teachers had voice disorder (VHI-10 score \> 11). Compared to Malays, a greater proportion of ethnic Chinese teachers reported voice disorder while ethnic Indian teachers were less likely to report this problem. There was a higher prevalence ratio (PR) of voice disorder among single or divorced/widowed teachers. Teachers with voice disorder were more likely to report higher rates of absenteeism (PR: 1.70, 95% CI 1.33, 2.19), lower quality of life with lower SF12-v2 physical (0.98, 95% CI 0.96, 0.99) and mental (0.97, 95% CI 0.96, 0.98) component summary scales; and higher anxiety levels (1.04, 95% CI 1.02, 1.06). CONCLUSIONS: The Malay-VHI-10 is valid and reliable. Voice disorder was associated with increased absenteeism, marginally associated with reduced health-related quality of life as well as increased anxiety among teachers.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15899, title = {Predictors of handgrip strength among adults of a rural community in Malaysia}, author = {F M Moy and A Darus and N N Hairi}, doi = {10.1177/1010539513510555}, issn = {1010-5395}, year = {2015}, date = {2015-01-01}, journal = {Asia Pac J Public Health}, volume = {27}, number = {2}, pages = {176-84}, abstract = {Handgrip strength is useful for screening the nutritional status of adult population as it is strongly associated with physical disabilities and mortality. Therefore, we aimed to determine the predictors of handgrip strength among adults of a rural community in Malaysia using a cross-sectional study design with multistage sampling. All adults aged 30 years and older from 1250 households were invited to our study. Structured questionnaire on sociodemographic characteristics, medical history, occupation history, lifestyle practices, and measurements, including anthropometry and handgrip strength were taken. There were 2199 respondents with 55.2% females and majority were of Malay ethnicity. Their mean (standard deviation) age was 53.4 (13.2) years. The response rate for handgrip strength was 94.2%. Females had significantly lower handgrip strength than males (P \< .05). In the multiple linear regression models, significant predictors of handgrip strength for males were age, height, job groups, and diabetes, while for females, the significant predictors were age, weight, height, and diabetes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14380, title = {Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: meta-analysis of individual participant data from prospective cohort studies of the CHANCES consortium}, author = {U Mons and A Muezzinler and C Gellert and B Schottker and C C Abnet and M Bobak and L Groot and N D Freedman and E Jansen and F Kee and D Kromhout and K Kuulasmaa and T Laatikainen and M G O'Doherty and B Bueno-de-Mesquita and P Orfanos and A Peters and Y T Schouw and T Wilsgaard and A Wolk and A Trichopoulou and P Boffetta and H Brenner}, doi = {10.1136/bmj.h1551}, issn = {0959-535x}, year = {2015}, date = {2015-01-01}, journal = {Bmj}, volume = {350}, pages = {h1551}, abstract = {OBJECTIVE: To investigate the impact of smoking and smoking cessation on cardiovascular mortality, acute coronary events, and stroke events in people aged 60 and older, and to calculate and report risk advancement periods for cardiovascular mortality in addition to traditional epidemiological relative risk measures. DESIGN: Individual participant meta-analysis using data from 25 cohorts participating in the CHANCES consortium. Data were harmonised, analysed separately employing Cox proportional hazard regression models, and combined by meta-analysis. RESULTS: Overall, 503,905 participants aged 60 and older were included in this study, of whom 37,952 died from cardiovascular disease. Random effects meta-analysis of the association of smoking status with cardiovascular mortality yielded a summary hazard ratio of 2.07 (95% CI 1.82 to 2.36) for current smokers and 1.37 (1.25 to 1.49) for former smokers compared with never smokers. Corresponding summary estimates for risk advancement periods were 5.50 years (4.25 to 6.75) for current smokers and 2.16 years (1.38 to 2.39) for former smokers. The excess risk in smokers increased with cigarette consumption in a dose-response manner, and decreased continuously with time since smoking cessation in former smokers. Relative risk estimates for acute coronary events and for stroke events were somewhat lower than for cardiovascular mortality, but patterns were similar. CONCLUSIONS: Our study corroborates and expands evidence from previous studies in showing that smoking is a strong independent risk factor of cardiovascular events and mortality even at older age, advancing cardiovascular mortality by more than five years, and demonstrating that smoking cessation in these age groups is still beneficial in reducing the excess risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14350, title = {Seroprevalence report on tick-borne encephalitis virus and Crimean-Congo hemorrhagic fever virus among Malaysian's farm workers}, author = {M Mohd Shukri and K Ling Kho and M Ghane Kisomi and R Lani and S Marlina and S F Muhd Radzi and S Tee Tay and L Ping Wong and A B Awang Mahmud and Q N Hassan Nizam and S Abu Bakar and K Zandi}, doi = {10.1186/s12889-015-1901-4}, issn = {1471-2458}, year = {2015}, date = {2015-01-01}, journal = {BMC Public Health}, volume = {15}, pages = {704}, abstract = {BACKGROUND: Tick-borne encephalitis virus (TBEV) and Crimean-Congo haemorrhagic fever virus (CCHFV) are important tick-borne viruses. Despite their wide geographical distribution and ease of acquisition, the prevalence of both viruses in Malaysia is still unknown. This study was conducted to determine the seroprevalence for TBEV and CCHFV among Malaysian farm workers as a high-risk group within the population. METHODS: We gave questionnaires to 209 farm workers and invited them to participate in the study. Eighty-five agreed to do so. We then collected and tested sera for the presence of anti-TBEV IgG (immunoglobulin G) and anti-CCHFV IgG using a commercial enzyme-linked immunosorbent assay (ELISA) kit. We also tested seroreactive samples against three other related flaviviruses: dengue virus (DENV), West Nile virus (WNV) and Japanese encephalitis virus (JEV) using the ELISA method. RESULTS: The preliminary results showed the presence of anti-TBEV IgG in 31 (36.5%) of 85 sera. However, when testing all the anti-TBEV IgG positive sera against the other three antigenically related flaviviruses to exclude possible cross reactivity, only five (4.2%) sera did not show any cross reactivity. Interestingly, most (70.97%) seropositives subjects mentioned tick-bite experience. However, there was no seroreactive sample for CCHFV. CONCLUSIONS: These viruses migrate to neighbouring countries so they should be considered threats for the future, despite the low seroprevalence for TBEV and no serological evidence for CCHFV in this study. Therefore, further investigation involving a large number of human, animal and tick samples that might reveal the viruses' true prevalence is highly recommended.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14423, title = {Utilization of the emergency department by older residents in Kuala Lumpur, Malaysia}, author = {M A Mohd Mokhtar and T M Pin and M I Zakaria and N N Hairi and S B Kamaruzzaman and C A Vyrn and P P Hua}, doi = {10.1111/ggi.12369}, issn = {1447-0594}, year = {2015}, date = {2015-01-01}, journal = {Geriatr Gerontol Int}, volume = {15}, number = {8}, pages = {944-50}, abstract = {AIM: To determine the pattern of utilization of emergency department (ED) services by older patients in Kuala Lumpur, Malaysia, compared with younger patients in the same setting. METHODS: The sociodemographics, clinical characteristics and resource utilization of consecutive patients attending the adult ED at the University Malaya Medical Center were recorded during a typical week. RESULTS: A total of 1649 patients were included in the study; 422/1649 (25.6%) were aged \>/=60 years and 1077 (74.4%) were aged \<60 years. Older adult patients were more likely to be diagnosed with ischemic heart disease (12.6% vs 2.5%, P \< 0.001), and more likely to require investigations such as electrocardiogram (68.1% vs 16.6%, P \< 0.001) or chest X-rays (67.6% vs 24.0%, P \< 0.001) than their younger counterparts. Logistic regression methods showed that older adults remained an independent predictor of hospital admission (OR 2.75, 95% CI 2.11-3.57). CONCLUSION: The ratio of older adult patients attending our ED over the proportion of older people in the general population was 26:6, which is far higher than reported in previous published studies carried out in other countries. Older ED attenders are also more likely to require investigations, procedures and hospital admissions. With the rapidly aging population in Malaysia, reconfiguration of resources will need to occur at a compatible rate in order to ensure that the healthcare needs of our older adults are met. Geriatr Gerontol Int 2015; 15: 944-950.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14236, title = {Cultural adaptation and psychometric assessment of Pain Catastrophizing Scale among young healthy Malay-speaking adults in military settings}, author = {F H Mohd Din and V C Hoe and C K Chan and M A Muslan}, url = {http://download.springer.com/static/pdf/191/art%253A10.1007%252Fs11136-014-0850-1.pdf?originUrl=http%3A%2F%2Flink.springer.com%2Farticle%2F10.1007%2Fs11136-014-0850-1\&token2=exp=1443532370~acl=%2Fstatic%2Fpdf%2F191%2Fart%25253A10.1007%25252Fs11136-014-0850-1.pdf%3ForiginUrl%3Dhttp%253A%252F%252Flink.springer.com%252Farticle%252F10.1007%252Fs11136-014-0850-1*~hmac=2b522a4ecc472e8fc150421c05f53a7c866ca428a26d150bc57f82e4e2d31aa2}, doi = {10.1007/s11136-014-0850-1}, issn = {0962-9343}, year = {2015}, date = {2015-01-01}, journal = {Qual Life Res}, volume = {24}, number = {5}, pages = {1275-80}, abstract = {PURPOSE: The Pain Catastrophizing Scale (PCS) is designed to assess negative thoughts in response to pain. It is composed of three domains: helplessness, rumination, and magnification. We report on the translation, adaptation, and validation of scores on a Malay-speaking version of the PCS, the PCS-MY. METHOD: Guidelines for the process of cross-cultural adaptations of assessment measures were implemented. A sample of 303 young military recruits participated in the study. Factor structure, reliability, and validity of scores on the PCS-MY were examined. Convergent validity was investigated with the Positive and Negative Affect Scale, Short-form 12 version 2, and Ryff's Psychological Well-being Scale. RESULTS: Most participants were men, ranging in age from 19 to 26. The reliability of the PCS-MY scores was adequate (alpha = 0.90; mean inter-item correlation = 0.43). Confirmatory factor analysis showed that a modified version of the PCS-MY provided best fit estimates to the sample data. The PCS-MY total score was negatively correlated with mental well-being and positively correlated with negative affect (all ps \< 0.001). CONCLUSION: The PCS-MY was demonstrated to have adequate reliability and validity estimates in the study sample.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14388, title = {Validity and reliability of the hausa version of multidimensional scale of perceived social support index}, author = {A H Mohammad and N Al Sadat and S Y Loh and K Chinna}, doi = {10.5812/ircmj.18776}, issn = {2074-1804 (Print) 2074-1804}, year = {2015}, date = {2015-01-01}, journal = {Iran Red Crescent Med J}, volume = {17}, number = {2}, pages = {e18776}, abstract = {BACKGROUND: Social support has been identified as one of the key factors for enhancing the quality of life after stroke. However, a scientific tool that is valid for evaluating social support among stroke survivors in Nigeria has not been developed so far. OBJECTIVES: The objective of this study was to examine the psychometric properties of the Hausa translated versions of the Multidimensional Scale of Perceived Social Support (MSPSS) and to validate it for future use in clinical research in Nigeria. PATIENTS AND METHODS: This cross-sectional study was conducted on a sample of 140 adult stroke survivors attending rehabilitation services at stroke referral centers in Kano, Nigeria. The psychometric analysis of the Hausa-MSPSS involved face, content, criterion and construct validity tests, as well as internal and test-retest reliability. Confirmatory factor analysis was performed to assess validity of the three-factor (Family, Friends and Significant others) model for the Hausa-MSPSS. RESULTS: Based on expert panel, clinicians' review and patients' feedback, the 12 item Hausa-MSPSS had sufficient face, content and criterion validity. In reliability analysis, the Cronbach's alpha was 0.781. In test-retest reliability analysis, the minimum kappa value was 0.673. In Confirmatory factor analysis, the three-factor model was not acceptable. An alternative two-factor model with Family and Friends, as the two domain was found to be acceptable (Chi-square/df \< 3, TLI, CFI \> 0.9, RMSEA \< 0.08). The average variances extracted for the two constructs were 0.5 and 0.7, respectively. The R-squared value between the two constructs was 0.397. Cross validity tested using 1000 bootstrap resamples gave satisfactory results (P = 0.079). CONCLUSIONS: The 11 item Hausa-MSPSS index is valid for the assessment of perceived social support among stroke survivors in Nigeria.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14414, title = {A Systematic Review of the Prevalence and Measurement of Chronic Pain in Asian Adults}, author = {L R Mohamed Zaki and N N Hairi}, doi = {10.1016/j.pmn.2014.08.012}, issn = {1524-9042}, year = {2015}, date = {2015-01-01}, journal = {Pain Manag Nurs}, volume = {16}, number = {3}, pages = {440-52}, abstract = {There are limited epidemiologic studies on chronic pain in Asian populations. The aim of this review was to gather all epidemiologic studies of chronic pain in Asian countries and systematically describe the measurement and prevalence of chronic pain in Asian adults. A systematic review was performed using PubMed, MEDLINE, EMBASE, Psych INFO, Cochrane Database for Systematic Review, and CINAHL. Additional studies were identified manually by searching bibliographies. We identified 19 relevant articles for this review. Most articles used the definition of chronic pain set by the International Association for the Study of Pain. The majority of the articles used simple single-question methods to measure chronic pain. The prevalence of chronic pain among Asian adults ranges from 7.1% (Malaysia) to 61% (Cambodia and Northern Iraq), whereas among the Asian geriatric population, the prevalence is even higher and ranges from 42% to 90.8%. This review showed that there is great variation in the reported prevalence of chronic pain in Asian adults and the prevalence of chronic pain is high among the Asian geriatric population. To measure the distribution of chronic pain in adults, a uniform measurement strategy should be adopted.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14208, title = {Investigation of dietary factors and endometrial cancer risk using a nutrient-wide association study approach in the EPIC and Nurses' Health Study (NHS) and NHSII}, author = {M A Merritt and I Tzoulaki and S S Tworoger and I De Vivo and S E Hankinson and J Fernandes and K K Tsilidis and E Weiderpass and A Tjonneland and K E Petersen and C C Dahm and K Overvad and L Dossus and M C Boutron-Ruault and G Fagherazzi and R T Fortner and R Kaaks and K Aleksandrova and H Boeing and A Trichopoulou and C Bamia and D Trichopoulos and D Palli and S Grioni and R Tumino and C Sacerdote and A Mattiello and H B Bueno-de-Mesquita and N C Onland-Moret and P H Peeters and I T Gram and G Skeie and J R Quiros and E J Duell and M J Sanchez and D Salmeron and A Barricarte and S Chamosa and U Ericson and E Sonestedt and L M Nilsson and A Idahl and K T Khaw and N Wareham and R C Travis and S Rinaldi and I Romieu and C J Patel and E Riboli and M J Gunter}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4324546/pdf/nihms646244.pdf}, doi = {10.1158/1055-9965.epi-14-0970}, issn = {1055-9965}, year = {2015}, date = {2015-01-01}, journal = {Cancer Epidemiol Biomarkers Prev}, volume = {24}, number = {2}, pages = {466-71}, abstract = {Data on the role of dietary factors in endometrial cancer development are limited and inconsistent. We applied a "nutrient-wide association study" approach to systematically evaluate dietary risk associations for endometrial cancer while controlling for multiple hypothesis tests using the false discovery rate (FDR) and validating the results in an independent cohort. We evaluated endometrial cancer risk associations for dietary intake of 84 foods and nutrients based on dietary questionnaires in three prospective studies, the European Prospective Investigation into Cancer and Nutrition (EPIC; N = 1,303 cases) followed by validation of nine foods/nutrients (FDR \</= 0.10) in the Nurses' Health Studies (NHS/NHSII; N = 1,531 cases). Cox regression models were used to estimate HRs and 95% confidence intervals (CI). In multivariate adjusted comparisons of the extreme categories of intake at baseline, coffee was inversely associated with endometrial cancer risk (EPIC, median intake 750 g/day vs. 8.6; HR, 0.81; 95% CI, 0.68-0.97}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15741, title = {Reproductive factors and risk of mortality in the European Prospective Investigation into Cancer and Nutrition; a cohort study}, author = {M A Merritt and E Riboli and N Murphy and M Kadi and A Tjonneland and A Olsen and K Overvad and L Dossus and L Dartois and F Clavel-Chapelon and R T Fortner and V A Katzke and H Boeing and A Trichopoulou and P Lagiou and D Trichopoulos and D Palli and S Sieri and R Tumino and C Sacerdote and S Panico and H B Bueno-de-Mesquita and P H Peeters and E Lund and A Nakamura and E Weiderpass and J R Quiros and A Agudo and E Molina-Montes and N Larranaga and M Dorronsoro and L Cirera and A Barricarte and A Olsson and S Butt and A Idahl and E Lundin and N J Wareham and T J Key and P Brennan and P Ferrari and P A Wark and T Norat and A J Cross and M J Gunter}, doi = {10.1186/s12916-015-0484-3}, issn = {1741-7015}, year = {2015}, date = {2015-01-01}, journal = {BMC Med}, volume = {13}, pages = {252}, abstract = {BACKGROUND: Reproductive events are associated with important physiologic changes, yet little is known about how reproductive factors influence long-term health in women. Our objective was to assess the relation of reproductive characteristics with all-cause and cause-specific mortality risk. METHODS: The analysis was performed within the European Investigation into Cancer and Nutrition prospective cohort study, which enrolled \>500,000 women and men from 1992 to 2000, who were residing in a given town/geographic area in 10 European countries. The current analysis included 322,972 eligible women aged 25-70 years with 99 % complete follow-up for vital status. We assessed reproductive characteristics reported at the study baseline including parity, age at the first birth, breastfeeding, infertility, oral contraceptive use, age at menarche and menopause, total ovulatory years, and history of oophorectomy/hysterectomy. Hazard ratios (HRs) and 95 % confidence intervals (CIs) for mortality were determined using Cox proportional hazards regression models adjusted for menopausal status, body mass index, physical activity, education level, and smoking status/intensity and duration. RESULTS: During a mean follow-up of 12.9 years, 14,383 deaths occurred. The HR (95 % CI) for risk of all-cause mortality was lower in parous versus nulliparous women (0.80; 0.76-0.84), in women who had ever versus never breastfed (0.92; 0.87-0.97), in ever versus never users of oral contraceptives (among non-smokers; 0.90; 0.86-0.95), and in women reporting a later age at menarche (\>/=15 years versus \<12; 0.90; 0.85-0.96; P for trend = 0.038). CONCLUSIONS: Childbirth, breastfeeding, oral contraceptive use, and a later age at menarche were associated with better health outcomes. These findings may contribute to the development of improved strategies to promote better long-term health in women.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14344, title = {A new formulation of Gamma Delta Tocotrienol has superior bioavailability compared to existing Tocotrienol-Rich Fraction in healthy human subjects}, author = {P Meganathan and R S Jabir and H G Fuang and N Bhoo-Pathy and R B Choudhury and N A Taib and K Nesaretnam and Z Chik}, doi = {10.1038/srep13550}, issn = {2045-2322}, year = {2015}, date = {2015-01-01}, journal = {Sci Rep}, volume = {5}, pages = {13550}, abstract = {Gamma and delta tocotrienols are isomers of Vitamin E with established potency in pre-clinical anti-cancer research. This single-dose, randomized, crossover study aimed to compare the safety and bioavailability of a new formulation of Gamma Delta Tocotrienol (GDT) in comparison with the existing Tocotrienol-rich Fraction (TRF) in terms of gamma and delta isomers in healthy volunteers. Subjects were given either two 300 mg GDT (450 mg gamma-T3 and 150 mg delta-T3) capsules or four 200 mg TRF (451.2 mg gamma-T3 \&102.72 mg delta-T3) capsules and blood samples were taken at several time points over 24 hours. Plasma tocotrienol concentrations were determined using HPLC method. The 90% CI for gamma and delta tocotrienols for the ratio of log-transformation of GDT/TRF for Cmax and AUC0-infinity (values were anti-logged and expressed as a percentage) were beyond the bioequivalence limits (106.21-195.46, 154.11-195.93 and 52.35-99.66, 74.82-89.44 respectively). The Wilcoxon Signed Rank Test for Tmax did not show any significant difference between GDT and TRF for both isomers (p \> 0.05). No adverse events were reported during the entire period of study. GDT was found not bioequivalent to TRF, in terms of AUC and Cmax. Gamma tocotrienol in GDT showed superior bioavailability whilst delta tocotrienol showed less bioavailability compared to TRF.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14613, title = {Projections of the current and future disease burden of hepatitis C virus infection in Malaysia}, author = {S A McDonald and M Dahlui and R Mohamed and H Naning and F H Shabaruddin and A Kamarulzaman}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4456147/pdf/pone.0128091.pdf}, doi = {10.1371/journal.pone.0128091}, issn = {1932-6203}, year = {2015}, date = {2015-01-01}, journal = {PLoS One}, volume = {10}, number = {6}, pages = {e0128091}, abstract = {BACKGROUND: The prevalence of hepatitis C virus (HCV) infection in Malaysia has been estimated at 2.5% of the adult population. Our objective, satisfying one of the directives of the WHO Framework for Global Action on Viral Hepatitis, was to forecast the HCV disease burden in Malaysia using modelling methods. METHODS: An age-structured multi-state Markov model was developed to simulate the natural history of HCV infection. We tested three historical incidence scenarios that would give rise to the estimated prevalence in 2009, and calculated the incidence of cirrhosis, end-stage liver disease, and death, and disability-adjusted life-years (DALYs) under each scenario, to the year 2039. In the baseline scenario, current antiviral treatment levels were extended from 2014 to the end of the simulation period. To estimate the disease burden averted under current sustained virological response rates and treatment levels, the baseline scenario was compared to a counterfactual scenario in which no past or future treatment is assumed. RESULTS: In the baseline scenario, the projected disease burden for the year 2039 is 94,900 DALYs/year (95% credible interval (CrI): 77,100 to 124,500), with 2,002 (95% CrI: 1340 to 3040) and 540 (95% CrI: 251 to 1,030) individuals predicted to develop decompensated cirrhosis and hepatocellular carcinoma, respectively, in that year. Although current treatment practice is estimated to avert a cumulative total of 2,200 deaths from DC or HCC, a cumulative total of 63,900 HCV-related deaths is projected by 2039. CONCLUSIONS: The HCV-related disease burden is already high and is forecast to rise steeply over the coming decades under current levels of antiviral treatment. Increased governmental resources to improve HCV screening and treatment rates and to reduce transmission are essential to address the high projected HCV disease burden in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14359, title = {Integrating Information and Communication Technology for Health Information System Strengthening: A Policy Analysis}, author = {N Marzuki and S Ismail and N Al-Sadat and F Z Ehsan and C K Chan and C W Ng}, doi = {10.1177/1010539515590180}, issn = {1010-5395}, year = {2015}, date = {2015-01-01}, journal = {Asia Pac J Public Health}, abstract = {Despite the high costs involved and the lack of definitive evidence of sustained effectiveness, many low- and middle-income countries had begun to strengthen their health information system using information and communication technology in the past few decades. Following this international trend, the Malaysian Ministry of Health had been incorporating Telehealth (National Telehealth initiatives) into national health policies since the 1990s. Employing qualitative approaches, including key informant interviews and document review, this study examines the agenda-setting processes of the Telehealth policy using Kingdon's framework. The findings suggested that Telehealth policies emerged through actions of policy entrepreneurs within the Ministry of Health, who took advantage of several simultaneously occurring opportunities-official recognition of problems within the existing health information system, availability of information and communication technology to strengthen health information system and political interests surrounding the national Multimedia Super Corridor initiative being developed at the time. The last was achieved by the inclusion of Telehealth as a component of the Multimedia Super Corridor.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14347, title = {ABO blood group alleles and prostate cancer risk: Results from the breast and prostate cancer cohort consortium (BPC3)}, author = {S C Markt and I M Shui and R H Unger and Y Urun and C D Berg and A Black and P Brennan and H B Bueno-de-Mesquita and S M Gapstur and E Giovannucci and C Haiman and B Henderson and R N Hoover and D J Hunter and T J Key and K T Khaw and F Canzian and N Larranga and L Le Marchand and J Ma and A Naccarati and A Siddiq and M J Stampfer and P Stattin and V L Stevens and D O Stram and A Tjonneland and R C Travis and D Trichopoulos and R G Ziegler and S Lindstrom and P Kraft and L A Mucci and T K Choueiri and K M Wilson}, doi = {10.1002/pros.23035}, issn = {0270-4137}, year = {2015}, date = {2015-01-01}, journal = {Prostate}, volume = {75}, number = {15}, pages = {1677-81}, abstract = {BACKGROUND: ABO blood group has been associated with risk of cancers of the pancreas, stomach, ovary, kidney, and skin, but has not been evaluated in relation to risk of aggressive prostate cancer. METHODS: We used three single nucleotide polymorphisms (SNPs) (rs8176746, rs505922, and rs8176704) to determine ABO genotype in 2,774 aggressive prostate cancer cases and 4,443 controls from the Breast and Prostate Cancer Cohort Consortium (BPC3). Unconditional logistic regression was used to calculate age and study-adjusted odds ratios and 95% confidence intervals for the association between blood type, genotype, and risk of aggressive prostate cancer (Gleason score \>/=8 or locally advanced/metastatic disease (stage T3/T4/N1/M1). RESULTS: We found no association between ABO blood type and risk of aggressive prostate cancer (Type A: OR = 0.97, 95%CI = 0.87-1.08; Type B: OR = 0.92, 95%CI =n0.77-1.09; Type AB: OR = 1.25, 95%CI = 0.98-1.59, compared to Type O, respectively). Similarly, there was no association between "dose" of A or B alleles and aggressive prostate cancer risk. CONCLUSIONS: ABO blood type was not associated with risk of aggressive prostate cancer. Prostate 75:1677-1681, 2015. (c) 2015 Wiley Periodicals, Inc.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15720, title = {Psychometric Validation of the Malaysian Chinese Version of the EORTC QLQ-C30 in Colorectal Cancer Patients}, author = {B A Magaji and F M Moy and A C Roslani and C W Law and I Sagap}, issn = {1513-7368}, year = {2015}, date = {2015-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {16}, number = {18}, pages = {8107-12}, abstract = {BACKGROUND AND AIMS: Colorectal cancer is the second most frequent cancer in Malaysia. We aimed to assess the validity and reliability of the Malaysian Chinese version of European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire core (QLQ-C30) in patients with colorectal cancer. MATERIALS AND METHODS: Translated versions of the QLQ-C30 were obtained from the EORTC. A cross sectional study design was used to obtain data from patients receiving treatment at two teaching hospitals in Kuala Lumpur, Malaysia. The Malaysian Chinese version of QLQ-C30 was self-administered in 96 patients while the Karnofsky Performance Scales (KPS) was generated by attending surgeons. Statistical analysis included reliability, convergent, discriminate validity, and known-groups comparisons. Statistical significance was based on p value \</=0.05. RESULTS: The internal consistencies of the Malaysian Chinese version were acceptable [Cronbach's alpha (alpha\>/= 0.70)] in the global health status/overall quality of life (GHS/QOL), functioning scales except cognitive scale (alpha\</=0.32) in all levels of analysis, and social/family functioning scale (alpha=0.63) in patients without a stoma. All questionnaire items fulfilled the criteria for convergent and discriminant validity except question number 5, with correlation with role (r = 0.62) and social/family (r = 0.41) functioning higher than with physical functioning scales (r = 0.34). The test-retest coefficients in the GHS/QOL, functioning scales and in most of the symptoms scales were moderate to high (r = 0.58 to 1.00). Patients with a stoma reported statistically significant lower physical functioning (p=0.015), social/family functioning (p=0.013), and higher constipation (p=0.010) and financial difficulty (p=0.037) compared to patients without stoma. There was no significant difference between patients with high and low KPS scores. CONCLUSIONS: Malaysian Chinese version of the QLQ-C30 is a valid and reliable measure of HRQOL in patients with colorectal cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15721, title = {Psychometric Validation of the Bahasa Malaysia Version of the EORTC QLQ-CR29}, author = {B A Magaji and F M Moy and A C Roslani and C W Law and F Raduan and I Sagap}, issn = {1513-7368}, year = {2015}, date = {2015-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {16}, number = {18}, pages = {8101-5}, abstract = {BACKGROUND: This study examined the psychometric properties of the Bahasa Malaysia (BM) version of the European Organization for Research and Treatment of Cancer (EORTC) Colorectal Cancer-specific Quality Of Life Questionnaire (QLQ-CR29). MATERIALS AND METHODS: We studied 93 patients recruited from University Malaya and Universiti Kebangsaan Medical Centers, Kuala Lumpur, Malaysia using a self-administered method. Tools included QLQ-C30, QLQ-CR29 and Karnofsky Performance Scales (KPS). Statistical analyses included Cronbach's alpha, test-retest correlations, multi-traits scaling and known-groups comparisons. A p value \</= 0.05 was considered significant. RESULTS: The internal consistency coefficients for body image, urinary frequency, blood and mucus and stool frequency scales were acceptable (Cronbach's alpha alpha \>/= 0.65). However, the coefficients were low for the blood and mucus and stool frequency scales in patients with a stoma bag (alpha = 0.46). Test-retest correlation coefficients were moderate to high (range: r = 0.51 to 1.00) for most of the scales except anxiety, urinary frequency, buttock pain, hair loss, stoma care related problems, and dyspareunia (r \</= 0.49). Convergent and discriminant validities were achieved in all scales. Patients with a stoma reported significantly higher symptoms of blood and mucus in the stool, flatulence, faecal incontinence, sore skin, and embarrassment due to the frequent need to change the stoma bag (p \< 0.05) compared to patients without stoma. None of the scales distinguished between patients based on the KPS scores. There were no overlaps between scales in the QLQ-C30 and QLQ-CR29 (r \< 0.40). CONCLUSIONS: the BM version of the QLQ-CR29 indicated acceptable psychometric properties in most of the scales similar to original validation study. This questionnaire could be used to complement the QLQ-C30 in assessing HRQOL among BM speaking population with colorectal cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14384, title = {Disparities in health-related quality of life among healthy adolescents in a developing country - the impact of gender, ethnicity, socio-economic status and weight status}, author = {D A Loh and F M Moy and N L Zaharan and Z Mohamed}, doi = {10.1111/cch.12252}, issn = {0305-1862}, year = {2015}, date = {2015-01-01}, journal = {Child Care Health Dev}, abstract = {BACKGROUND: Physical functioning and psychological resilience in adulthood is shaped during adolescence. Self-reported health-related quality of life (HRQoL) assessments during this life phase are important first-hand accounts of their well-being. This study aimed, firstly, to identify differences in HRQoL according to gender, ethnicity, socio-economic status and weight status; and secondly, to examine associations between weight status and HRQoL among an urban sample of multi-ethnic adolescents in Kuala Lumpur, Malaysia. METHODS: A cross-sectional study involving 652 adolescents (aged 13 years) was conducted in Kuala Lumpur. Weight and height were measured. Body mass index z-scores were categorized according to the International Obesity Task Force criteria. HRQoL was assessed using the Malay version of the Pediatric Quality of Life Inventory 4.0 Generic Core Scales. Univariate analyses of differences in HRQoL according to gender, ethnicity (Malays, Chinese and Indians), maternal education level and weight status were performed. Complex samples general linear model was used to examine the associations between HRQoL and weight status, adjusted for confounders. RESULTS: Female adolescents reported significantly lower emotional functioning scores (mean, 95% confidence interval: 59.25, 57.33-61.17). When the three main ethnic groups were studied, Malay adolescents scored significantly lower emotional functioning scores (59.00, 57.13-60.87) compared with their Chinese peers. Adolescents with tertiary-educated mothers reported lower emotional functioning scores (57.45, 53.85-61.06) compared with those with primary-educated mothers. Obese adolescents reported poorer HRQoL scores with significantly impaired physical and social functioning after controlling for confounders. CONCLUSIONS: These findings detected disparities in HRQoL among the adolescents when gender, ethnicity, maternal education level and weight status were considered. Further studies should address these health inequalities by implementing gender-specific and culturally appropriate measures to attain optimal well-being and avoid potential burden of disease.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14383, title = {MultiComponent Exercise and theRApeutic lifeStyle (CERgAS) intervention to improve physical performance and maintain independent living among urban poor older people--a cluster randomised controlled trial}, author = {D A Loh and N N Hairi and W Y Choo and F Mohd Hairi and D Peramalah and S Kandiben and P L Lee and N Gani and M F Madzlan and M A Abd Hamid and Z Akram and A S Chu and A Bulgiba and R G Cumming}, doi = {10.1186/s12877-015-0002-7}, issn = {1471-2318}, year = {2015}, date = {2015-01-01}, journal = {BMC Geriatr}, volume = {15}, pages = {8}, abstract = {BACKGROUND: The ability of older people to function independently is crucial as physical disability and functional limitation have profound impacts on health. Interventions that either delay the onset of frailty or attenuate its severity potentially have cascading benefits for older people, their families and society. This study aims to develop and evaluate the effectiveness of a multiComponent Exercise and theRApeutic lifeStyle (CERgAS) intervention program targeted at improving physical performance and maintaining independent living as compared to general health education among older people in an urban poor setting in Malaysia. METHODS: This cluster randomised controlled trial will be a 6-week community-based intervention programme for older people aged 60 years and above from urban poor settings. A minimum of 164 eligible participants will be recruited from 8 clusters (low-cost public subsidised flats) and randomised to the intervention and control arm. This study will be underpinned by the Health Belief Model with an emphasis towards self-efficacy. The intervention will comprise multicomponent group exercise sessions, nutrition education, oral care education and on-going support and counselling. These will be complemented with a kit containing practical tips on exercise, nutrition and oral care after each session. Data will be collected over four time points; at baseline, immediately post-intervention, 3-months and 6-months follow-up. DISCUSSION: Findings from this trial will potentially provide valuable evidence to improve physical function and maintain independence among older people from low-resource settings. This will inform health policies and identify locally acceptable strategies to promote healthy aging, prevent and delay functional decline among older Malaysian adults. TRIAL REGISTRATION: ISRCTN22749696.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14369, title = {A cluster randomized trial on improving nurses' detection and management of elder abuse and neglect (I-NEED): study protocol}, author = {D A Loh and W Y Choo and N N Hairi and S Othman and F Mohd Hairi and F H Mohd Mydin and S N Jaafar and M P Tan and Z Mohd Ali and S Abdul Aziz and R Ramli and R Mohamad and Z Lal Mohammad and N Hassan and P Brownell and A Bulgiba}, doi = {10.1111/jan.12699}, issn = {0309-2402}, year = {2015}, date = {2015-01-01}, journal = {J Adv Nurs}, abstract = {AIM: The aim of this study was to describe a trial protocol of an educational intervention for nurses to improve their awareness and practice in detecting and managing elder abuse and neglect. BACKGROUND: Knowledgeable and skilful nurses are crucial amidst the growing numbers of maltreated older patients. DESIGN: This trial is a multi-site, three-armed, community-based cluster randomized controlled trial with 6-months follow-up. METHODS: This study will involve 390 community and registered nurses from government health clinics in Negeri Sembilan, Malaysia (protocol approved in October 2013). This three-phased study, premised on the Precede-Proceed Model, comprises baseline focus group discussion and survey (Phase 1), development of training module (Phase 2) and implementation and evaluation of the training (Phase 3). Eligible participants will be randomized to the control group (continuous nursing education), intervention group A (face-to-face intensive training programme) or group B (face-to-face intensive training programme and an educational video). Outcome measures include improvement in knowledge and awareness on elder abuse and neglect and the number of cases identified and managed during follow-up. Data will be collected at baseline, immediate postintervention, 3- and 6-month follow-up. CONCLUSION: Findings from this study will provide empirical support for the development of a training module for nurses on the detection and management of elder abuse and neglect, towards improving healthcare delivery and the well-being of vulnerable older adults. This study is funded by the University of Malaya Research Grant (RP001C-13HTM), (FL002-13SBS) and University of Malaya Grand Challenge (PEACE) Grant (GC001C-14HTM) awarded in May 2013, July 2013 and September 2014.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14376, title = {Household catastrophic healthcare expenditure and impoverishment due to rotavirus gastroenteritis requiring hospitalization in Malaysia}, author = {T Loganathan and W S Lee and K F Lee and M Jit and C W Ng}, doi = {10.1371/journal.pone.0125878}, issn = {1932-6203}, year = {2015}, date = {2015-01-01}, journal = {PLoS One}, volume = {10}, number = {5}, pages = {e0125878}, abstract = {BACKGROUND: While healthcare costs for rotavirus gastroenteritis requiring hospitalization may be burdensome on households in Malaysia, exploration on the distribution and catastrophic impact of these expenses on households are lacking. OBJECTIVES: We assessed the economic burden, levels and distribution of catastrophic healthcare expenditure, the poverty impact on households and inequities related to healthcare payments for acute gastroenteritis requiring hospitalization in Malaysia. METHODS: A two-year prospective, hospital-based study was conducted from 2008 to 2010 in an urban (Kuala Lumpur) and rural (Kuala Terengganu) setting in Malaysia. All children under the age of 5 years admitted for acute gastroenteritis were included. Patients were screened for rotavirus and information on healthcare expenditure was obtained. RESULTS: Of the 658 stool samples collected at both centers, 248 (38%) were positive for rotavirus. Direct and indirect costs incurred were significantly higher in Kuala Lumpur compared with Kuala Terengganu (US$222 Vs. US$45; p\<0.001). The mean direct and indirect costs for rotavirus gastroenteritis consisted 20% of monthly household income in Kuala Lumpur, as compared with only 5% in Kuala Terengganu. Direct medical costs paid out-of-pocket caused 141 (33%) households in Kuala Lumpur to experience catastrophic expenditure and 11 (3%) households to incur poverty. However in Kuala Terengganu, only one household (0.5%) experienced catastrophic healthcare expenditure and none were impoverished. The lowest income quintile in Kuala Lumpur was more likely to experience catastrophic payments compared to the highest quintile (87% vs 8%). The concentration index for out-of-pocket healthcare payments was closer to zero at Kuala Lumpur (0.03) than at Kuala Terengganu (0.24). CONCLUSIONS: While urban households were wealthier, healthcare expenditure due to gastroenteritis had more catastrophic and poverty impact on the urban poor. Universal rotavirus vaccination would reduce both disease burden and health inequities in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15728, title = {Barriers to early presentation of self-discovered breast cancer in Singapore and Malaysia: a qualitative multicentre study}, author = {J N Lim and B Potrata and L Simonella and C W Ng and T C Aw and M Dahlui and M Hartman and R Mazlan and N A Taib}, doi = {10.1136/bmjopen-2015-009863}, issn = {2044-6055}, year = {2015}, date = {2015-01-01}, journal = {BMJ Open}, volume = {5}, number = {12}, pages = {e009863}, abstract = {OBJECTIVE: To explore and compare barriers to early presentation of self-discovered breast cancer in Singapore and Malaysia. DESIGN: A qualitative interview study with thematic analysis of transcripts. PARTICIPANTS: 67 patients with self-discovered breast symptoms were included in the analysis. Of these, 36% were of Malay ethnicity, 39% were Chinese and 25% Indian, with an average age of 58 years (range 24-82 years). The number of women diagnosed at early stages of cancer almost equalled those at advanced stages. Approximately three-quarters presented with a painless lump, one-quarter experienced a painful lump and 10% had atypical symptoms. SETTING: University hospital setting in Singapore and Malaysia. RESULTS: Patients revealed barriers to early presentation not previously reported: the poor quality of online website information about breast symptoms, financial issues and the negative influence of relatives in both countries, while perceived poor quality of care and services in state-run hospitals and misdiagnosis by healthcare professionals were reported in Malaysia. The pattern of presentation by ethnicity remained unchanged where more Malay delayed help-seeking and had more advanced cancer compared to Chinese and Indian patients. CONCLUSIONS: There are few differences in the pattern of presentation and in the reported barriers to seek medical care after symptom discovery between Singapore and Malaysia despite their differing economic status. Strategies to reduce delayed presentation are: a need to improve knowledge of disease, symptoms and causes, quality of care and services, and quality of online information; and addressing fear of diagnosis, treatment and hospitalisation, with more effort focused on the Malay ethnic group. Training is needed to avoid missed diagnoses and other factors contributing to delay among health professionals.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14356, title = {Cardiovascular Risk Factors and Ethnicity Are Independent Factors Associated with Lower Urinary Tract Symptoms}, author = {J Lim and N Bhoo-Pathy and S Sothilingam and R Malek and M Sundram and G H Tan and B Bahadzor and T A Ong and K L Ng and A H Abdul Razack}, doi = {10.1371/journal.pone.0130820}, issn = {1932-6203}, year = {2015}, date = {2015-01-01}, journal = {PLoS One}, volume = {10}, number = {6}, pages = {e0130820}, abstract = {OBJECTIVES: To determine the lower urinary tract symptoms (LUTS) profile and factors affecting its degree of severity including cardiovascular risk profile, age, ethnicity, education level and prostate volume in a multiethnic Asian setting. MATERIALS AND METHODS: We conducted a cross-sectional study of 1021 men aged 40-79 years with no clinical evidence of prostate cancer, prostate surgery or 5alpha-reductase inhibitor treatment of known prostate conditions. The severity of LUTS was assessed using the International Prostate Symptom Score (IPSS). Potential factors associated with LUTS including age, ethnicity, education, history of hypertension, diabetes and hypercholesterolemia, height, weight, and prostate volume were evaluated using univariable and multivariable analyses. RESULTS: There were 506 (50%) men found to have moderate-to-severe LUTS attaining an IPSS above 7. Overall, nocturia (45.5%) was the most frequently reported symptom. Multivariable analysis showed that age, ethnicity, prostate volume and history of hypertension and hypercholesterolemia were independent factors associated with severity of LUTS (p \< 0.05). Considering individual lower urinary tract symptoms, we found a strong association of storage symptom with history of hypertension and hypercholesterolemia. Malay men were significantly bothered by post micturition symptom compared to their Chinese and Indian counterparts. Stratified analyses of LUTS demonstrated a mutually exclusive cardiovascular risk factors profile defined by ethnicity. CONCLUSION: Severity of LUTS varies between different ethnicities across all age groups. In addition to age and prostate volume, ethnicity and cardiovascular risk factors including hypertension and hypercholesterolemia may also need to be taken into account in managing men with LUTS.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14361, title = {Subtypes of fruit and vegetables, variety in consumption and risk of colon and rectal cancer in the European Prospective Investigation into Cancer and Nutrition}, author = {M Leenders and P D Siersema and K Overvad and A Tjonneland and A Olsen and M C Boutron-Ruault and N Bastide and G Fagherazzi and V Katzke and T Kuhn and H Boeing and K Aleksandrova and A Trichopoulou and P Lagiou and E Klinaki and G Masala and S Grioni and M Santucci De Magistris and R Tumino and F Ricceri and P H Peeters and E Lund and G Skeie and E Weiderpass and J R Quiros and A Agudo and M J Sanchez and M Dorronsoro and C Navarro and E Ardanaz and B Ohlsson and K Jirstrom and B Van Guelpen and M Wennberg and K T Khaw and N Wareham and T J Key and I Romieu and I Huybrechts and A J Cross and N Murphy and E Riboli and H B Bueno-de-Mesquita}, doi = {10.1002/ijc.29640}, issn = {0020-7136}, year = {2015}, date = {2015-01-01}, journal = {Int J Cancer}, volume = {137}, number = {11}, pages = {2705-14}, abstract = {Previously, a lower risk of colorectal cancer was observed with fruit and vegetable consumption in the European Prospective Investigation into Cancer and Nutrition within a follow-up period of 9 years which was not fully supported by a recent meta-analysis. Therefore, we were interested in the relation with extended follow-up, also focusing on single subtypes and a variety of intake of fruit and vegetables. Fruit and vegetable consumption was assessed at baseline. After an average of 13 years of follow-up, 3,370 participants were diagnosed with colon or rectal cancer. Diet diversity scores were constructed to quantify variety in fruit and vegetable consumption. A lower risk of colon cancer was observed with higher self-reported consumption of fruit and vegetable combined (HR Q4 vs. Q1 0.87, 95% CI 0.75-1.01, p for trend 0.02), but no consistent association was observed for separate consumption of fruits and vegetables. No associations with risk of rectal cancer were observed. The few observed associations for some fruit and vegetable subtypes with colon cancer risk may have been due to chance. Variety in consumption of fruits and vegetables was not associated with a lower risk of colon or rectal cancer. Although a lower risk of colon cancer is suggested with high consumption of fruit and vegetables, this study does not support a clear inverse association between fruit and vegetable consumption and colon or rectal cancer beyond a follow-up of more than 10 years. Attenuation of the risk estimates from dietary changes over time cannot be excluded, but appears unlikely.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14358, title = {Surveillance of adult Aedes mosquitoes in Selangor, Malaysia}, author = {S M Lau and I Vythilingam and J I Doss and S D Sekaran and T H Chua and W Y Wan Sulaiman and K Chinna and Y A Lim and B Venugopalan}, doi = {10.1111/tmi.12555}, issn = {1360-2276}, year = {2015}, date = {2015-01-01}, journal = {Trop Med Int Health}, volume = {20}, number = {10}, pages = {1271-80}, abstract = {OBJECTIVE: To determine the effectiveness of using sticky traps and the NS1 dengue antigen kit for the surveillance of Aedes mosquitoes for dengue control. METHODS: Apartments were selected in a dengue-endemic area, and sticky traps were set to capture adult Aedes mosquitoes. NS1 dengue antigen kit was used to detect dengue antigen in mosquitoes, and positive mosquitoes were serotyped using real-time RT-PCR. RESULTS: The sticky traps were effective in capturing Aedes aegypti, and a minimum of three traps per floor was sufficient. Multiple serotypes were found in individual mosquitoes. CONCLUSION: The sticky trap and the NS1 dengue antigen test kit can be used as surveillance tool in dengue control programmes. This proactive method will be better suited for control programmes than current reactive methods.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15740, title = {Pre-diagnostic polyphenol intake and breast cancer survival: the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort}, author = {C Kyro and R Zamora-Ros and A Scalbert and A Tjonneland and L Dossus and C Johansen and P E Bidstrup and E Weiderpass and J Christensen and H Ward and D Aune and E Riboli and M His and F Clavel-Chapelon and L Baglietto and V Katzke and T Kuhn and H Boeing and A Floegel and K Overvad and C Lasheras and N Travier and M J Sanchez and P Amiano and M D Chirlaque and E Ardanaz and K T Khaw and N Wareham and A Perez-Cornago and A Trichopoulou and P Lagiou and E Vasilopoulou and G Masala and S Grioni and F Berrino and R Tumino and C Sacerdote and A Mattiello and H B Bueno-de-Mesquita and P H Peeters and C Gils and S Borgquist and S Butt and A Zeleniuch-Jacquotte and M Sund and A Hjartaker and G Skeie and A Olsen and I Romieu}, doi = {10.1007/s10549-015-3595-9}, issn = {0167-6806}, year = {2015}, date = {2015-01-01}, journal = {Breast Cancer Res Treat}, volume = {154}, number = {2}, pages = {389-401}, abstract = {The aim was to investigate the association between pre-diagnostic intakes of polyphenol classes (flavonoids, lignans, phenolic acids, stilbenes, and other polyphenols) in relation to breast cancer survival (all-cause and breast cancer-specific mortality). We used data from the European Prospective Investigation into Cancer and Nutrition cohort. Pre-diagnostic usual diet was assessed using dietary questionnaires, and polyphenol intakes were estimated using the Phenol-Explorer database. We followed 11,782 breast cancer cases from time of diagnosis until death, end of follow-up or last day of contact. During a median of 6 years, 1482 women died (753 of breast cancer). We related polyphenol intake to all-cause and breast cancer-specific mortality using Cox proportional hazard models with time since diagnosis as underlying time and strata for age and country. Among postmenopausal women, an intake of lignans in the highest versus lowest quartile was related to a 28 % lower risk of dying from breast (adjusted model: HR, quartile 4 vs. quartile 1, 0.72, 95 % CI 0.53; 0.98). In contrast, in premenopausal women, a positive association between lignan intake and all-cause mortality was found (adjusted model: HR, quartile 4 vs. quartile 1, 1.63, 95 % CI 1.03; 2.57). We found no association for other polyphenol classes. Intake of lignans before breast cancer diagnosis may be related to improved survival among postmenopausal women, but may on the contrary worsen the survival for premenopausal women. This suggests that the role of phytoestrogens in breast cancer survival is complex and may be dependent of menopausal status.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15748, title = {The Association between Glyceraldehyde-Derived Advanced Glycation End-Products and Colorectal Cancer Risk}, author = {S Y Kong and M Takeuchi and H Hyogo and G McKeown-Eyssen and S Yamagishi and K Chayama and P J O'Brien and P Ferrari and K Overvad and A Olsen and A Tjonneland and M C Boutron-Ruault and N Bastide and F Carbonnel and T Kuhn and R Kaaks and H Boeing and K Aleksandrova and A Trichopoulou and P Lagiou and E Vasilopoulou and G Masala and V Pala and M Santucci De Magistris and R Tumino and A Naccarati and H B Bueno-de-Mesquita and P H Peeters and E Weiderpass and J R Quiros and P Jakszyn and M J Sanchez and M Dorronsoro and D Gavrila and E Ardanaz and M Rutegard and H Nystrom and N J Wareham and K T Khaw and K E Bradbury and I Romieu and H Freisling and F Stavropoulou and M J Gunter and A J Cross and E Riboli and M Jenab and W R Bruce}, doi = {10.1158/1055-9965.Epi-15-0422}, issn = {1055-9965}, year = {2015}, date = {2015-01-01}, journal = {Cancer Epidemiol Biomarkers Prev}, volume = {24}, number = {12}, pages = {1855-63}, abstract = {BACKGROUND: A large proportion of colorectal cancers are thought to be associated with unhealthy dietary and lifestyle exposures, particularly energy excess, obesity, hyperinsulinemia, and hyperglycemia. It has been suggested that these processes stimulate the production of toxic reactive carbonyls from sugars such as glyceraldehyde. Glyceraldehyde contributes to the production of a group of compounds known as glyceraldehyde-derived advanced glycation end-products (glycer-AGEs), which may promote colorectal cancer through their proinflammatory and pro-oxidative properties. The objective of this study nested within a prospective cohort was to explore the association of circulating glycer-AGEs with risk of colorectal cancer. METHODS: A total of 1,055 colorectal cancer cases (colon n = 659; rectal n = 396) were matchced (1:1) to control subjects. Circulating glycer-AGEs were measured by a competitive ELISA. Multivariable conditional logistic regression models were used to calculate ORs and 95% confidence intervals (95% CI), adjusting for potential confounding factors, including smoking, alcohol, physical activity, body mass index, and diabetes status. RESULTS: Elevated glycer-AGEs levels were not associated with colorectal cancer risk (highest vs. lowest quartile, 1.10; 95% CI, 0.82-1.49). Subgroup analyses showed possible divergence by anatomical subsites (OR for colon cancer, 0.83; 95% CI, 0.57-1.22; OR for rectal cancer, 1.90; 95% CI, 1.14-3.19; Pheterogeneity = 0.14). CONCLUSIONS: In this prospective study, circulating glycer-AGEs were not associated with risk of colon cancer, but showed a positive association with the risk of rectal cancer. IMPACT: Further research is needed to clarify the role of toxic products of carbohydrate metabolism and energy excess in colorectal cancer development.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14614, title = {Utility of pre-treatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as prognostic factors in breast cancer}, author = {C H Koh and N Bhoo-Pathy and K L Ng and R S Jabir and G H Tan and M H See and S Jamaris and N A Taib}, url = {http://www.nature.com/bjc/journal/v113/n1/pdf/bjc2015183a.pdf}, doi = {10.1038/bjc.2015.183}, issn = {0007-0920}, year = {2015}, date = {2015-01-01}, journal = {Br J Cancer}, volume = {113}, number = {1}, pages = {150-8}, abstract = {BACKGROUND: Peripheral blood-derived inflammation-based scores such as the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have recently been proposed as prognostic markers in solid tumours. Although evidence to support these markers as unfavourable prognostic factors is more compelling in gastrointestinal cancers, very little is known of their impact on breast cancer. We investigated the association between the NLR and PLR, and overall survival after breast cancer. METHODS: Data from the University of Malaya Medical Centre Breast Cancer Registry was used. Of 2059 consecutive patients diagnosed from 2000 to 2008, we included 1435 patients with an available pre-treatment differential blood count ( approximately 70%). Patients were stratified into quintiles of the NLR/PLR. Multivariable Cox regression was used to determine the independent prognostic significances of the NLR/PLR. RESULTS: Compared with the first quintile of the NLR, women in quintile 5 were younger, had bigger tumours, nodal involvement, distant metastases and higher tumour grades. Higher NLR quintiles were significantly associated with poorer survival with a 5-year relative survival ratio (RSR) of 76.4% (95% CI: 69.6-82.1%) in quintile 1, 79.4% (95% CI: 74.4-83.7%) in quintile 2, 72.1% (95% CI: 66.3-77.3%) in quintile 3, 65.6% (95% CI: 59.8-70.8%) in quintile 4 and 51.1% (95% CI: 43.3-58.5%) in quintile 5. Following adjustment for demography, tumour characteristics, treatment and the PLR, the adjusted hazard ratio (HR) for quintile 5 vs quintile 1 was 1.50 (95% CI: 1.08-1.63); Ptrend=0.004. Results were unchanged when the NLR was analysed as a dichotomous variable using different cutoff points. Although patients in PLR quintile 5 had lower survival than in quintile 1 (5-year RSR: 53.2% (95% CI: 46.9-59.2%) vs 77.0% (95% CI: 70.9-82.2%)), this association was not significant after multivariable adjustment. However, a PLR \>185 was significantly associated with poorer survival; adjusted HR: 1.25 (95% CI: 1.04-1.52). CONCLUSIONS: Both the NLR and PLR are independently associated with an increased risk of mortality in breast cancer. Their added value in the prognostication of breast cancer in clinical practice warrants investigation.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14340, title = {Sleep Duration, Sleep Quality, and Markers of Subclinical Arterial Disease in Healthy Men and Women}, author = {C W Kim and Y Chang and D Zhao and M Cainzos-Achirica and S Ryu and H S Jung and K E Yun and Y Choi and J Ahn and Y Zhang and S Rampal and Y Baek and J A Lima and H Shin and E Guallar and J Cho and E Sung}, doi = {10.1161/atvbaha.115.306110}, issn = {1079-5642}, year = {2015}, date = {2015-01-01}, journal = {Arterioscler Thromb Vasc Biol}, volume = {35}, number = {10}, pages = {2238-45}, abstract = {OBJECTIVE: Short and long sleep duration are associated with increased risk of clinical cardiovascular events, but the association between sleep duration and subclinical cardiovascular disease is not well established. We examined the association between sleep duration and sleep quality with coronary artery calcification (CAC) and with brachial-ankle pulse wave velocity (PWV) in a large sample of young and middle-aged asymptomatic adults. APPROACH AND RESULTS: We conducted a cross-sectional study of adult men and women who underwent a health checkup examination, including assessment of sleep duration and quality and coupled with either CAC (n=29 203) or brachial-ankle PWV (n=18 106). The multivariate-adjusted CAC score ratios (95% confidence interval) comparing sleep durations of \</=5, 6, 8, and \>/=9 hours with 7 hours of sleep were 1.50 (1.17-1.93), 1.34 (1.10-1.63), 1.37 (0.99-1.89), and 1.72 (0.90-3.28), respectively (P for quadratic trend=0.002). The corresponding average differences in brachial-ankle PWV were 6.7 (0.75-12.6), 2.9 (-1.7 to 7.4), 10.5 (4.5-16.5), and 9.6 (-0.7 to 19.8) cm/s, respectively (P for quadratic trend=0.019). Poor subjective sleep quality was associated with CAC in women but not in men, whereas the association between poor subjective sleep quality and brachial-ankle PWV was stronger in men than in women. CONCLUSIONS: In this large study of apparently healthy men and women, extreme sleep duration and poor subjective sleep quality were associated with increased prevalence of CAC and higher PWV. Our results underscore the importance of an adequate quantity and quality of sleep to maintain cardiovascular health.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14353, title = {Traditional and Complementary Medicine (TCM) among Study Population with Cardiovascular Risk; use and Substitution for Conventional Medicine in Pahang, Malaysia}, author = {Y Kew and Y L Chia and S M Lai and K Y Chong and X L Ho and D W Liew and F M Moy and S Selvarajah}, issn = {0300-5283 (Print) 0300-5283}, year = {2015}, date = {2015-01-01}, journal = {Med J Malaysia}, volume = {70}, number = {2}, pages = {86-92}, abstract = {INTRODUCTION: Cardiovascular diseases are the main cause of morbidity and mortality in Malaysia. There is evidence of high traditional and complementary medicine (TCM) use among population with cardiovascular risk and there have been anecdotal reports about substitution of conventional medicines with TCM. We investigated the prevalence of TCM use, treatment preference and substitution of conventional medicines in study population with cardiovascular risk factors in Pahang, Malaysia. METHODS: A cross-sectional survey was conducted using an interviewer-administered questionnaire in five districts of Pahang. A total of 1250 households were chosen through proportionate and systematic sampling. Respondents aged 18 years and above were selected. RESULTS: The study population with cardiovascular risk factors who used TCM was higher than the general population (31.7% versus 25.9%). There were no clear preferences in using TCM by gender, age groups, educational level and income even though other bumiputeras showed a slight inclination towards TCM use. Among the study population with cardiovascular risk factors who consumed TCM, 20-30% of them were using TCM as a substitute for their conventional medications. Respondents from the younger age group (18-40 years) (57.1%), highest educational level (43.2%), other bumiputeras (38.4%) and highest income group (31.4%) preferred the combination of both conventional and traditional medicine. CONCLUSION: TCM use among population with cardiovascular risk factors is high. The high preference for combination therapy of TCM and conventional medications among young adults and the use of TCM to substitute conventional medications show that much research is needed to provide proven TCM therapies to avoid self-mismanagement of cardiovascular risk in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14373, title = {Fiber and prebiotic supplementation in enteral nutrition: A systematic review and meta-analysis}, author = {M Kamarul Zaman and K F Chin and V Rai and H A Majid}, doi = {10.3748/wjg.v21.i17.5372}, issn = {1007-9327}, year = {2015}, date = {2015-01-01}, journal = {World J Gastroenterol}, volume = {21}, number = {17}, pages = {5372-81}, abstract = {AIM: To investigate fiber and prebiotic supplementation of enteral nutrition (EN) for diarrhea, fecal microbiota and short-chain fatty acids (SCFAs). METHODS: MEDLINE, EMBASE, Cochrane Library, CINAHL, Academic Search Premier, and Web of Science databases were searched for human experimental and observational cohort studies conducted between January 1990 and June 2014. The keywords used for the literature search were fiber, prebiotics and enteral nutrition. English language studies with adult patient populations on exclusive EN were selected. Abstracts and/or full texts of selected studies were reviewed and agreed upon by two independent researchers for inclusion in the meta-analysis. Tools used for the quality assessment were Jadad Scale and the Scottish Intercollegiate Guidelines Network Critical Appraisal of the Medical Literature. RESULTS: A total of 456 possible articles were retrieved, and 430 were excluded due to lack of appropriate data. Of the 26 remaining studies, only eight investigated the effects of prebiotics. Results of the meta-analysis indicated that overall, fiber reduces diarrhea in patients receiving EN (OR = 0.47; 95%CI: 0.29-0.77; P = 0.02). Subgroup analysis revealed a positive effect of fiber supplementation in EN towards diarrhea in stable patients (OR = 0.31; 95%CI: 0.19-0.51; P \< 0.01), but not in critically ill patients (OR = 0.89; 95%CI: 0.41-1.92; P = 0.77). Prebiotic supplementation in EN does not improve the incidence of diarrhea despite its manipulative effect on bifidobacteria concentrations and SCFA in healthy humans. In addition, the effect of fiber and/or prebiotic supplementation towards fecal microbiota and SCFA remain disputable. CONCLUSION: Fiber helps minimize diarrhea in patients receiving EN, particularly in non-critically ill patients. However, the effect of prebiotics in moderating diarrhea is inconclusive.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14341, title = {WHO guidelines for a healthy diet and mortality from cardiovascular disease in European and American elderly: the CHANCES project}, author = {N Jankovic and A Geelen and M T Streppel and L C Groot and J C Kiefte-de Jong and P Orfanos and C Bamia and A Trichopoulou and P Boffetta and M Bobak and H Pikhart and F Kee and M G O'Doherty and G Buckland and J Woodside and O H Franco and M A Ikram and E A Struijk and A Pajak and S Malyutina and R Kubinova and M Wennberg and Y Park and H B Bueno-de-Mesquita and E Kampman and E J Feskens}, doi = {10.3945/ajcn.114.095117}, issn = {0002-9165}, year = {2015}, date = {2015-01-01}, journal = {Am J Clin Nutr}, abstract = {BACKGROUND: Cardiovascular disease (CVD) represents a leading cause of mortality worldwide, especially in the elderly. Lowering the number of CVD deaths requires preventive strategies targeted on the elderly. OBJECTIVE: The objective was to generate evidence on the association between WHO dietary recommendations and mortality from CVD, coronary artery disease (CAD), and stroke in the elderly aged \>/=60 y. DESIGN: We analyzed data from 10 prospective cohort studies from Europe and the United States comprising a total sample of 281,874 men and women free from chronic diseases at baseline. Components of the Healthy Diet Indicator (HDI) included saturated fatty acids, polyunsaturated fatty acids, mono- and disaccharides, protein, cholesterol, dietary fiber, and fruit and vegetables. Cohort-specific HRs adjusted for sex, education, smoking, physical activity, and energy and alcohol intakes were pooled by using a random-effects model. RESULTS: During 3,322,768 person-years of follow-up, 12,492 people died of CVD. An increase of 10 HDI points (complete adherence to an additional WHO guideline) was, on average, not associated with CVD mortality (HR: 0.94; 95% CI: 0.86, 1.03), CAD mortality (HR: 0.99; 95% CI: 0.85, 1.14), or stroke mortality (HR: 0.95; 95% CI: 0.88, 1.03). However, after stratification of the data by geographic region, adherence to the HDI was associated with reduced CVD mortality in the southern European cohorts (HR: 0.87; 95% CI: 0.79, 0.96; I2 = 0%) and in the US cohort (HR: 0.85; 95% CI: 0.83, 0.87; I2 = not applicable). CONCLUSION: Overall, greater adherence to the WHO dietary guidelines was not significantly associated with CVD mortality, but the results varied across regions. Clear inverse associations were observed in elderly populations in southern Europe and the United States.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15742, title = {The Malaysian Breast Cancer Survivorship Cohort (MyBCC): a study protocol}, author = {T Islam and N Bhoo-Pathy and T T Su and H A Majid and A M Nahar and C G Ng and M Dahlui and S Hussain and M Cantwell and L Murray and N A Taib}, doi = {10.1136/bmjopen-2015-008643}, issn = {2044-6055}, year = {2015}, date = {2015-01-01}, journal = {BMJ Open}, volume = {5}, number = {10}, pages = {e008643}, abstract = {INTRODUCTION: Over recent decades, the burden of breast cancer has been increasing at an alarming rate in Asia. Prognostic research findings from Western countries may not readily be adapted to Asia, as the outcome of breast cancer depends on a multitude of factors ranging from genetic, clinical and histological predictors, to lifestyle and social predictors. The primary aim of this study is to determine the impact of lifestyle (eg, nutrition, physical activity), mental and sociocultural condition, on the overall survival and quality of life (QoL) among multiethnic Malaysian women following diagnosis of breast cancer. This study aims to advance the evidence on prognostic factors of breast cancer within the Asian setting. The findings may guide management of patients with breast cancer not only during active treatment but also during the survivorship period. METHODS: This hospital-based prospective cohort study will comprise patients with breast cancer (18 years and above), managed in the University Malaya Medical Centre (UMMC). We aim to recruit 1000 cancer survivors over a 6-year period. Data collection will occur at baseline (within 3 months of diagnosis), 6 months, and 1, 3 and 5 years following diagnosis. The primary outcomes are disease-free survival and overall survival, and secondary outcome is QoL. Factors measured are demographic and socioeconomic factors, lifestyle factors (eg, dietary intake, physical activity), anthropometry measurements (eg, height, weight, waist, hip circumference, body fat analysis), psychosocial aspects, and complementary and alternative medicine (CAM) usage. ETHICS AND DISSEMINATION: This protocol was approved by the UMMC Ethical Committee in January 2012. All participants are required to provide written informed consent. The findings from our cohort study will be disseminated via scientific publication as well as presentation to stakeholders including the patients, clinicians, the public and policymakers, via appropriate avenues.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14596, title = {Fine-scale mapping of the 4q24 locus identifies two independent loci associated with breast cancer risk}, author = {X Guo and J Long and C Zeng and K Michailidou and M Ghoussaini and M K Bolla and Q Wang and R L Milne and X O Shu and Q Cai and J Beesley and S P Kar and I L Andrulis and H Anton-Culver and V Arndt and M W Beckmann and A Beeghly-Fadiel and J Benitez and W Blot and N Bogdanova and S E Bojesen and H Brauch and H Brenner and L A Brinton and A Broeks and T Bruning and B Burwinkel and H Cai and S V Canisius and J Chang-Claude and J Y Choi and F J Couch and A Cox and S S Cross and K Czene and H Darabi and P Devilee and A Droit and T Dork and P A Fasching and O Fletcher and H Flyger and F Fostira and V Gaborieau and M Garcia-Closas and G G Giles and M Grip and P Guenel and C A Haiman and U Hamann and M Hartman and A Hollestelle and J L Hopper and C N Hsiung and H Ito and A Jakubowska and N Johnson and M Kabisch and D Kang and S Khan and J A Knight and V M Kosma and D Lambrechts and L Le Marchand and J Li and A Lindblom and A Lophatananon and J Lubinski and A Mannermaa and S Manoukian and S Margolin and F Marme and K Matsuo and C A McLean and A Meindl and K Muir and S L Neuhausen and H Nevanlinna and S Nord and J E Olson and N Orr and P Peterlongo and T Choudary Putti and A Rudolph and S Sangrajrang and E J Sawyer and M K Schmidt and R K Schmutzler and C Y Shen and J Shi and M J Shrubsole and M C Southey and A Swerdlow and S H Teo and B Thienpont and A E Toland and R A Tollenaar and I P Tomlinson and T Truong and C C Tseng and others}, url = {http://cebp.aacrjournals.org/content/early/2015/09/09/1055-9965.EPI-15-0363 http://cebp.aacrjournals.org/content/24/11/1680}, doi = {10.1158/1055-9965.epi-15-0363}, issn = {1055-9965}, year = {2015}, date = {2015-01-01}, journal = {Cancer Epidemiol Biomarkers Prev}, abstract = {BACKGROUND: A recent association study identified a common variant (rs9790517) at 4q24 to be associated with breast cancer risk. Independent association signals and potential functional variants in this locus have not been explored. METHODS: We conducted a fine-mapping analysis in 55,540 breast cancer cases and 51,168 controls from the Breast Cancer Association Consortium. RESULTS: Conditional analyses identified two independent association signals among women of European ancestry, represented by rs9790517 (conditional p = 2.51 x 10-4; OR = 1.04; 95% CI 1.02-1.07) and rs77928427 (p = 1.86 x 10-4; OR = 1.04; 95% CI 1.02-1.07). Functional annotation using data from the Encyclopedia of DNA Elements (ENCODE) project revealed two putative functional variants, rs62331150 and rs73838678 in linkage disequilibrium (LD) with rs9790517 (r2 \> 0.90) residing in the active promoter or enhancer, respectively, of the nearest gene, TET2. Both variants are located in DNase I hypersensitivity and transcription factor binding sites. Using data from both The Cancer Genome Atlas (TCGA) and Molecular Taxonomy of Breast Cancer International Consortium (METABRIC), we showed that rs62331150 was associated with level of expression of TET2 in breast normal and tumor tissue. CONCLUSION: Our study identified two independent association signals at 4q24 in relation to breast cancer risk and suggested that observed association in this locus may be mediated through the regulation of TET2. IMPACT: Fine-mapping study with large sample size warranted for identification of independent loci for breast cancer risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14177, title = {Dietary patterns in relation to quality-adjusted life years in the EPIC-NL cohort}, author = {H P Fransen and J W Beulens and A M May and E A Struijk and J M Boer and G A Wit and N C Onland-Moret and Y T Schouw and H B Bueno-de-Mesquita and J Hoekstra and P H Peeters}, url = {http://ac.els-cdn.com/S0091743515001735/1-s2.0-S0091743515001735-main.pdf?_tid=3189a2a2-66a8-11e5-84a4-00000aacb360\&acdnat=1443531007_5ad81b689c2d2633082d199f7c1e3bd3}, doi = {10.1016/j.ypmed.2015.05.014}, issn = {0091-7435}, year = {2015}, date = {2015-01-01}, journal = {Prev Med}, volume = {77}, pages = {119-24}, abstract = {BACKGROUND: Dietary patterns have been associated with the incidence or mortality of individual non-communicable diseases, but their association with disease burden has received little attention. OBJECTIVE: The aim of our study was to relate dietary patterns to health expectancy using quality-adjusted life years (QALYs) as outcome parameter. METHODS: Data from the EPIC-NL study were used, a prospective cohort study of 33,066 healthy men and women aged 20-70 years at recruitment. A lifestyle questionnaire and a validated food frequency questionnaire were administered at study entry (1993-1997). Five dietary patterns were studied: three a priori patterns (the modified Mediterranean Diet Score (mMDS), the WHO-based Healthy Diet Indicator (HDI) and the Dutch Healthy Diet index (DHD-index)) and two a posteriori data-based patterns. QALYs were used as a summary health measure for healthy life expectancy, combining a person's life expectancy with a weight reflecting loss of quality of life associated with having chronic diseases. RESULTS: The mean QALYs of the participants were 74.9 (standard deviation 4.4). A higher mMDS and HDI were associated with a longer life in good health. Participants who had a high mMDS score (6-9) had 0.17 [95% CI, 0.05; 0.30] more QALYs than participants with a low score (0-3), equivalent to two months longer life in good health. Participants with a high HDI score also had more QALYs (0.15 [95% CI, 0.03; 0.27]) than participants with a low HDI score. CONCLUSION: A Mediterranean-type diet and the Healthy Diet Indicator were associated with approximately 2months longer life in good health.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15827, title = {Reproductive and hormone-related risk factors for epithelial ovarian cancer by histologic pathways, invasiveness and histologic subtypes: Results from the EPIC cohort}, author = {R T Fortner and J Ose and M A Merritt and H Schock and A Tjonneland and L Hansen and K Overvad and L Dossus and F Clavel-Chapelon and L Baglietto and H Boeing and A Trichopoulou and V Benetou and P Lagiou and C Agnoli and A Mattiello and G Masala and R Tumino and C Sacerdote and H B Bueno-de-Mesquita and N C Onland-Moret and P H Peeters and E Weiderpass and I Torhild Gram and E J Duell and N Larranaga and E Ardanaz and M J Sanchez and M D Chirlaque and J Brandstedt and A Idahl and E Lundin and K T Khaw and N Wareham and R C Travis and S Rinaldi and I Romieu and M J Gunter and E Riboli and R Kaaks}, doi = {10.1002/ijc.29471}, issn = {0020-7136}, year = {2015}, date = {2015-01-01}, journal = {Int J Cancer}, volume = {137}, number = {5}, pages = {1196-208}, abstract = {Whether risk factors for epithelial ovarian cancer (EOC) differ by subtype (i.e., dualistic pathway of carcinogenesis, histologic subtype) is not well understood; however, data to date suggest risk factor differences. We examined associations between reproductive and hormone-related risk factors for EOC by subtype in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Among 334,126 women with data on reproductive and hormone-related risk factors (follow-up: 1992-2010), 1,245 incident cases of EOC with known histology and invasiveness were identified. Data on tumor histology, grade, and invasiveness, were available from cancer registries and pathology record review. We observed significant heterogeneity by the dualistic model (i.e., type I [low grade serous or endometrioid, mucinous, clear cell, malignant Brenner] vs. type II [high grade serous or endometrioid]) for full-term pregnancy (phet = 0.02). Full-term pregnancy was more strongly inversely associated with type I than type II tumors (ever vs. never: type I: relative risk (RR) 0.47 [95% confidence interval (CI): 0.33-0.69]; type II, RR: 0.81 [0.61-1.06]). We observed no significant differences in risk in analyses by major histologic subtypes of invasive EOC (serous, mucinous, endometrioid, clear cell). None of the investigated factors were associated with borderline tumors. Established protective factors, including duration of oral contraceptive use and full term pregnancy, were consistently inversely associated with risk across histologic subtypes (e.g., ever full-term pregnancy: serous, RR: 0.73 [0.58-0.92]; mucinous, RR: 0.53 [0.30-0.95]; endometrioid, RR: 0.65 [0.40-1.06]; clear cell, RR: 0.34 [0.18-0.64]; phet = 0.16). These results suggest limited heterogeneity between reproductive and hormone-related risk factors and EOC subtypes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15771, title = {Body iron status and gastric cancer risk in the EURGAST study}, author = {A Fonseca-Nunes and A Agudo and N Aranda and V Arija and A J Cross and E Molina and M J Sanchez and H B Bueno-de-Mesquita and P Siersema and E Weiderpass and V Krogh and A Mattiello and R Tumino and C Saieva and A Naccarati and B Ohlsson and K Sjoberg and M C Boutron-Ruault and C Cadeau and G Fagherazzi and H Boeing and A Steffen and T Kuhn and V Katzke and A Tjonneland and A Olsen and K T Khaw and N Wareham and T Key and Y Lu and E Riboli and P H Peeters and D Gavrila and M Dorronsoro and J R Quiros and A Barricarte and M Jenab and R Zamora-Ros and H Freisling and A Trichopoulou and P Lagiou and C Bamia and P Jakszyn}, doi = {10.1002/ijc.29669}, issn = {0020-7136}, year = {2015}, date = {2015-01-01}, journal = {Int J Cancer}, volume = {137}, number = {12}, pages = {2904-14}, abstract = {Although it appears biologically plausible for iron to be associated with gastric carcinogenesis, the evidence is insufficient to lead to any conclusions. To further investigate the relationship between body iron status and gastric cancer risk, we conducted a nested case-control study in the multicentric European Prospective Investigation into Cancer and Nutrition (EPIC) study. The study included 456 primary incident gastric adenocarcinoma cases and 900 matched controls that occurred during an average of 11 years of follow-up. We measured prediagnostic serum iron, ferritin, transferrin and C-reactive protein, and further estimated total iron-binding capacity (TIBC) and transferrin saturation (TS). Odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of gastric cancer by iron metrics were estimated from multivariable conditional logistic regression models. After adjusting for relevant confounders, we observed a statistically significant inverse association between gastric cancer and ferritin and TS indices (ORlog2 = 0.80, 95% CI = 0.72-0.88; OR10%increment = 0.87, 95% CI = 0.78-0.97, respectively). These associations appear to be restricted to noncardia gastric cancer (ferritin showed a p for heterogeneity = 0.04 and TS had a p for heterogeneity = 0.02), and no differences were found by histological type. TIBC increased risk of overall gastric cancer (OR50 microg/dl = 1.13, 95% CI = 1.02-1.2) and also with noncardia gastric cancer (p for heterogeneity = 0.04). Additional analysis suggests that time between blood draw and gastric cancer diagnosis could modify these findings. In conclusion, our results showed a decreased risk of gastric cancer related to higher body iron stores as measured by serum iron and ferritin. Further investigation is needed to clarify the role of iron in gastric carcinogenesis.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14355, title = {Body iron status and gastric cancer risk in the EURGAST study}, author = {A Fonseca-Nunes and A Agudo and N Aranda and V Arija and A J Cross and E Molina and M J Sanchez and B Bueno-de-Mesquita and P Siersema and E Weiderpass and V Krogh and A Mattiello and R Tumino and C Saieva and A Naccarati and B Ohlsson and K Sjoberg and M C Boutron-Ruault and C Cadeau and G Fagherazzi and H Boeing and A Steffen and T Kuhn and V Katzke and A Tjonneland and A Olsen and K T Khaw and N Wareham and T Key and Y Lu and E Riboli and P H Peeters and D Gavrila and M Dorronsoro and J R Quiros and A Barricarte and M Jenab and R Zamora-Ros and H Freisling and A Trichopoulou and P Lagiou and C Bamia and P Jakszyn}, url = {http://onlinelibrary.wiley.com/store/10.1002/ijc.29669/asset/ijc29669.pdf?v=1\&t=ilc7cnsn\&s=15da4f882d227c5467496861a5611df32cc835a6}, doi = {10.1002/ijc.29669}, issn = {0020-7136}, year = {2015}, date = {2015-01-01}, journal = {Int J Cancer}, abstract = {Although it appears biologically plausible for iron to be associated with gastric carcinogenesis, the evidence is insufficient to lead to any conclusions. To further investigate the relationship between body iron status and gastric cancer risk, we conducted a nested case-control study in the multicentric European Prospective Investigation into Cancer and Nutrition (EPIC) study. The study included 456 primary incident gastric adenocarcinoma cases and 900 matched controls that occurred during an average of 11 years of follow-up. We measured prediagnostic serum iron, ferritin, transferrin and C-reactive protein, and further estimated total iron-binding capacity (TIBC) and transferrin saturation (TS). Odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of gastric cancer by iron metrics were estimated from multivariable conditional logistic regression models. After adjusting for relevant confounders, we observed a statistically significant inverse association between gastric cancer and ferritin and TS indices (ORlog2 = 0.80, 95% CI = 0.72-0.88; OR10%increment = 0.87, 95% CI = 0.78-0.97, respectively). These associations appear to be restricted to noncardia gastric cancer (ferritin showed a p for heterogeneity = 0.04 and TS had a p for heterogeneity = 0.02), and no differences were found by histological type. TIBC increased risk of overall gastric cancer (OR50 microg/dl = 1.13, 95% CI = 1.02-1.2) and also with noncardia gastric cancer (p for heterogeneity = 0.04). Additional analysis suggests that time between blood draw and gastric cancer diagnosis could modify these findings. In conclusion, our results showed a decreased risk of gastric cancer related to higher body iron stores as measured by serum iron and ferritin. Further investigation is needed to clarify the role of iron in gastric carcinogenesis.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15730, title = {Effect of microbial cell preparation on renal profile and liver function among type 2 diabetics: a randomized controlled trial}, author = {S Firouzi and B N Mohd-Yusof and H A Majid and A Ismail and N A Kamaruddin}, doi = {10.1186/s12906-015-0952-5}, issn = {1472-6882}, year = {2015}, date = {2015-01-01}, journal = {BMC Complement Altern Med}, volume = {15}, pages = {433}, abstract = {BACKGROUND: The beneficial effect of probiotics on renal profile and liver function has been reported among patients with chronic kidney disease and fatty liver respectively. However, its effect on renal profile and liver function among type 2 diabetic individuals has not been fully understood. To investigate the effect of microbial cell preparation on renal profile and liver function tests among type 2 diabetic individuals. METHODS: A randomized, double-blind, parallel-group, controlled clinical trial was conducted on a total of 136 type 2 diabetics age 30-70 years old in a teaching hospital in Kuala Lumpur, Malaysia. Subjects were randomly assigned to receive microbial cell preparation (N = 68) or a placebo (N = 68) for 12 weeks. The outcomes measured at baseline, week 6, and week 12 and included changes in renal profile (Sodium, Potassium, Urea, Creatinine, Glomerular Filtration Rate), and liver function tests (Albumin, Total Protein, Alkaline Phosphatase, Alanine Aminotransferase, Aspartate Aminotransferase). Intention to treat (ITT) analysis was performed on all the recruited subjects, while per protocol (PP) analysis was conducted on those who completed the trial with good compliance. RESULT: The urea levels significantly declined in the probiotic group. Serum urea levels reduced from 4.26 mmol/L to 4.04 mmol/L in Probiotic Group while it increased in Placebo Group from 4.03 mmol/L to 4.24 mmol/L. These changes were significant between groups in ITT analysis (p = 0.018). Other parameters did not change significantly between groups. CONCLUSION: 12 weeks supplementation with daily dosage of 6 x 10(10) Colony Forming Units of multi-strain microbial cell preparation significantly improved urea levels. TRIAL REGISTRATION: ( CLINICAL TRIALS: # NCT01752803).}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14338, title = {Metabolomic profiles of hepatocellular carcinoma in a European prospective cohort}, author = {A Fages and T Duarte-Salles and M Stepien and P Ferrari and V Fedirko and C Pontoizeau and A Trichopoulou and K Aleksandrova and A Tjonneland and A Olsen and F Clavel-Chapelon and M C Boutron-Ruault and G Severi and R Kaaks and T Kuhn and A Floegel and H Boeing and P Lagiou and C Bamia and D Trichopoulos and D Palli and V Pala and S Panico and R Tumino and P Vineis and H B Bueno-de-Mesquita and P H Peeters and E Weiderpass and A Agudo and E Molina-Montes and J M Huerta and E Ardanaz and M Dorronsoro and K Sjoberg and B Ohlsson and K T Khaw and N Wareham and R C Travis and J A Schmidt and A Cross and M Gunter and E Riboli and A Scalbert and I Romieu and B Elena-Herrmann and M Jenab}, url = {http://download.springer.com/static/pdf/828/art%253A10.1186%252Fs12916-015-0462-9.pdf?originUrl=http%3A%2F%2Fhttp%3A%2F%2Fbmcmedicine.biomedcentral.com%2Farticle%2F10.1186%2Fs12916-015-0462-9\&token2=exp=1457005171~acl=%2Fstatic%2Fpdf%2F828%2Fart%25253A10.1186%25252Fs12916-015-0462-9.pdf*~hmac=a708504d4ad94862d6c62a1ea1b19e83a66b0c304db4679c93a1bedd31e0aa30}, doi = {10.1186/s12916-015-0462-9}, issn = {1741-7015}, year = {2015}, date = {2015-01-01}, journal = {BMC Med}, volume = {13}, number = {1}, pages = {242}, abstract = {BACKGROUND: Hepatocellular carcinoma (HCC), the most prevalent form of liver cancer, is difficult to diagnose and has limited treatment options with a low survival rate. Aside from a few key risk factors, such as hepatitis, high alcohol consumption, smoking, obesity, and diabetes, there is incomplete etiologic understanding of the disease and little progress in identification of early risk biomarkers. METHODS: To address these aspects, an untargeted nuclear magnetic resonance metabolomic approach was applied to pre-diagnostic serum samples obtained from first incident, primary HCC cases (n = 114) and matched controls (n = 222) identified from amongst the participants of a large European prospective cohort. RESULTS: A metabolic pattern associated with HCC risk comprised of perturbations in fatty acid oxidation and amino acid, lipid, and carbohydrate metabolism was observed. Sixteen metabolites of either endogenous or exogenous origin were found to be significantly associated with HCC risk. The influence of hepatitis infection and potential liver damage was assessed, and further analyses were made to distinguish patterns of early or later diagnosis. CONCLUSION: Our results show clear metabolic alterations from early stages of HCC development with application for better etiologic understanding, prevention, and early detection of this increasingly common cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15758, title = {Violence Against Children in the Asia Pacific Region: The Situation Is Becoming Clearer}, author = {M P Dunne and W Y Choo and B Madrid and R Subrahmanian and L Rumble and S Blight and M C Maternowska}, doi = {10.1177/1010539515602184}, issn = {1010-5395}, year = {2015}, date = {2015-01-01}, journal = {Asia Pac J Public Health}, volume = {27}, number = {8 Suppl}, pages = {6s-8s}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14168, title = {Dietary fat, fat subtypes and hepatocellular carcinoma in a large European cohort}, author = {T Duarte-Salles and V Fedirko and M Stepien and K Aleksandrova and C Bamia and P Lagiou and A S Laursen and L Hansen and K Overvad and A Tjonneland and M C Boutron-Ruault and G Fagherazzi and M His and H Boeing and V Katzke and T Kuhn and A Trichopoulou and E Valanou and M Kritikou and G Masala and S Panico and S Sieri and F Ricceri and R Tumino and H B Bueno-de-Mesquita and P H Peeters and A Hjartaker and G Skeie and E Weiderpass and E Ardanaz and C Bonet and M D Chirlaque and M Dorronsoro and J R Quiros and I Johansson and B Ohlsson and K Sjoberg and M Wennberg and K T Khaw and R C Travis and N Wareham and P Ferrari and H Freisling and I Romieu and A J Cross and M Gunter and Y Lu and M Jenab}, url = {http://onlinelibrary.wiley.com/doi/10.1002/ijc.29643/abstract}, doi = {10.1002/ijc.29643}, issn = {0020-7136}, year = {2015}, date = {2015-01-01}, journal = {Int J Cancer}, volume = {137}, number = {11}, pages = {2715-28}, abstract = {The role of amount and type of dietary fat consumption in the etiology of hepatocellular carcinoma (HCC) is poorly understood, despite suggestive biological plausibility. The associations of total fat, fat subtypes and fat sources with HCC incidence were investigated in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, which includes 191 incident HCC cases diagnosed between 1992 and 2010. Diet was assessed by country-specific, validated dietary questionnaires. A single 24-hr diet recall from a cohort subsample was used for measurement error calibration. Hazard ratios (HR) and 95% confidence intervals (95% CI) were estimated from Cox proportional hazard models. Hepatitis B and C viruses (HBV/HCV) status and biomarkers of liver function were assessed separately in a nested case-control subset with available blood samples (HCC = 122). In multivariable calibrated models, there was a statistically significant inverse association between total fat intake and risk of HCC (per 10 g/day}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14171, title = {Risk and Protective Factors for Cigarette Use in Young Adolescents in a School Setting: What Could Be Done Better?}, author = {M Dahlui and N K Jahan and H A Majid and M Y Jalaludin and L Murray and M Cantwell and T T Su and N Al-Sadat}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4466253/pdf/pone.0129628.pdf}, doi = {10.1371/journal.pone.0129628}, issn = {1932-6203}, year = {2015}, date = {2015-01-01}, journal = {PLoS One}, volume = {10}, number = {6}, pages = {e0129628}, abstract = {Smoking among Malaysian adolescents remains a public health concern despite concerted efforts in tobacco control. The aims of this study were to examine the prevalence and determinants of current-smoking status in young adolescents. This cross sectional study used the first round of the Malaysian Health and Adolescents Research Team's prospective cohort study. It was conducted in three States of the Central and Northern regions of Peninsular Malaysia between March and May 2012. The study used the multistage stratified sampling design. A total of 1,342 adolescents of both sexes, aged 12-13 years, were sampled from randomly selected urban and rural national schools. Information on current smoking status and associated factors were collected by a self-administered, pre-tested, validated, structured questionnaire. Seven percent of the samples were current-smokers; the majority (62%) of them started smoking at the age of 11 years or below. The prevalence of current smoking was significantly higher in males (odds ratio [OR] = 2.37; 95% CI: 1.46, 3.84), those who were influenced by smoker friends (OR = 8.35; 95% CI: 4.90, 14.25), who were unaware of the health risks of smoking (OR =1.85; 95% CI: 1.02, 3.36) and who reported a lack of satisfaction about their overall life (OR =3.26; 95% CI: 1.73, 6.12). The study findings provide valuable information to strengthen the existing school-based smoking prevention program through integration of social competence and social influence curricula. The program should empower the young adolescents to refuse tobacco offers, to overcome social influences and to resist peer pressure to avoid starting smoking. Particular focuses to include mental health service to prevent both emotional and behavioural problems are needed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15729, title = {HIV/AIDS Related Stigma and Discrimination against PLWHA in Nigerian Population}, author = {M Dahlui and N Azahar and A Bulgiba and R Zaki and O M Oche and F O Adekunjo and K Chinna}, doi = {10.1371/journal.pone.0143749}, issn = {1932-6203}, year = {2015}, date = {2015-01-01}, journal = {PLoS One}, volume = {10}, number = {12}, pages = {e0143749}, abstract = {BACKGROUND: HIV/AIDS remain a major public health concern in Nigeria. People living with HIV/AIDS (PLWHA) face not only personal medical problems but also social problems associated with the disease such as stigma and discriminatory attitudes. This study provides an insight into HIV/AIDS related stigma and discrimination against PLWHA in Nigeria. METHODS: The data for this study was extracted from the 2013 Nigeria Demographic and Health Survey conducted by the National Population Commission. All men and women aged 15-49 years, permanent residents and visitors of the households were eligible for the interview. Several questionnaires were used in the survey, some covering questions on HIV/AIDS. RESULTS: A total of 56 307 men and women aged 15-49 years participated in this national survey. About half of the population in Nigeria have HIV stigma. Younger persons, men, those without formal education and those within poor wealth index are more likely to have stigma towards PLWHA. In addition, married people are more likely to have stigma on PLWHA and are more likely to blame PLWHA for bringing the disease to the community. Also about half of the population discriminates against PLWHA. However, those with higher levels of education and those from higher wealth index seem to be more compassionate towards PLWHA. About 70% in the population are willing to care for relative with AIDS, even more so among those with higher level of education. CONCLUSION: There is a high level of HIV stigma and discrimination against PLWHA in the Nigerian population. Education seems to play a major role in the society with respect to HIV stigma and discrimination against PLWHA. Educating the population with factual information on HIV/AIDS is needed to reduce stigma and discrimination towards PLWHA in the community.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15746, title = {Quality of Life in CAM and Non-CAM Users among Breast Cancer Patients during Chemotherapy in Malaysia}, author = {P L Chui and K L Abdullah and L P Wong and N A Taib}, doi = {10.1371/journal.pone.0139952}, issn = {1932-6203}, year = {2015}, date = {2015-01-01}, journal = {PLoS One}, volume = {10}, number = {10}, pages = {e0139952}, abstract = {BACKGROUND: Complementary and alternative medicine (CAM) use has become increasingly popular among patients with cancer. The purposes of this study were to compare the QOL in CAM users and non-CAM users and to determine whether CAM use influences QOL among breast cancer patients during chemotherapy. METHODOLOGY: A cross-sectional survey was conducted at two outpatient chemotherapy centers. A total of 546 patients completed the questionnaires on CAM use. QOL was evaluated based on the European Organization for Research and Treatment of Cancer (EORTC) core quality of life (QLQ-C30) and breast cancer-specific quality of life (QLQ-BR23) questionnaires. RESULTS: A total of 70.7% of patients were identified as CAM users. There was no significant difference in global health status scores and in all five subscales of the QLQ C30 functional scales between CAM users and non-CAM users. On the QLQ-C30 symptom scales, CAM users (44.96+/-3.89) had significantly (p = 0.01) higher mean scores for financial difficulties than non-CAM users (36.29+/-4.81). On the QLQ-BR23 functional scales, CAM users reported significantly higher mean scores for sexual enjoyment (6.01+/-12.84 vs. 4.64+/-12.76}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15969, title = {Reliability and validity of the Malay International Physical Activity Questionnaire (IPAQ-M) among a Malay population in Malaysia}, author = {A H Chu and F M Moy}, doi = {10.1177/1010539512444120}, issn = {1010-5395}, year = {2015}, date = {2015-01-01}, journal = {Asia Pac J Public Health}, volume = {27}, number = {2}, pages = {Np2381-9}, abstract = {The International Physical Activity Questionnaire (IPAQ) was developed to assess the physical activity patterns in populations. The authors aim to examine the reliability and validity of the Malay version of IPAQ (IPAQ-M). The IPAQ-M was self-administered twice at a 1-week interval to assess its test-retest reliability. Criterion validity was assessed between the IPAQ-M and a 7-day physical activity log (PA-Log). A total of 81 Malay adults participated in the study. Intraclass correlation coefficients (ICC), kappa (kappa), correlation coefficients (rho), and Bland-Altman plot were used for data analyses. The ICC scores revealed moderate to good correlations (ICC = 0.54-0.92; P \< .001) on items categorized by intensities and domains and a kappa of 0.73 for total activity. Validity results from the PA-Log were statistically significant (P \< .001) across intensities and domains (rho = 0.67-0.98). The IPAQ-M demonstrated good reliability and validity for the evaluation of physical activity among this Malay population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14363, title = {Perceived Barriers and Facilitators for Return to Work Among Colorectal Cancer Survivors: Malaysian Healthcare Professionals Experience-A Qualitative Inquiry}, author = {S L Chow and S Y Loh and T T Su}, url = {https://www.jstage.jst.go.jp/article/juoeh/37/2/37_127/_pdf}, doi = {10.7888/juoeh.37.127}, issn = {0387-821X (Print) 0387-821x}, year = {2015}, date = {2015-01-01}, journal = {J uoeh}, volume = {37}, number = {2}, pages = {127-38}, abstract = {Return to work (RTW) can be a challenging occupational health (OH) issue among previously-employed colorectal cancer survivors. This study aimed to explore the various perceived barriers and facilitators encountered during the RTW process in cancer survivorship, from the perception of healthcare professionals (HCP). Face to face, semistructured interviews were carried out on twelve HCP (government and private sectors) from various disciplines. Data collected were transcribed verbatim and data management was aided by NVivo software 8.0. A new theory from contextual data was generated using open coding, axial coding and selective coding. The HCP shared numerous barriers and facilitators associated with RTW, under four categories. The key barriers were disturbing side effects, psychological barriers (personal factor), compensation (financial factor), poor ability to multitask (work-related factor), long paid medical leaves policy, employer's lackadaisical attitude, lack of knowledge and awareness of RTW (environmental factor). Key facilitators identified were desire to resume working life and to contribute to society (personal factor), financial pressure, maintain organizational health insurance (financial factor), less physically demanding job (work-related factor), supportive workplace and strict organizational policy on medical leaves (environmental factor). While not all HCP were trained in RTW, they all agreed that RTW is important for survivors and workplace. Occupational health doctors have a direct role in helping survivors RTW. Early Intervention on RTW during survivorship should involve occupational health doctors and employers, targeting the modifiable factors (environmental and work-related) to improve RTW after cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14205, title = {Coffee consumption and coronary artery calcium in young and middle-aged asymptomatic adults}, author = {Y Choi and Y Chang and S Ryu and J Cho and S Rampal and Y Zhang and J Ahn and J A Lima and H Shin and E Guallar}, url = {http://heart.bmj.com/content/101/9/686.full.pdf}, doi = {10.1136/heartjnl-2014-306663}, issn = {1355-6037}, year = {2015}, date = {2015-01-01}, journal = {Heart}, volume = {101}, number = {9}, pages = {686-91}, abstract = {OBJECTIVE: To investigate the association between regular coffee consumption and the prevalence of coronary artery calcium (CAC) in a large sample of young and middle-aged asymptomatic men and women. METHODS: This cross-sectional study included 25 138 men and women (mean age 41.3 years) without clinically evident cardiovascular disease who underwent a health screening examination that included a validated food frequency questionnaire and a multidetector CT to determine CAC scores. We used robust Tobit regression analyses to estimate the CAC score ratios associated with different levels of coffee consumption compared with no coffee consumption and adjusted for potential confounders. RESULTS: The prevalence of detectable CAC (CAC score \>0) was 13.4% (n=3364), including 11.3% prevalence for CAC scores 1-100 (n=2832), and 2.1% prevalence for CAC scores \>100 (n=532). The mean +/-SD consumption of coffee was 1.8+/-1.5 cups/day. The multivariate-adjusted CAC score ratios (95% CIs) comparing coffee drinkers of \<1, 1-\<3, 3-\<5, and \>/=5 cups/day to non-coffee drinkers were 0.77 (0.49 to 1.19), 0.66 (0.43 to 1.02), 0.59 (0.38 to 0.93), and 0.81 (0.46 to 1.43), respectively (p for quadratic trend=0.02). The association was similar in subgroups defined by age, sex, smoking status, alcohol consumption, status of obesity, diabetes, hypertension, and hypercholesterolaemia. CONCLUSIONS: In this large sample of men and women apparently free of clinically evident cardiovascular disease, moderate coffee consumption was associated with a lower prevalence of subclinical coronary atherosclerosis.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14169, title = {Relation of Dietary Glycemic Index and Glycemic Load to Coronary Artery Calcium in Asymptomatic Korean Adults}, author = {Y Choi and Y Chang and S Ryu and J Cho and M K Kim and Y Ahn and J E Lee and E Sung and B Kim and J Ahn and C W Kim and S Rampal and D Zhao and Y Zhang and R Pastor-Barriuso and J A Lima and E C Chung and H Shin and E Guallar}, url = {http://ac.els-cdn.com/S0002914915013296/1-s2.0-S0002914915013296-main.pdf?_tid=fc65512a-66a7-11e5-9aaf-00000aab0f26\&acdnat=1443530918_1573934e4f89455fa9637edba408cdf6}, doi = {10.1016/j.amjcard.2015.05.005}, issn = {0002-9149}, year = {2015}, date = {2015-01-01}, journal = {Am J Cardiol}, volume = {116}, number = {4}, pages = {520-6}, abstract = {The relation between glycemic index, glycemic load, and subclinical coronary atherosclerosis is unknown. The aim of the study was to evaluate the associations between energy-adjusted glycemic index, glycemic load, and coronary artery calcium (CAC). This study was cross-sectional analysis of 28,429 asymptomatic Korean men and women (mean age 41.4 years) without a history of diabetes or cardiovascular disease. All participants underwent a health screening examination between March 2011 and April 2013, and dietary intake over the preceding year was estimated using a validated food frequency questionnaire. Cardiac computed tomography was used for CAC scoring. The prevalence of detectable CAC (CAC score \>0) was 12.4%. In multivariable-adjusted models, the CAC score ratios (95% confidence intervals) comparing the highest to the lowest quintile of glycemic index and glycemic load were 1.74 (1.08 to 2.81; p trend = 0.03) and 3.04 (1.43 to 6.46; p trend = 0.005), respectively. These associations did not differ by clinical subgroups, including the participants at low cardiovascular risk. In conclusion, these findings suggest that high dietary glycemic index and glycemic load were associated with a greater prevalence and degree of CAC, with glycemic load having a stronger association.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14172, title = {Egg consumption and coronary artery calcification in asymptomatic men and women}, author = {Y Choi and Y Chang and J E Lee and S Chun and J Cho and E Sung and B S Suh and S Rampal and D Zhao and Y Zhang and R Pastor-Barriuso and J A Lima and H Shin and S Ryu and E Guallar}, url = {http://ac.els-cdn.com/S0021915015013507/1-s2.0-S0021915015013507-main.pdf?_tid=ef114ad8-66a7-11e5-a255-00000aab0f02\&acdnat=1443530896_4de289dffd62a114f24e99f82f25dea7}, doi = {10.1016/j.atherosclerosis.2015.05.036}, issn = {0021-9150}, year = {2015}, date = {2015-01-01}, journal = {Atherosclerosis}, volume = {241}, number = {2}, pages = {305-12}, abstract = {OBJECTIVE: The association of egg consumption with subclinical coronary atherosclerosis remains unknown. Our aim was to examine the association between egg consumption and prevalence of coronary artery calcium (CAC). METHODS: Cross-sectional study of 23,417 asymptomatic adult men and women without a history of cardiovascular disease (CVD) or hypercholesterolemia, who underwent a health screening examination including cardiac computed tomography for CAC scoring and completed a validated food frequency questionnaire at the Kangbuk Samsung Hospital Total Healthcare Centers, South Korea (March 2011-April 2013). RESULTS: The prevalence of detectable CAC (CAC score \> 0) was 11.2%. In multivariable-adjusted models, CAC score ratio (95% confidence interval [CI]) comparing participants eating \>/= 7 eggs/wk to those eating \< 1 egg/wk was 1.80 (1.14-2.83; P for trend = 0.003). The multivariable CAC score ratio (95% CI) associated with an increase in consumption of 1 egg/day was 1.54 (1.11-2.14). The positive association seemed to be more pronounced among participants with low vegetable intake (P for interaction = 0.02) and those with high BMI (P for interaction = 0.05). The association was attenuated and no longer significant after further adjustment for dietary cholesterol. CONCLUSION: Egg consumption was associated with an increased prevalence of subclinical coronary atherosclerosis and with a greater degree of coronary calcification in asymptomatic Korean adults, which may be mediated by dietary cholesterol. The association was particularly pronounced among individuals with low vegetable intake and those with high BMI.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14357, title = {Common variation at 2p13.3, 3q29, 7p13 and 17q25.1 associated with susceptibility to pancreatic cancer}, author = {E J Childs and E Mocci and D Campa and P M Bracci and S Gallinger and M Goggins and D Li and R E Neale and S H Olson and G Scelo and L T Amundadottir and W R Bamlet and M F Bijlsma and A Blackford and M Borges and P Brennan and H Brenner and H B Bueno-de-Mesquita and F Canzian and G Capurso and G M Cavestro and K G Chaffee and S J Chanock and S P Cleary and M Cotterchio and L Foretova and C Fuchs and N Funel and M Gazouli and M Hassan and J M Herman and I Holcatova and E A Holly and R N Hoover and R J Hung and V Janout and T J Key and J Kupcinskas and R C Kurtz and S Landi and L Lu and E Malecka-Panas and A Mambrini and B Mohelnikova-Duchonova and J P Neoptolemos and A L Oberg and I Orlow and C Pasquali and R Pezzilli and C Rizzato and A Saldia and A Scarpa and R Z Stolzenberg-Solomon and O Strobel and F Tavano and Y K Vashist and P Vodicka and B M Wolpin and H Yu and G M Petersen and H A Risch and A P Klein}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520746/pdf/nihms695333.pdf}, doi = {10.1038/ng.3341}, issn = {1061-4036}, year = {2015}, date = {2015-01-01}, journal = {Nat Genet}, volume = {47}, number = {8}, pages = {911-6}, abstract = {Pancreatic cancer is the fourth leading cause of cancer death in the developed world. Both inherited high-penetrance mutations in BRCA2 (ref. 2), ATM, PALB2 (ref. 4), BRCA1 (ref. 5), STK11 (ref. 6), CDKN2A and mismatch-repair genes and low-penetrance loci are associated with increased risk. To identify new risk loci, we performed a genome-wide association study on 9,925 pancreatic cancer cases and 11,569 controls, including 4,164 newly genotyped cases and 3,792 controls in 9 studies from North America, Central Europe and Australia. We identified three newly associated regions: 17q25.1 (LINC00673, rs11655237, odds ratio (OR) = 1.26, 95% confidence interval (CI) = 1.19-1.34}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14371, title = {Validation of the Framingham general cardiovascular risk score in a multiethnic Asian population: a retrospective cohort study}, author = {Y C Chia and S Y Gray and S M Ching and H M Lim and K Chinna}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442208/pdf/bmjopen-2014-007324.pdf}, doi = {10.1136/bmjopen-2014-007324}, year = {2015}, date = {2015-01-01}, journal = {BMJ Open}, volume = {5}, number = {5}, pages = {e007324}, abstract = {OBJECTIVE: This study aims to examine the validity of the Framingham general cardiovascular disease (CVD) risk chart in a primary care setting. DESIGN: This is a 10-year retrospective cohort study. SETTING: A primary care clinic in a teaching hospital in Malaysia. PARTICIPANTS: 967 patients' records were randomly selected from patients who were attending follow-up in the clinic. MAIN OUTCOME MEASURES: Baseline demographic data, history of diabetes and smoking, blood pressure (BP), and serum lipids were captured from patient records in 1998. Each patient's Framingham CVD score was computed from these parameters. All atherosclerotic CVD events occurring between 1998 and 2007 were counted. RESULTS: In 1998, mean age was 57 years with 33.8% men, 6.1% smokers, 43.3% diabetics and 59.7% hypertensive. Median BP was 140/80 mm Hg and total cholesterol 6.0 mmol/L (1.3). The predicted median Framingham general CVD risk score for the study population was 21.5% (IQR 1.2-30.0) while the actual CVD events that occurred in the 10 years was 13.1% (127/967). The median CVD points for men was 30.0, giving them a CVD risk of more than 30%; for women it is 18.5, a CVD risk of 21.5%. Our study found that the Framingham general CVD risk score to have moderate discrimination with an area under the receiver operating characteristic curve (AUC) of 0.63. It also discriminates well for Malay (AUC 0.65}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14348, title = {Practices of Dengue Fever Prevention and the Associated Factors among the Orang Asli in Peninsular Malaysia}, author = {J R Chandren and L P Wong and S AbuBakar}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4534093/pdf/pntd.0003954.pdf}, doi = {10.1371/journal.pntd.0003954}, issn = {1935-2727}, year = {2015}, date = {2015-01-01}, journal = {PLoS Negl Trop Dis}, volume = {9}, number = {8}, pages = {e0003954}, abstract = {BACKGROUND: Dengue is prevalent among Malaysia's indigenous peoples, known as the Orang Asli, and it poses a serious health threat to them. The study aims to look at the socio-demographic factors, health beliefs, and knowledge about dengue and its association to dengue prevention practices among Orang Asli communities in Peninsular Malaysia. METHODS: A cross-sectional survey was conducted in 16 randomly selected Orang Asli villages from eight states in Peninsular Malaysia from April 2012 until February 2013. RESULTS: A total of 560 Orang Asli were interviewed and 505 completed the survey. Slightly above half of the participants (n = 280, 55.4%) had a total dengue prevention score of 51-100 (of a possible score of 0-100). Multivariate analysis findings showed dengue knowledge, perceived barriers to perform dengue prevention, fogging frequency, and perceived susceptibility to dengue fever as significant factors associated to dengue prevention practices. Participants with a lower dengue knowledge score (score 0-18) were less likely (OR = 0.63, 95%CI = 0.44-0.92 vs. score 19-36}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14398, title = {Plasma elaidic acid level as biomarker of industrial trans fatty acids and risk of weight change: report from the EPIC study}, author = {V Chajes and C Biessy and P Ferrari and I Romieu and H Freisling and I Huybrechts and A Scalbert and B Bueno Mesquita and D Romaguera and M J Gunter and P Vineis and C P Hansen and M U Jakobsen and F Clavel-Chapelon and G Fagherazzi and M C Boutron-Ruault and V Katzke and J Neamat-Allah and H Boeing and U Bachlechner and A Trichopoulou and A Naska and P Orfanos and V Pala and G Masala and A Mattiello and G Skeie and E Weiderpass and A Agudo and J M Huerta and E Ardanaz and M J Sanchez and M Dorronsoro and J R Quiros and I Johansson and A Winkvist and E Sonested and T Key and K T Khaw and N J Wareham and P H Peeters and N Slimani}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4326417/pdf/pone.0118206.pdf}, doi = {10.1371/journal.pone.0118206}, issn = {1932-6203}, year = {2015}, date = {2015-01-01}, journal = {PLoS One}, volume = {10}, number = {2}, pages = {e0118206}, abstract = {BACKGROUND: Few epidemiological studies have examined the association between dietary trans fatty acids and weight gain, and the evidence remains inconsistent. The main objective of the study was to investigate the prospective association between biomarker of industrial trans fatty acids and change in weight within the large study European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. METHODS: Baseline plasma fatty acid concentrations were determined in a representative EPIC sample from the 23 participating EPIC centers. A total of 1,945 individuals were followed for a median of 4.9 years to monitor weight change. The association between elaidic acid level and percent change of weight was investigated using a multinomial logistic regression model, adjusted by length of follow-up, age, energy, alcohol, smoking status, physical activity, and region. RESULTS: In women, doubling elaidic acid was associated with a decreased risk of weight loss (odds ratio (OR) = 0.69, 95% confidence interval (CI) = 0.55-0.88}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14377, title = {TERT gene harbors multiple variants associated with pancreatic cancer susceptibility}, author = {D Campa and C Rizzato and R Stolzenberg-Solomon and P Pacetti and P Vodicka and S P Cleary and G Capurso and H B Bueno-de-Mesquita and J Werner and M Gazouli and K Butterbach and A Ivanauskas and N Giese and G M Petersen and P Fogar and Z Wang and C Bassi and M Ryska and G E Theodoropoulos and C Kooperberg and D Li and W Greenhalf and C Pasquali and T Hackert and C S Fuchs and B Mohelnikova-Duchonova and C Sperti and N Funel and A K Dieffenbach and N J Wareham and J Buring and I Holcatova and E Costello and C F Zambon and J Kupcinskas and H A Risch and P Kraft and P M Bracci and R Pezzilli and S H Olson and H D Sesso and P Hartge and O Strobel and E Malecka-Panas and K Visvanathan and A A Arslan and S Pedrazzoli and P Soucek and D Gioffreda and T J Key and R Talar-Wojnarowska and A Scarpa and A Mambrini and E J Jacobs and K Jamroziak and A Klein and F Tavano and F Bambi and S Landi and M A Austin and L Vodickova and H Brenner and S J Chanock and G Delle Fave and A Piepoli and M Cantore and W Zheng and B M Wolpin and L T Amundadottir and F Canzian}, url = {http://onlinelibrary.wiley.com/doi/10.1002/ijc.29590/abstract}, doi = {10.1002/ijc.29590}, issn = {0020-7136}, year = {2015}, date = {2015-01-01}, journal = {Int J Cancer}, volume = {137}, number = {9}, pages = {2175-83}, abstract = {A small number of common susceptibility loci have been identified for pancreatic cancer, one of which is marked by rs401681 in the TERT-CLPTM1L gene region on chromosome 5p15.33. Because this region is characterized by low linkage disequilibrium, we sought to identify whether additional single nucleotide polymorphisms (SNPs) could be related to pancreatic cancer risk, independently of rs401681. We performed an in-depth analysis of genetic variability of the telomerase reverse transcriptase (TERT) and the telomerase RNA component (TERC) genes, in 5,550 subjects with pancreatic cancer and 7,585 controls from the PANcreatic Disease ReseArch (PANDoRA) and the PanScan consortia. We identified a significant association between a variant in TERT and pancreatic cancer risk (rs2853677, odds ratio = 0.85; 95% confidence interval = 0.80-0.90}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14364, title = {Brachial-ankle pulse wave velocity is associated with coronary calcium in young and middle-aged asymptomatic adults: The Kangbuk Samsung Health Study}, author = {M Cainzos-Achirica and S Rampal and Y Chang and S Ryu and Y Zhang and D Zhao and J Cho and Y Choi and R Pastor-Barriuso and S Y Lim and J Bruguera and R Elosua and J A Lima and H Shin and E Guallar}, url = {http://ac.els-cdn.com/S0021915015013453/1-s2.0-S0021915015013453-main.pdf?_tid=f3f529ca-e12c-11e5-b077-00000aacb35e\&acdnat=1457002069_d04e396c1e45f1d96fb58fbccf5b5e8f}, doi = {10.1016/j.atherosclerosis.2015.05.031}, issn = {0021-9150}, year = {2015}, date = {2015-01-01}, journal = {Atherosclerosis}, volume = {241}, number = {2}, pages = {350-6}, abstract = {OBJECTIVE: To evaluate the association between brachial-ankle pulse wave velocity (baPWV), a convenient, non-radiating, readily available measurement of arterial stiffness, and coronary artery calcium (CAC), a reliable marker of coronary atherosclerosis, in a large sample of young and middle-aged asymptomatic adults; and to assess the incremental value of baPWV for detecting prevalent CAC beyond traditional risk factors. METHODS: Cross-sectional study of 15,185 asymptomatic Korean adults who voluntarily underwent a comprehensive health screening program including measurement of baPWV and CAC. BaPWV was measured using an oscillometric method with cuffs placed on both arms and ankles. CAC burden was assessed using a multi-detector CT scan and scored following Agatston's method. RESULTS: The prevalence of CAC \> 0 and CAC \> 100 increased across baPWV quintiles. The multivariable-adjusted odds ratios (95% CI) for CAC \> 0 comparing baPWV quintiles 2-5 versus quintile 1 were 1.06 (0.87-1.30), 1.24 (1.02-1.50), 1.39 (1.15-1.69) and 1.60 (1.31-1.96), respectively (P trend \< 0.001). Similarly, the relative prevalence ratios for CAC \> 100 were 1.30 (0.74-2.26), 1.59 (0.93-2.71), 1.74 (1.03-2.94) and 2.59 (1.54-4.36), respectively (P trend \< 0.001). For CAC \> 100, the area under the ROC curve for baPWV alone was 0.71 (0.68-0.74), and the addition of baPWV to traditional risk factors significantly improved the discrimination and calibration of models for detecting prevalent CAC \> 0 and CAC \> 100. CONCLUSIONS: BaPWV was independently associated with the presence and severity of CAC in a large sample of young and middle-aged asymptomatic adults. BaPWV may be a valuable tool for identifying apparently low-risk individuals with increased burden of coronary atherosclerosis.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14393, title = {Diabetes and onset of natural menopause: results from the European Prospective Investigation into Cancer and Nutrition}, author = {J S Brand and N C Onland-Moret and M J Eijkemans and A Tjonneland and N Roswall and K Overvad and G Fagherazzi and F Clavel-Chapelon and L Dossus and A Lukanova and V Grote and M M Bergmann and H Boeing and A Trichopoulou and M Tzivoglou and D Trichopoulos and S Grioni and A Mattiello and G Masala and R Tumino and P Vineis and H B Bueno-de-Mesquita and E Weiderpass and M L Redondo and M J Sanchez and J M Castano and L Arriola and E Ardanaz and E J Duell and O Rolandsson and P W Franks and S Butt and P Nilsson and K T Khaw and N Wareham and R Travis and I Romieu and M J Gunter and E Riboli and Y T Schouw}, url = {http://humrep.oxfordjournals.org/content/30/6/1491.full.pdf}, doi = {10.1093/humrep/dev054}, issn = {0268-1161}, year = {2015}, date = {2015-01-01}, journal = {Hum Reprod}, volume = {30}, number = {6}, pages = {1491-8}, abstract = {STUDY QUESTION: Do women who have diabetes before menopause have their menopause at an earlier age compared with women without diabetes? SUMMARY ANSWER: Although there was no overall association between diabetes and age at menopause, our study suggests that early-onset diabetes may accelerate menopause. WHAT IS KNOWN ALREADY: Today, more women of childbearing age are being diagnosed with diabetes, but little is known about the impact of diabetes on reproductive health. STUDY DESIGN, SIZE, DURATION: We investigated the impact of diabetes on age at natural menopause (ANM) in 258 898 women from the European Prospective Investigation into Cancer and Nutrition (EPIC), enrolled between 1992 and 2000. PARTICIPANTS/MATERIALS, SETTING, METHODS: Determinant and outcome information was obtained through questionnaires. Time-dependent Cox regression analyses were used to estimate the associations of diabetes and age at diabetes diagnosis with ANM, stratified by center and adjusted for age, smoking, reproductive and diabetes risk factors and with age from birth to menopause or censoring as the underlying time scale. MAIN RESULTS AND THE ROLE OF CHANCE: Overall, no association between diabetes and ANM was found (hazard ratio (HR) = 0.94; 95% confidence interval (CI) 0.89-1.01). However, women with diabetes before the age of 20 years had an earlier menopause (10-20 years: HR = 1.43; 95% CI 1.02-2.01, \<10 years: HR = 1.59; 95% CI 1.03-2.43) compared with non-diabetic women, whereas women with diabetes at age 50 years and older had a later menopause (HR = 0.81; 95% CI 0.70-0.95). None of the other age groups were associated with ANM. LIMITATIONS, REASONS FOR CAUTION: Strengths of the study include the large sample size and the broad set of potential confounders measured. However, results may have been underestimated due to survival bias. We cannot be sure about the sequence of the events in women with a late age at diabetes, as both events then occur in a short period. We could not distinguish between type 1 and type 2 diabetes. WIDER IMPLICATIONS OF THE FINDINGS: Based on the literature, an accelerating effect of early-onset diabetes on ANM might be plausible. A delaying effect of late-onset diabetes on ANM has not been reported before, and is not in agreement with recent studies suggesting the opposite association. STUDY FUNDING/COMPETING INTERESTS: The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Generale de l'Education Nationale, Institut National de la Sante et de la Recherche Medicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ) and Federal Ministry of Education and Research (BMMF) (Germany); Ministry of Health and Social Solidarity, Stavros Niarchos Foundation and Hellenic Health Foundation (Greece); Italian Association for Research on Cancer (AIRC) and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); ERC-2009-AdG 232997 and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway); Health Research Fund (FIS), Regional Governments of Andalucia, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Scientific Council and Regional Government of Skane and Vasterbotten (Sweden); Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, and Wellcome Trust (UK). None of the authors reported a conflict of interest.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14615, title = {Prognostic role of adjuvant radiotherapy in triple-negative breast cancer: A historical cohort study}, author = {N Bhoo-Pathy and H M Verkooijen and F Y Wong and J P Pignol and A Kwong and E Y Tan and N Aishah Taib and W L Nei and G F Ho and B Tan and P Chan and S C Lee and M Hartman and C H Yip and R Dent}, url = {http://onlinelibrary.wiley.com/doi/10.1002/ijc.29617/abstract http://onlinelibrary.wiley.com/store/10.1002/ijc.29617/asset/ijc29617.pdf?v=1\&t=j730rpne\&s=349ac5d7a63459f5cd8e0093ba97c6cd884aa768}, doi = {10.1002/ijc.29617}, issn = {0020-7136}, year = {2015}, date = {2015-01-01}, journal = {Int J Cancer}, volume = {137}, number = {10}, pages = {2504-12}, abstract = {The value of adjuvant radiotherapy in triple-negative breast cancer (TNBC) is currently debated. We assessed the association between adjuvant radiotherapy and survival in a large cohort of Asian women with TNBC. Women diagnosed with TNBC from 2006 to 2011 in five Asian centers (N = 1,138) were included. Survival between patients receiving mastectomy only, breast-conserving therapy (BCT, lumpectomy and adjuvant radiotherapy) and mastectomy with radiotherapy were compared, and adjusted for demography, tumor characteristics and chemotherapy types. Median age at diagnosis was 53 years (range: 23-96 years). Median tumor size at diagnosis was 2.5 cm and most patients had lymph node-negative disease. The majority of patients received adjuvant chemotherapy (n = 861, 76%) comprising predominantly anthracycline-based regimes. In 775 women with T1-2, N0-1, M0 TNBCs, 5-year relative survival ratio (RSR) was highest in patients undergoing mastectomy only (94.7%, 95% CI: 88.8-98.8%), followed by BCT (90.8%, 95% CI: 85.0-94.7%), and mastectomy with radiotherapy (82.3%, 95% CI: 73.4-88.1%). The adjusted risks of mortality between the three groups were not significantly different. In 363 patients with T3-4, N2-3, M0 TNBCs, BCT was associated with highest 5-year RSR (94.1%, 95% CI: 81.3-99.4%), followed by mastectomy with radiotherapy (62.7%, 95% CI: 54.3-70.1%), and mastectomy only (58.6%, 95% CI: 43.5-71.6%). Following multivariable adjustment, BCT and mastectomy with radiotherapy remained significantly associated with lower mortality risk compared to mastectomy only. Overall, adjuvant radiotherapy was associated with higher survival in women aged \<40 years, but not in older women. Adjuvant radiotherapy appears to be independently associated with a survival gain in locally advanced as well as in very young TNBC.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @phdthesis{MHA100027, title = {Economic Evaluation of Rotavirus Vaccination in Libya}, author = {Salem Ibrahim Alkoshi}, year = {2015}, date = {2015-01-01}, note = {Doctor of Philosophy}, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @article{RN15739, title = {Trends in presentation, management and survival of patients with de novo metastatic breast cancer in a Southeast Asian setting}, author = {N Bhoo-Pathy and H M Verkooijen and E Y Tan and H Miao and N A Taib and J S Brand and R A Dent and M H See and S Subramaniam and P Chan and S C Lee and M Hartman and C H Yip}, doi = {10.1038/srep16252}, issn = {2045-2322}, year = {2015}, date = {2015-01-01}, journal = {Sci Rep}, volume = {5}, pages = {16252}, abstract = {Up to 25% of breast cancer patients in Asia present with de novo metastatic disease. We examined the survival trends of Asian patients with metastatic breast cancer over fifteen years. The impact of changes in patient's demography, tumor characteristics, tumor burden, and treatment on survival trend were examined. Patients with de novo metastatic breast cancer from three hospitals in Malaysia and Singapore (N = 856) were grouped by year of diagnosis: 1996-2000, 2001-2005 and 2006-2010. Step-wise multivariable Poisson regression was used to estimate the contribution of above-mentioned factors on the survival trend. Proportions of patients presenting with metastatic breast cancer were 10% in 1996-2000, 7% in 2001-2005, and 9% in 2006-2010. Patients in 2006-2010 were significantly older, appeared to have higher disease burden, and received more chemotherapy, endocrine therapy, and surgery of primary tumor. The three-year relative survival in the above periods were 20.6% (95% CI: 13.9%-28.2%), 28.8% (95% CI: 23.4%-34.2%), and 33.6% (95% CI: 28.8%-38.5%), respectively. Adjustment for treatment considerably attenuated the relative excess risk of mortality in recent years, compared to other factors. Substantial improvements in survival were observed in patients with de novo metastatic breast cancer in this study.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14402, title = {Coffee and tea consumption and risk of pre- and postmenopausal breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study}, author = {N Bhoo-Pathy and P H Peeters and C S Uiterwaal and H B Bueno-de-Mesquita and A M Bulgiba and B H Bech and K Overvad and A Tjonneland and A Olsen and F Clavel-Chapelon and G Fagherazzi and F Perquier and B Teucher and R Kaaks and M Schutze and H Boeing and P Lagiou and P Orfanos and A Trichopoulou and C Agnoli and A Mattiello and D Palli and R Tumino and C Sacerdote and F J Duijnhoven and T Braaten and E Lund and G Skeie and M L Redondo and G Buckland and M J Perez and M D Chirlaque and E Ardanaz and P Amiano and E Wirfalt and P Wallstrom and I Johansson and L M Nilsson and K T Khaw and N Wareham and N E Allen and T J Key and S Rinaldi and I Romieu and V Gallo and E Riboli and C H Gils}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4349221/pdf/13058_2015_Article_521.pdf}, doi = {10.1186/s13058-015-0521-3}, issn = {1465-5411}, year = {2015}, date = {2015-01-01}, journal = {Breast Cancer Res}, volume = {17}, pages = {15}, abstract = {INTRODUCTION: Specific coffee subtypes and tea may impact risk of pre- and post-menopausal breast cancer differently. We investigated the association between coffee (total, caffeinated, decaffeinated) and tea intake and risk of breast cancer. METHODS: A total of 335,060 women participating in the European Prospective Investigation into Nutrition and Cancer (EPIC) Study, completed a dietary questionnaire from 1992 to 2000, and were followed-up until 2010 for incidence of breast cancer. Hazard ratios (HR) of breast cancer by country-specific, as well as cohort-wide categories of beverage intake were estimated. RESULTS: During an average follow-up of 11 years, 1064 premenopausal, and 9134 postmenopausal breast cancers were diagnosed. Caffeinated coffee intake was associated with lower risk of postmenopausal breast cancer: adjusted HR=0.90, 95% confidence interval (CI): 0.82 to 0.98, for high versus low consumption; Ptrend=0.029. While there was no significant effect modification by hormone receptor status (P=0.711), linear trend for lower risk of breast cancer with increasing caffeinated coffee intake was clearest for estrogen and progesterone receptor negative (ER-PR-), postmenopausal breast cancer (P=0.008). For every 100 ml increase in caffeinated coffee intake, the risk of ER-PR- breast cancer was lower by 4% (adjusted HR: 0.96, 95% CI: 0.93 to 1.00). Non-consumers of decaffeinated coffee had lower risk of postmenopausal breast cancer (adjusted HR=0.89; 95% CI: 0.80 to 0.99) compared to low consumers, without evidence of dose-response relationship (Ptrend=0.128). Exclusive decaffeinated coffee consumption was not related to postmenopausal breast cancer risk, compared to any decaffeinated-low caffeinated intake (adjusted HR=0.97; 95% CI: 0.82 to 1.14), or to no intake of any coffee (HR: 0.96; 95%: 0.82 to 1.14). Caffeinated and decaffeinated coffee were not associated with premenopausal breast cancer. Tea intake was neither associated with pre- nor post-menopausal breast cancer. CONCLUSIONS: Higher caffeinated coffee intake may be associated with lower risk of postmenopausal breast cancer. Decaffeinated coffee intake does not seem to be associated with breast cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15737, title = {Reproductive factors and epithelial ovarian cancer survival in the EPIC cohort study}, author = {J Besevic and M J Gunter and R T Fortner and K K Tsilidis and E Weiderpass and N C Onland-Moret and L Dossus and A Tjonneland and L Hansen and K Overvad and S Mesrine and L Baglietto and F Clavel-Chapelon and R Kaaks and K Aleksandrova and H Boeing and A Trichopoulou and P Lagiou and C Bamia and G Masala and C Agnoli and R Tumino and F Ricceri and S Panico and H B Bueno-de-Mesquita and P H Peeters and M Jareid and J R Quiros and E J Duell and M J Sanchez and N Larranaga and M D Chirlaque and A Barricarte and J A Dias and E Sonestedt and A Idahl and E Lundin and N J Wareham and K T Khaw and R C Travis and S Rinaldi and I Romieu and E Riboli and M A Merritt}, doi = {10.1038/bjc.2015.377}, issn = {0007-0920}, year = {2015}, date = {2015-01-01}, journal = {Br J Cancer}, volume = {113}, number = {11}, pages = {1622-31}, abstract = {BACKGROUND: Reproductive factors influence the risk of developing epithelial ovarian cancer (EOC), but little is known about their association with survival. We tested whether prediagnostic reproductive factors influenced EOC-specific survival among 1025 invasive EOC cases identified in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which included 521,330 total participants (approximately 370,000 women) aged 25-70 years at recruitment from 1992 to 2000. METHODS: Information on reproductive characteristics was collected at recruitment. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), and multivariable models were adjusted for age and year of diagnosis, body mass index, tumour stage, smoking status and stratified by study centre. RESULTS: After a mean follow-up of 3.6 years (+/-3.2 s.d.) following EOC diagnosis, 511 (49.9%) of the 1025 women died from EOC. We observed a suggestive survival advantage in menopausal hormone therapy (MHT) users (ever vs never use}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14395, title = {Fruit and vegetable consumption in relation to hepatocellular carcinoma in a multi-centre, European cohort study}, author = {C Bamia and P Lagiou and M Jenab and K Aleksandrova and V Fedirko and D Trichopoulos and K Overvad and A Tjonneland and A Olsen and F Clavel-Chapelon and M C Boutron-Ruault and M Kvaskoff and V A Katzke and T Kuhn and H Boeing and U Nothlings and D Palli and S Sieri and S Panico and R Tumino and A Naccarati and H B Bueno-de-Mesquita and P H Peeters and E Weiderpass and G Skeie and J R Quiros and A Agudo and M D Chirlaque and M J Sanchez and E Ardanaz and M Dorronsoro and U Ericson and L M Nilsson and M Wennberg and K T Khaw and N Wareham and T J Key and R C Travis and P Ferrari and M Stepien and T Duarte-Salles and T Norat and N Murphy and E Riboli and A Trichopoulou}, url = {http://www.nature.com/bjc/journal/v112/n7/pdf/bjc2014654a.pdf}, doi = {10.1038/bjc.2014.654}, issn = {0007-0920}, year = {2015}, date = {2015-01-01}, journal = {Br J Cancer}, volume = {112}, number = {7}, pages = {1273-82}, abstract = {BACKGROUND: Vegetable and/or fruit intakes in association with hepatocellular carcinoma (HCC) risk have been investigated in case-control studies conducted in specific European countries and cohort studies conducted in Asia, with inconclusive results. No multi-centre European cohort has investigated the indicated associations. METHODS: In 486,799 men/women from the European Prospective Investigation into Cancer and nutrition, we identified 201 HCC cases after 11 years median follow-up. We calculated adjusted hazard ratios (HRs) for HCC incidence for sex-specific quintiles and per 100 g d(-1) increments of vegetable/fruit intakes. RESULTS: Higher vegetable intake was associated with a statistically significant, monotonic reduction of HCC risk: HR (100 g d(-1) increment): 0.83; 95% CI: 0.71-0.98. This association was consistent in sensitivity analyses with no apparent heterogeneity across strata of HCC risk factors. Fruit intake was not associated with HCC incidence: HR (100 g d(-1) increment): 1.01; 95% CI: 0.92-1.11. CONCLUSIONS: Vegetable, but not fruit, intake is associated with lower HCC risk with no evidence for heterogeneity of this association in strata of important HCC risk factors. Mechanistic studies should clarify pathways underlying this association. Given that HCC prognosis is poor and that vegetables are practically universally accessible, our results may be important, especially for those at high risk for the disease.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14421, title = {The perceived cancer-related financial hardship among patients and their families: a systematic review}, author = {M Azzani and A C Roslani and T T Su}, url = {http://download.springer.com/static/pdf/229/art%253A10.1007%252Fs00520-014-2474-y.pdf?originUrl=http%3A%2F%2Flink.springer.com%2Farticle%2F10.1007%2Fs00520-014-2474-y\&token2=exp=1449624652~acl=%2Fstatic%2Fpdf%2F229%2Fart%25253A10.1007%25252Fs00520-014-2474-y.pdf%3ForiginUrl%3Dhttp%253A%252F%252Flink.springer.com%252Farticle%252F10.1007%252Fs00520-014-2474-y*~hmac=e710d95aef075a2a3cf5a33d34bbad28b1ddc6b8a765ef551ea0f24538a64792}, doi = {10.1007/s00520-014-2474-y}, issn = {0941-4355}, year = {2015}, date = {2015-01-01}, journal = {Support Care Cancer}, volume = {23}, number = {3}, pages = {889-98}, abstract = {PURPOSE: The escalating health-care spending for cancer management has caused cancer patients to struggle further as a result of financial burden. This systematic review was carried out to investigate the prevalence of perceived financial hardship and associated factors among cancer patients and their families. METHODS: A systematic search for studies concerning the perception of financial burden among cancer patients and their families was conducted. Several electronic resources such as Medline, Elsevier (Science Direct), Web of Science, Embase, PubMed, CINAHL and Scopus (SciVerse) were searched. Additionally, manual search through indices citation was also thoroughly utilized. The main outcome of interest was the prevalence of perceived financial hardship among cancer patients and their families. Studies reported only the cost of cancer treatment and qualitative studies were excluded. Our search was limited to articles that were published from 2003 to 2013. RESULT: Ten studies were included in this review and with a majority originating from high-income countries. The prevalence of the financial burden perception was reported between 14.8 and 78.8 %. The most frequent and significant risk factor reported associated with the perception of financial difficulty was the households with low income. Discontinuation of treatment and poverty were conversely the important consequences of financial burden in cancer patients and their families. CONCLUSION: Evidently, cancer is a long-term illness that requires a high financial cost, and a significant number of cancer patients and families struggle with financial difficulty. Identifying such groups with a high risk of facing financial difficulty is a crucial measure to ensure safety nets are readily available for these targeted population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15792, title = {Polymorphisms of the resistin gene and their association with obesity and resistin levels in Malaysian Malays}, author = {Y D Apalasamy and S Rampal and A Salim and F M Moy and T T Su and H A Majid and A Bulgiba and Z Mohamed}, doi = {10.1007/s10528-015-9678-9}, issn = {0006-2928}, year = {2015}, date = {2015-01-01}, journal = {Biochem Genet}, volume = {53}, number = {4-6}, pages = {120-31}, abstract = {Single nucleotide polymorphisms (SNP) in the resistin gene (RETN) are linked to obesity and resistin levels in various populations. However, results have been inconsistent. This study aimed to investigate association between polymorphisms in the resistin gene with obesity in a homogenous Malaysian Malay population. This study is also aimed to determine association between resistin levels with certain SNPs and haplotypes of RETN. A total of 631 Malaysian Malay subjects were included in this study and genotyping was carried out using Sequenom MassARRAY. There was no significant difference found in both allelic and genotype frequencies of each of the RETN SNPs between the obese and non-obese groups after Bonferroni correction. RETN rs34861192 and rs3219175 SNPs were significantly associated with log-resistin levels. The GG genotype carriers are found to have higher levels of log-resistin compared to A allele carriers. The RETN haplotypes (CAG, CGA and GA) were significantly associated with resistin levels. However, the haplotypes of the RETN gene were not associated with obesity. Resistin levels were not correlated to metabolic parameters such as body weight, waist circumference, body mass index, and lipid parameters. RETN SNPs and haplotypes are of apparent functional importance in the regulation of resistin levels but are not correlated with obesity and related markers.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14516, title = {Gender-dependent association of a beta(2)-adrenergic gene variant with obesity parameters in Malaysian Malays}, author = {Y D Apalasamy and M F Ming and S Rampal and A Bulgiba and Z Mohamed}, url = {http://aph.sagepub.com/content/27/2/NP154.full.pdf}, doi = {10.1177/1010539511430250}, issn = {1010-5395}, year = {2015}, date = {2015-01-01}, journal = {Asia Pac J Public Health}, volume = {27}, number = {2}, pages = {Np154-65}, abstract = {Recent findings have shown that the rs1042714 (Gln27Glu) single-nucleotide polymorphism (SNP) on the beta2-adrenoceptor gene may predispose to obesity. The findings from other studies carried on different populations, however, have been inconsistent. The authors investigated the association between the rs1042714 SNP with obesity-related parameters. DNA of 672 Malaysian Malays was analyzed using real-time polymerase chain reaction. Univariate and multivariate linear regression analyses revealed significant associations between rs1042714 and diastolic blood pressure in the pooled Malaysian Malay subjects under additive and recessive models. After gender stratification, however, a significant association was found between the rs1042714 and triglyceride and the rs1042714 and log-transformed high-density lipoprotein cholesterol levels in Malaysian Malay men. No significant association was found between the SNP and log-transformed body mass index. This polymorphism may have an important role in the development of obesity-related traits in Malaysian Malays. Gender is an effect modifier for the effect of the rs1042714 polymorphism on obesity-related traits in Malaysian Malays.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14404, title = {Anticipating rotavirus vaccines: a pre-vaccine assessment of incidence and economic burden of rotavirus hospitalizations among children \<5 year of age in Libya, 2012-13}, author = {S Alkoshi and E Leshem and U D Parashar and M Dahlui}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4324033/pdf/12889_2015_Article_1400.pdf}, doi = {10.1186/s12889-015-1400-7}, issn = {1471-2458}, year = {2015}, date = {2015-01-01}, journal = {BMC Public Health}, volume = {15}, pages = {26}, abstract = {BACKGROUND: Libya introduced rotavirus vaccine in October 2013. We examined pre-vaccine incidence of rotavirus hospitalizations and associated economic burden among children \< 5 years in Libya to provide baseline data for future vaccine impact evaluations. METHODS: Prospective, hospital-based active surveillance for rotavirus was conducted at three public hospitals in two cities during August 2012 - April 2013. Clinical, demographic and estimated cost data were collected from children \<5 hospitalized for diarrhea; stool specimens were tested for rotavirus with a commercial enzyme immunoassay. Annual rotavirus hospitalization incidence rate estimates included a conservative estimate based on the number of cases recorded during the nine months and an extrapolation to estimate 12 months incidence rate. National rotavirus disease and economic burden were estimated by extrapolating incidence and cost data to the national population of children aged \< 5 years. RESULTS: A total of 410 children \< 5 years of age with diarrhea were enrolled, of whom 239 (58%) tested positive rotavirus, yielding an incidence range of 418-557 rotavirus hospitalizations per 100,000 children \< 5 years of age. Most (86%) rotavirus cases were below two years of age with a distinct seasonal peak in winter (December-March) months. The total cost of treatment for each rotavirus patient was estimated at US$ 679 (range: 200-5,423). By extrapolation, we estimated 2,948 rotavirus hospitalizations occur each year in Libyan children \< 5 years of age, incurring total costs of US$ 2,001,662 (range: 1,931,726-2,094,005). CONCLUSIONS: Rotavirus incurs substantial morbidity and economic burden in Libya, highlighting the potential value of vaccination of Libyan children against rotavirus.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15736, title = {The association of coffee intake with liver cancer risk is mediated by biomarkers of inflammation and hepatocellular injury: data from the European Prospective Investigation into Cancer and Nutrition}, author = {K Aleksandrova and C Bamia and D Drogan and P Lagiou and A Trichopoulou and M Jenab and V Fedirko and I Romieu and H B Bueno-de-Mesquita and T Pischon and K Tsilidis and K Overvad and A Tjonneland and M C Bouton-Ruault and L Dossus and A Racine and R Kaaks and T Kuhn and C Tsironis and E M Papatesta and G Saitakis and D Palli and S Panico and S Grioni and R Tumino and P Vineis and P H Peeters and E Weiderpass and M Lukic and T Braaten and J R Quiros and L Lujan-Barroso and M J Sanchez and M D Chilarque and E Ardanas and M Dorronsoro and L M Nilsson and M Sund and P Wallstrom and B Ohlsson and K E Bradbury and K T Khaw and N Wareham and M Stepien and T Duarte-Salles and N Assi and N Murphy and M J Gunter and E Riboli and H Boeing and D Trichopoulos}, doi = {10.3945/ajcn.115.116095}, issn = {0002-9165}, year = {2015}, date = {2015-01-01}, journal = {Am J Clin Nutr}, volume = {102}, number = {6}, pages = {1498-508}, abstract = {BACKGROUND: Higher coffee intake has been purportedly related to a lower risk of liver cancer. However, it remains unclear whether this association may be accounted for by specific biological mechanisms. OBJECTIVE: We aimed to evaluate the potential mediating roles of inflammatory, metabolic, liver injury, and iron metabolism biomarkers on the association between coffee intake and the primary form of liver cancer-hepatocellular carcinoma (HCC). DESIGN: We conducted a prospective nested case-control study within the European Prospective Investigation into Cancer and Nutrition among 125 incident HCC cases matched to 250 controls using an incidence-density sampling procedure. The association of coffee intake with HCC risk was evaluated by using multivariable-adjusted conditional logistic regression that accounted for smoking, alcohol consumption, hepatitis infection, and other established liver cancer risk factors. The mediating effects of 21 biomarkers were evaluated on the basis of percentage changes and associated 95% CIs in the estimated regression coefficients of models with and without adjustment for biomarkers individually and in combination. RESULTS: The multivariable-adjusted RR of having \>/=4 cups (600 mL) coffee/d compared with \<2 cups (300 mL)/d was 0.25 (95% CI: 0.11, 0.62; P-trend = 0.006). A statistically significant attenuation of the association between coffee intake and HCC risk and thereby suspected mediation was confirmed for the inflammatory biomarker IL-6 and for the biomarkers of hepatocellular injury glutamate dehydrogenase, alanine aminotransferase, aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), and total bilirubin, which-in combination-attenuated the regression coefficients by 72% (95% CI: 7%, 239%). Of the investigated biomarkers, IL-6, AST, and GGT produced the highest change in the regression coefficients: 40%, 56%, and 60%, respectively. CONCLUSION: These data suggest that the inverse association of coffee intake with HCC risk was partly accounted for by biomarkers of inflammation and hepatocellular injury.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14469, title = {Psychometric properties of the self-report Malay version of the Pediatric Quality of Life (PedsQLTM) 4.0 Generic Core Scales among multiethnic Malaysian adolescents}, author = {H A Ainuddin and S Y Loh and K Chinna and W Y Low and A C Roslani}, url = {http://chc.sagepub.com/content/19/2/229.full.pdf}, doi = {10.1177/1367493513504834}, issn = {1367-4935}, year = {2015}, date = {2015-01-01}, journal = {J Child Health Care}, volume = {19}, number = {2}, pages = {229-38}, abstract = {Adolescence is the potential period for growth and optimal functioning, but developmental issues like time of transition from childhood to adulthood will create stress and affect the adolescent's quality of life (QOL). However, there is a lack of research tool for measuring adolescent's QOL in Malaysia. The aim of the study was to determine the validity and reliability of the self-report Malay version of the pediatric QOL (PedsQL) 4.0 Generic Core Scales in assessing the QOL of Malaysian adolescents. A cross-sectional study design using the 23-item self-report Malay version of the PedsQL 4.0 Generic Core Scales was administered on a convenient cluster sampling (n = 297 adolescent) from a secondary school. The internal consistency reliability had Cronbach's alpha values ranging from .70 to .89. Factor analysis reported a six-factor structure via principal axis factor analysis. In conclusion, the self-report Malay version of the pediatric QOL 4.0 Generic Core Scales is a reliable and valid tool to measure the QOL of multiethnic Malaysian adolescents.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14392, title = {Child maltreatment experience among primary school children: a large scale survey in Selangor state, Malaysia}, author = {A Ahmed and C Wan-Yuen and M J Marret and C Guat-Sim and S Othman and K Chinna}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364765/pdf/pone.0119449.pdf}, doi = {10.1371/journal.pone.0119449}, issn = {1932-6203}, year = {2015}, date = {2015-01-01}, journal = {PLoS One}, volume = {10}, number = {3}, pages = {e0119449}, abstract = {Official reports of child maltreatment in Malaysia have persistently increased throughout the last decade. However there is a lack of population surveys evaluating the actual burden of child maltreatment, its correlates and its consequences in the country. This cross sectional study employed 2 stage stratified cluster random sampling of public primary schools, to survey 3509 ten to twelve year old school children in Selangor state. It aimed to estimate the prevalence of parental physical and emotional maltreatment, parental neglect and teacher- inflicted physical maltreatment. It further aimed to examine the associations between child maltreatment and important socio-demographic factors; family functioning and symptoms of depression among children. Logistic regression on weighted samples was used to extend results to a population level. Three quarters of 10-12 year olds reported at least one form of maltreatment, with parental physical maltreatment being most common. Males had higher odds of maltreatment in general except for emotional maltreatment. Ethnicity and parental conflict were key factors associated with maltreatment. The study contributes important evidence towards improving public health interventions for child maltreatment prevention in the country.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14431, title = {Clinical breast examination as the recommended breast cancer screening modality in a rural community in Malaysia; what are the factors that could enhance its uptake?}, author = {N D Farid and N A Aziz and N Al-Sadat and M Jamaludin and M Dahlui}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154699/pdf/pone.0106469.pdf}, doi = {10.1371/journal.pone.0106469}, issn = {1932-6203}, year = {2014}, date = {2014-01-01}, journal = {PLoS One}, volume = {9}, number = {9}, pages = {e106469}, abstract = {Breast cancer is the most common cause of deaths and the most frequently diagnosed cancer among women worldwide. This study aimed to determine the prevalence of breast cancer screening, specifically on clinical breast examination, and the predictors of its uptake among women in Malaysia. A cross-sectional study was carried out in five selected districts whereby women aged between 20 to 64 years old, from a total of 1000 households were interviewed. A total of 1192 women responded to the survey of which 53.3% reported had ever done clinical breast examination. Significant associations with clinical breast examination were noted for income and distance from the hospital. These factors should be considered in developing interventions aimed at promoting clinical breast examination. In particular, healthcare providers should be proactive in raising awareness about clinical breast examination among women in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN13990, title = {Association between physical activity and metabolic syndrome among Malay adults in a developing country, Malaysia}, author = {A H Chu and F M Moy}, url = {http://ac.els-cdn.com/S144024401300090X/1-s2.0-S144024401300090X-main.pdf?_tid=383edc82-66a5-11e5-8e63-00000aacb35f\&acdnat=1443529730_a137219d9b277b8e9dbc22c317136800}, doi = {10.1016/j.jsams.2013.04.003}, year = {2014}, date = {2014-01-01}, journal = {J Sci Med Sport}, volume = {17}, number = {2}, pages = {195-200}, abstract = {OBJECTIVES: Metabolic syndrome is a highly prevalent health problem within the adult population in developing countries. We aimed to study the association of physical activity levels and metabolic risk factors among Malay adults in Malaysia. DESIGN: Cross-sectional. METHODS: Body mass index, waist circumference, and systolic/diastolic blood pressure, fasting blood glucose, fasting triglyceride and high-density lipoprotein cholesterol levels were measured in 686 Malay participants (aged 35-74 years). Self-reported physical activity was obtained with the validated International Physical Activity Questionnaire (Malay version) and categorized into low, moderate or high activity levels. RESULTS: Individuals who were classified as overweight and obese predominated (65.6%). On the basis of the modified NCEP ATP III criteria, metabolic syndrome was diagnosed in 31.9% of all participants, of whom 46.1% were men and 53.9% were women. The prevalence of metabolic syndrome among participants with low, moderate or high activity levels was 13.3%, 11.7% and 7.0%, respectively (p\<0.001). Statistically significant negative associations were found between a number of metabolic risk factors and activity categories (p\<0.05). The odds ratios for metabolic syndrome in the moderate and high activity categories were 0.42 (95% CI: 0.27-0.65) and 0.52 (95% CI: 0.35-0.76), respectively, adjusted for gender. CONCLUSIONS: Moderate and high activity levels were each associated with reduced odds for metabolic syndrome independent of gender. Although a slightly lower prevalence of metabolic syndrome was associated with high activity than with moderate activity, potential health benefits were observed when moderate activity was performed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14447, title = {Do workplace physical activity interventions improve mental health outcomes?}, author = {A H Chu and D Koh and F M Moy and F Muller-Riemenschneider}, url = {http://occmed.oxfordjournals.org/content/64/4/235.full.pdf}, doi = {10.1093/occmed/kqu045}, issn = {0962-7480}, year = {2014}, date = {2014-01-01}, journal = {Occup Med (Lond)}, volume = {64}, number = {4}, pages = {235-45}, abstract = {BACKGROUND: Mental health is an important issue in the working population. Interventions to improve mental health have included physical activity. AIMS: To review evidence for the effectiveness of workplace physical activity interventions on mental health outcomes. METHODS: A literature search was conducted for studies published between 1990 and August 2013. Inclusion criteria were physical activity trials, working populations and mental health outcomes. Study quality was assessed using the Jadad scale. RESULTS: Of 3684 unique articles identified, 17 met all selection criteria, including 13 randomized controlled trials, 2 comparison trials and 2 controlled trials. Studies were grouped into two key intervention areas: physical activity and yoga exercise. Of eight high-quality trials, two provided strong evidence for a reduction in anxiety, one reported moderate evidence for an improvement in depression symptoms and one provided limited evidence on relieving stress. The remaining trials did not provide evidence on improved mental well-being. CONCLUSIONS: Workplace physical activity and yoga programmes are associated with a significant reduction in depressive symptoms and anxiety, respectively. Their impact on stress relief is less conclusive.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15883, title = {Development of Conceptual Framework to Understand Factors Associated with Return to Work among Cancer Survivors: A Systematic Review}, author = {S L Chow and A S Ting and T T Su}, issn = {2251-6085 (Print) 2251-6085}, year = {2014}, date = {2014-01-01}, journal = {Iran J Public Health}, volume = {43}, number = {4}, pages = {391-405}, abstract = {This systematic review was conducted to develop a conceptual framework that addresses various factors associated with return to work among cancer survivors. Databases Medline, EMBASE, ProQuest, PubMed and ScienceDirect were systematically searched using medical subject headings [MeSH] for studies published in English from 1990 to 2013. Studies that described adult cancer patients' self-reported data or patients' point of view on factors associated with return to work or employment status following cancer diagnosis were included. Articles selection was conducted in three steps: selection based on title and abstract, retrieval of full text and additions of articles from reference lists and recommendations from experts. Disagreement in data extraction was solved by consultation of third reviewer. Out of twenty seven articles, breast cancer was the most studied type of cancer (30%) while colorectal cancer was studied independently in two articles (7.4%). Conceptual framework on return to work identifies factors under environmental, personal, work demand, work ability, health status and financial factors. Extensive search of scientific databases over last 24 years and the development of the conceptual frame-work are the strength of this review. Conceptual framework reveals the various factors including non-medical factors associated with return to work upon cancer diagnosis. It serves as a reminder to the policy makers to focus on modifiable factors as potential areas for intervention to assist cancer survivors return to work, especially those with little financial assistance and health insurance.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15888, title = {Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia}, author = {L K Chen and L K Liu and J Woo and P Assantachai and T W Auyeung and K S Bahyah and M Y Chou and L Y Chen and P S Hsu and O Krairit and J S Lee and W J Lee and Y Lee and C K Liang and P Limpawattana and C S Lin and L N Peng and S Satake and T Suzuki and C W Won and C H Wu and S N Wu and T Zhang and P Zeng and M Akishita and H Arai}, doi = {10.1016/j.jamda.2013.11.025}, issn = {1525-8610}, year = {2014}, date = {2014-01-01}, journal = {J Am Med Dir Assoc}, volume = {15}, number = {2}, pages = {95-101}, abstract = {Sarcopenia, a newly recognized geriatric syndrome, is characterized by age-related decline of skeletal muscle plus low muscle strength and/or physical performance. Previous studies have confirmed the association of sarcopenia and adverse health outcomes, such as falls, disability, hospital admission, long term care placement, poorer quality of life, and mortality, which denotes the importance of sarcopenia in the health care for older people. Despite the clinical significance of sarcopenia, the operational definition of sarcopenia and standardized intervention programs are still lacking. It is generally agreed by the different working groups for sarcopenia in the world that sarcopenia should be defined through a combined approach of muscle mass and muscle quality, however, selecting appropriate diagnostic cutoff values for all the measurements in Asian populations is challenging. Asia is a rapidly aging region with a huge population, so the impact of sarcopenia to this region is estimated to be huge as well. Asian Working Group for Sarcopenia (AWGS) aimed to promote sarcopenia research in Asia, and we collected the best available evidences of sarcopenia researches from Asian countries to establish the consensus for sarcopenia diagnosis. AWGS has agreed with the previous reports that sarcopenia should be described as low muscle mass plus low muscle strength and/or low physical performance, and we also recommend outcome indicators for further researches, as well as the conditions that sarcopenia should be assessed. In addition to sarcopenia screening for community-dwelling older people, AWGS recommends sarcopenia assessment in certain clinical conditions and healthcare settings to facilitate implementing sarcopenia in clinical practice. Moreover, we also recommend cutoff values for muscle mass measurements (7.0 kg/m(2) for men and 5.4 kg/m(2) for women by using dual X-ray absorptiometry, and 7.0 kg/m(2) for men and 5.7 kg/m(2) for women by using bioimpedance analysis), handgrip strength (\<26 kg for men and \<18 kg for women), and usual gait speed (\<0.8 m/s). However, a number of challenges remained to be solved in the future. Asia is made up of a great number of ethnicities. The majority of currently available studies have been published from eastern Asia, therefore, more studies of sarcopenia in south, southeastern, and western Asia should be promoted. On the other hand, most Asian studies have been conducted in a cross-sectional design and few longitudinal studies have not necessarily collected the commonly used outcome indicators as other reports from Western countries. Nevertheless, the AWGS consensus report is believed to promote more Asian sarcopenia research, and most important of all, to focus on sarcopenia intervention studies and the implementation of sarcopenia in clinical practice to improve health care outcomes of older people in the communities and the healthcare settings in Asia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14448, title = {Metabolically-healthy obesity and coronary artery calcification}, author = {Y Chang and B K Kim and K E Yun and J Cho and Y Zhang and S Rampal and D Zhao and H S Jung and Y Choi and J Ahn and J A Lima and H Shin and E Guallar and S Ryu}, url = {http://ac.els-cdn.com/S0735109714020518/1-s2.0-S0735109714020518-main.pdf?_tid=f42734aa-e12d-11e5-a984-00000aacb35f\&acdnat=1457002499_6b39e2489a7aa88ca3d7b38198c4417b}, doi = {10.1016/j.jacc.2014.03.042}, issn = {0735-1097}, year = {2014}, date = {2014-01-01}, journal = {J Am Coll Cardiol}, volume = {63}, number = {24}, pages = {2679-86}, abstract = {OBJECTIVES: The purpose of this study was to compare the coronary artery calcium (CAC) scores of metabolically-healthy obese (MHO) and metabolically healthy normal-weight individuals in a large sample of apparently healthy men and women. BACKGROUND: The risk of cardiovascular disease among obese individuals without obesity-related metabolic abnormalities, referred to as MHO, is controversial. METHODS: We conducted a cross-sectional study of 14,828 metabolically-healthy adults with no known cardiovascular disease who underwent a health checkup examination that included estimation of CAC scores by cardiac tomography. Being metabolically healthy was defined as not having any metabolic syndrome component and having a homeostasis model assessment of insulin resistance \<2.5. RESULTS: MHO individuals had a higher prevalence of coronary calcification than normal weight subjects. In multivariable-adjusted models, the CAC score ratio comparing MHO with normal-weight participants was 2.26 (95% confidence interval: 1.48 to 3.43). In mediation analyses, further adjustment for metabolic risk factors markedly attenuated this association, which was no longer statistically significant (CAC score ratio 1.24; 95% confidence interval: 0.79 to 1.96). These associations did not differ by clinically-relevant subgroups. CONCLUSIONS: MHO participants had a higher prevalence of subclinical coronary atherosclerosis than metabolically-healthy normal-weight participants, which supports the idea that MHO is not a harmless condition. This association, however, was mediated by metabolic risk factors at levels below those considered abnormal, which suggests that the label of metabolically healthy for obese subjects may be an artifact of the cutoff levels used in the definition of metabolic health.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14451, title = {Spectrum of very early breast cancer in a setting without organised screening}, author = {N Bhoo-Pathy and S Subramaniam and N A Taib and M Hartman and Z Alias and G H Tan and R I Ibrahim and C H Yip and H M Verkooijen}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4007242/pdf/bjc2014183a.pdf}, doi = {10.1038/bjc.2014.183}, issn = {0007-0920}, year = {2014}, date = {2014-01-01}, journal = {Br J Cancer}, volume = {110}, number = {9}, pages = {2187-94}, abstract = {BACKGROUND: Within a setting without organised breast cancer screening, the characteristics and survival of very early breast cancer were determined. METHODS: All 4930 women diagnosed with breast cancer in University Malaya Medical Center, Malaysia from 1993 to 2011 were included. Factors associated with very early presentation (stage I) at diagnosis were identified. Tumour characteristics, management patterns, and survival of very early breast cancer were described, and where appropriate, compared with other settings. RESULTS: Proportion of women presenting with stage I breast cancer significantly increased from 15.2% to 25.2% over two decades. Factors associated with very early presentation were Chinese ethnicity, positive family history of breast cancer, and recent period of diagnosis. Within stage I breast cancers, median tumour size at presentation was 1.5 cm. A majority of stage I breast cancer patients received mastectomy, which was associated with older age, Chinese ethnicity, postmenopausal status, and larger tumours. Chemotherapy was administered in 36% of patients. Five-year age-adjusted relative survival for women with stage I breast cancer was 99.1% (95% CI: 97.6-99.6%). CONCLUSIONS: The proportion of women presenting with very early breast cancer in this setting without organised screening is increasing. These women seem to survive just as well as their counterparts from affluent settings.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14621, title = {Postmastectomy radiotherapy in patients with breast cancer}, author = {N Bhoo-Pathy and J P Pignol and H M Verkooijen}, url = {http://ac.els-cdn.com/S014067361462239X/1-s2.0-S014067361462239X-main.pdf?_tid=efd6b488-673a-11e5-a52a-00000aacb35d\&acdnat=1443594033_0579b07bf3de591afaaa2d1736c4dd30}, doi = {10.1016/s0140-6736(14)62239-x}, issn = {0140-6736}, year = {2014}, date = {2014-01-01}, journal = {Lancet}, volume = {384}, number = {9957}, pages = {1846}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15891, title = {Association of ADIPOQ gene with obesity and adiponectin levels in Malaysian Malays}, author = {Y D Apalasamy and S Rampal and A Salim and F M Moy and A Bulgiba and Z Mohamed}, doi = {10.1007/s11033-014-3147-0}, issn = {0301-4851}, year = {2014}, date = {2014-01-01}, journal = {Mol Biol Rep}, volume = {41}, number = {5}, pages = {2917-21}, abstract = {Studies have shown that single-nucleotide polymorphisms (SNPs) on the ADIPOQ gene have been linked with obesity and with adiponectin levels in various populations. Here, we aimed to investigate the association of ADIPOQ rs17366568 and rs3774261 SNPs with obesity and with adiponectin levels in Malaysian Malays. Obesity parameters and adiponectin levels were measured in 574 subjects. Genotyping was performed using real-time polymerase chain reaction and Sequenom MassARRAY. A significant genotypic association was observed between ADIPOQ rs17366568 and obesity. The frequencies of AG and AA genotypes were significantly higher in the obese group (11%) than in the non-obese group (5%) (P=0.024). The odds of A alleles occurring among the obese group were twice those among the non-obese group (odds ratio 2.15; 95% confidence interval 1.13-4.09). However, no significant association was found between allelic frequencies of ADIPOQ rs17366568 and obesity after Bonferroni correction (P\>0.025) or between ADIPOQ rs3774261 and obesity both at allelic and genotypic levels. ADIPOQ SNPs were not significantly associated with log-adiponectin levels. GA, GG, and AG haplotypes of the ADIPOQ gene were not associated with obesity. We confirmed the previously reported association of ADIPOQ rs17366568 with the risk of obesity. ADIPOQ SNPs are not important modulators of adiponectin levels in this population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14438, title = {Genetic associations of the INSIG2 rs7566605 polymorphism with obesity-related metabolic traits in Malaysian Malays}, author = {Y D Apalasamy and F M Moy and S Rampal and A Bulgiba and Z Mohamed}, doi = {10.4238/2014.July.4.4}, issn = {1676-5680}, year = {2014}, date = {2014-01-01}, journal = {Genet Mol Res}, volume = {13}, number = {3}, pages = {4904-10}, abstract = {A genome-wide association study showed that the tagging single nucleotide polymorphism (SNP) rs7566605 in the insulin-induced gene 2 (INSIG2) was associated with obesity. Attempts to replicate this result in different populations have produced inconsistent findings. We aimed to study the association between the rs7566605 SNP with obesity and other metabolic parameters in Malaysian Malays. Anthropometric and obesity-related metabolic parameters and DNA samples were collected. We genotyped the rs7566605 polymorphism in 672 subjects using real-time polymerase chain reaction. No significant associations were found between the rs7566605 tagging SNP of INSIG2 with obesity or other metabolic parameters in the Malaysian Malay population. The INSIG2 rs7566605 SNP may not play a role in the development of obesity-related metabolic traits in Malaysian Malays.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14411, title = {Cost-effectiveness analysis of rotavirus vaccination among Libyan children using a simple economic model}, author = {S Alkoshi and N Maimaiti and M Dahlui}, url = {http://www.libyanjournalofmedicine.net/index.php/ljm/article/download/26236/pdf_1}, doi = {10.3402/ljm.v9.26236}, issn = {1819-6357}, year = {2014}, date = {2014-01-01}, journal = {Libyan J Med}, volume = {9}, pages = {26236}, abstract = {BACKGROUND: Rotavirus infection is a major cause of childhood diarrhea in Libya. The objective of this study is to evaluate the cost-effectiveness of rotavirus vaccination in that country. METHODS: We used a published decision tree model that has been adapted to the Libyan situation to analyze a birth cohort of 160,000 children. The evaluation of diarrhea events in three public hospitals helped to estimate the rotavirus burden. The economic analysis was done from two perspectives: health care provider and societal. Univariate sensitivity analyses were conducted to assess uncertainty in some values of the variables selected. RESULTS: The three hospitals received 545 diarrhea patients aged\</=5 with 311 (57%) rotavirus positive test results during a 9-month period. The societal cost for treatment of a case of rotavirus diarrhea was estimated at US$ 661/event. The incremental cost-effectiveness ratio with a vaccine price of US$ 27 per course was US$ 8,972 per quality-adjusted life year gained from the health care perspective. From a societal perspective, the analysis shows cost savings of around US$ 16 per child. CONCLUSION: The model shows that rotavirus vaccination could be economically a very attractive intervention in Libya.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14367, title = {Rota Viral Infection: A Significant Disease Burden to Libya}, author = {S Alkoshi and K Ernst and N Maimaiti and M Dahlui}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4441888/pdf/IJPH-43-1356.pdf}, issn = {2251-6085 (Print) 2251-6085}, year = {2014}, date = {2014-01-01}, journal = {Iran J Public Health}, volume = {43}, number = {10}, pages = {1356-63}, abstract = {BACKGROUND: Rotavirus is a common infection causing 450,000 deaths annually primarily in children 5 years and below. Despite the high burden of disease, little is known about the epidemiology of rotavirus in Libya. The aim of this study was to estimate the rotavirus disease burden among Libyan children. METHODS: A cross-sectional study was carried out prospectively among children 5 years old and below between August 2012 and April 2013. Stool samples of children with diarrhea attending the outpatient department or admitted to the pediatric wards, at three public hospitals within the northwestern region of Libya were tested for rotavirus. The seasonality, symptomology demographics and outcomes of rotavirus cases were determined and compared to other diarrhea illnesses. An estimated incidence rate per 100,000 children aged 5 years and below was determined. RESULTS: A total of 545 children with diarrhea were identified for participation. Results of rotavirus immunoassays determined 57% of cases were caused by rotavirus. Inpatients were more likely to be rotavirus positive than outpatients (58% vs. 53%, P\<0.05), Most rotavirus positive cases (86%) were found among children below 2 years of age. Rotaviral cases peaked in the winter, constituting 76% of diarrheal illness in February and very few rotavirus cases in the summer months. The incidence rate of rotavirus diarrhea was estimated at 640/100,000 children aged 5 years and below. CONCLUSION: Rotavirus infection poses a significant disease burden in Libya. Preventive measures such as proper hygiene should be emphasized. Introduction of vaccination against rotavirus into the national immunization program should be examined, as it would likely be a cost-effective investment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14443, title = {The Malaysia DREEM: perceptions of medical students about the learning environment in a medical school in Malaysia}, author = {R A Al-Naggar and M Abdulghani and M T Osman and W Al-Kubaisy and A M Daher and K N Nor Aripin and A Assabri and D A Al-Hidabi and M I Ibrahim and A Al-Rofaai and H S Ibrahim and H Al-Talib and A Al-Khateeb and G Q Othman and Q A Abdulaziz and K Chinna and Y V Bobryshev}, url = {https://www.dovepress.com/getfile.php?fileID=20370}, doi = {10.2147/amep.s61805}, issn = {1179-7258}, year = {2014}, date = {2014-01-01}, journal = {Adv Med Educ Pract}, volume = {5}, pages = {177-84}, abstract = {BACKGROUND: Students' perceptions of their learning environment, by defining its strengths and weaknesses, are important for continuous improvement of the educational environments and curriculum. Therefore, the aim of this study was to explore students' perceptions of their learning environment, among medical students in Malaysia. Various aspects of the education environment were compared between year levels and sex. METHODS: This cross-sectional study was conducted at the Management and Science University, Shah Alam, Malaysia in 2012. A total number of 438 medical students participated in this study, and the response rate was 87.6%. Data were analyzed using SPSS. Comparisons of the mean scores of Dundee Ready Education Environment Measure (DREEM) subscales were calculated. The t-test was used to determine statistically significant differences. RESULTS: The majority of the study participants were female, Malay, and from year 3 (68.7%, 65.3%, and 55.7%; respectively). Analysis of each of the 50 items of the DREEM inventory showed that 47 items scored ranged between 2.00 and 3.00, and three items scored below 2.00. These were identified as problem areas in this medical school that are required to be critically addressed. The overall score showed that the medical students' perceptions were positive. The students' perception toward educational environment was positive for all five DREEM subscales. CONCLUSION: The study found that, in general, the perceptions of the participants about the learning environment were positive. Nevertheless, the study also found there is a need for curriculum improvement in this school and identified priority areas for such improvement.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @phdthesis{MHA100007, title = {A Mixed-Method Research on the Impact and Determinants of Quality of Life Among Stroke Survivors in Nigeria}, author = {Ashiru Hamza Mohammad}, year = {2014}, date = {2014-01-01}, urldate = {2014-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Doctor of Philosophy}, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @article{RN14432, title = {A longitudinal study of age-related changes in intraocular pressure: the Kangbuk Samsung Health Study}, author = {D Zhao and M H Kim and R Pastor-Barriuso and Y Chang and S Ryu and Y Zhang and S Rampal and H Shin and J M Kim and D S Friedman and E Guallar and J Cho}, doi = {10.1167/iovs.14-14151}, issn = {0146-0404}, year = {2014}, date = {2014-01-01}, journal = {Invest Ophthalmol Vis Sci}, volume = {55}, number = {10}, pages = {6244-50}, abstract = {PURPOSE: To examine the longitudinal association between age and intraocular pressure (IOP) in a large sample of Korean men and women. METHODS: We conducted a prospective cohort study of 274,064 young and middle-aged Korean adults with normal fundoscopic findings, following them from January 1, 2002, to February 28, 2010. Health exams were scheduled annually or biennially. At each visit, IOP was measured in both eyes using automated noncontact tonometers. The longitudinal change in IOP with age was evaluated using three-level mixed models for longitudinal paired-eye data, accounting for correlations between paired eyes and repeated measurements over time. RESULTS: In fully adjusted models, the average longitudinal change in IOP per 1-year increase in age was -0.065 mm Hg (95% confidence interval [CI] -0.068 to -0.063), with marked sex differences (P \< 0.001). In men, the average annual IOP change was -0.093 mm Hg (95% CI -0.096 to -0.091) throughout follow-up. In women, the average annual IOP change was -0.006 mm Hg (95% CI -0.010 to -0.003), with a relatively flat association in the age range of 30 to 59 years and more marked annual decreases at younger and older ages. CONCLUSIONS: Intraocular pressure was inversely associated with age in a large cohort of Korean adults attending health-screening visits. For men, this inverse association was observed throughout the entire age range, while for women it was evident only in younger (\<30 years of age) and older (\>/=60 years of age) women, with no association in women aged 30 to 59. Further research is needed to better understand the underlying mechanisms and to reconsider cutoffs for defining high IOP by age and sex groups in Asian populations.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14439, title = {Thyroid hormones and coronary artery calcification in euthyroid men and women}, author = {Y Zhang and B K Kim and Y Chang and S Ryu and J Cho and W Y Lee and E J Rhee and M J Kwon and S Rampal and D Zhao and R Pastor-Barriuso and J A Lima and H Shin and E Guallar}, doi = {10.1161/atvbaha.114.303889}, issn = {1079-5642}, year = {2014}, date = {2014-01-01}, journal = {Arterioscler Thromb Vasc Biol}, volume = {34}, number = {9}, pages = {2128-34}, abstract = {OBJECTIVE: Overt and subclinical hypothyroidism are risk factors for atherosclerosis. It is unclear whether thyroid hormone levels within the normal range are also associated with atherosclerosis measured by coronary artery calcium (CAC). APPROACH AND RESULTS: We conducted a cross-sectional study of 41 403 apparently healthy young and middle-aged men and women with normal thyroid hormone levels. Free thyroxin, free triiodothyronine, and thyroid-stimulating hormone levels were measured by electrochemiluminescent immunoassay. CAC score was measured by multidetector computed tomography. The multivariable adjusted CAC ratios comparing the highest versus the lowest quartile of thyroid hormones were 0.74 (95% confidence interval, 0.60-0.91; P for trend \<0.001) for free thyroxin, 0.81 (0.66-1.00; P for trend=0.05) for free triiodothyronine, and 0.78 (0.64-0.95; P for trend=0.01) for thyroid-stimulating hormone. Similarly, the odds ratios for detectable CAC (CAC \>0) comparing the highest versus the lowest quartiles of thyroid hormones were 0.87 (0.79-0.96; P for linear trend \<0.001) for free thyroxin, 0.90 (0.82-0.99; P for linear trend=0.02) for free triiodothyronine, and 0.91 (0.83-1.00; P for linear trend=0.03) for thyroid-stimulating hormone. CONCLUSIONS: In a large cohort of apparently healthy young and middle-aged euthyroid men and women, low-normal free thyroxin and thyroid-stimulating hormone were associated with a higher prevalence of subclinical coronary artery disease and with a greater degree of coronary calcification.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14452, title = {Thyroid hormones and mortality risk in euthyroid individuals: the Kangbuk Samsung health study}, author = {Y Zhang and Y Chang and S Ryu and J Cho and W Y Lee and E J Rhee and M J Kwon and R Pastor-Barriuso and S Rampal and W K Han and H Shin and E Guallar}, doi = {10.1210/jc.2013-3832}, issn = {0021-972x}, year = {2014}, date = {2014-01-01}, journal = {J Clin Endocrinol Metab}, volume = {99}, number = {7}, pages = {2467-76}, abstract = {CONTEXT: Hyperthyroidism and hypothyroidism, both overt and subclinical, are associated with all-cause and cardiovascular mortality. The association between thyroid hormones and mortality in euthyroid individuals, however, is unclear. OBJECTIVE: To examine the prospective association between thyroid hormones levels within normal ranges and mortality endpoints. SETTING AND DESIGN: A prospective cohort study of 212 456 middle-aged South Korean men and women who had normal thyroid hormone levels and no history of thyroid disease at baseline from January 1, 2002 to December 31, 2009. Free T4 (FT4), free T3 (FT3), and TSH levels were measured by RIA. Vital status and cause of death ascertainment were based on linkage to the National Death Index death certificate records. RESULTS: After a median follow-up of 4.3 years, 730 participants died (335 deaths from cancer and 112 cardiovascular-related deaths). FT4 was inversely associated with all-cause mortality (HR = 0.77, 95% confidence interval 0.63-0.95, comparing the highest vs lowest quartile of FT4; P for linear trend = .01), and FT3 was inversely associated cancer mortality (HR = 0.62, 95% confidence interval 0.45-0.85; P for linear trend = .001). TSH was not associated with mortality endpoints. CONCLUSIONS: In a large cohort of euthyroid men and women, FT4 and FT3 levels within the normal range were inversely associated with the risk of all-cause mortality and cancer mortality, particularly liver cancer mortality.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14450, title = {Genome-wide analysis of copy number variation identifies candidate gene loci associated with the progression of non-alcoholic fatty liver disease}, author = {S M Zain and R Mohamed and D N Cooper and R Razali and S Rampal and S Mahadeva and W K Chan and A Anwar and N S Rosli and A S Mahfudz and P L Cheah and R C Basu and Z Mohamed}, doi = {10.1371/journal.pone.0095604}, issn = {1932-6203}, year = {2014}, date = {2014-01-01}, journal = {PLoS One}, volume = {9}, number = {4}, pages = {e95604}, abstract = {Between 10 and 25% of individuals with non-alcoholic fatty liver disease (NAFLD) develop hepatic fibrosis leading to cirrhosis and hepatocellular carcinoma (HCC). To investigate the molecular basis of disease progression, we performed a genome-wide analysis of copy number variation (CNV) in a total of 49 patients with NAFLD [10 simple steatosis and 39 non-alcoholic steatohepatitis (NASH)] and 49 matched controls using high-density comparative genomic hybridization (CGH) microarrays. A total of 11 CNVs were found to be unique to individuals with simple steatosis, whilst 22 were common between simple steatosis and NASH, and 224 were unique to NASH. We postulated that these CNVs could be involved in the pathogenesis of NAFLD progression. After stringent filtering, we identified four rare and/or novel CNVs that may influence the pathogenesis of NASH. Two of these CNVs, located at 13q12.11 and 12q13.2 respectively, harbour the exportin 4 (XPO4) and phosphodiesterase 1B (PDE1B) genes which are already known to be involved in the etiology of liver cirrhosis and HCC. Cross-comparison of the genes located at these four CNV loci with genes already known to be associated with NAFLD yielded a set of genes associated with shared biological processes including cell death, the key process involved in 'second hit' hepatic injury. To our knowledge, this pilot study is the first to provide CNV information of potential relevance to the NAFLD spectrum. These data could prove invaluable in predicting patients at risk of developing NAFLD and more importantly, those who will subsequently progress to NASH.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14415, title = {A review of breast cancer research in malaysia}, author = {C H Yip and N Bhoo Pathy and S H Teo}, issn = {0300-5283 (Print) 0300-5283}, year = {2014}, date = {2014-01-01}, journal = {Med J Malaysia}, volume = {69 Suppl A}, pages = {8-22}, abstract = {Four hundred and nineteen articles related to breast cancer were found in a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. One hundred and fifty four articles were selected and reviewed on the basis of clinical relevance and future research implications. Overall, Malaysian women have poor survival from breast cancer and it is estimated that half of the deaths due to breast cancer could be prevented. Five-year survival in Malaysia was low and varies among different institutions even within the same disease stage, suggesting an inequity of access to optimal treatment or a lack of compliance to optimal treatment. Malaysian women have poor knowledge of the risk factors, symptoms and methods for early detection of breast cancer, leading to late presentation. Moreover, Malaysian women experience cancer fatalism, belief in alternative medicine, and lack of autonomy in decision making resulting in delays in seeking or avoidance of evidence-based medicine. There are ethnic differences in estrogen receptor status, HER2 overexpression and incidence of triple negative breast cancer which warrant further investigation. Malay women present with larger tumours and at later stages, and even after adjustment for these and other prognostic factors (stage, pathology and treatment), Malay women have a poorer survival. Although the factors responsible for these ethnic differences have not been elucidated, it is thought that pharmacogenomics, lifestyle factors (such as weight-gain, diet and exercise), and psychosocial factors (such as acceptance of 2nd or 3rd line chemotherapy) may be responsible for the difference in survival. Notably, survivorship studies show self-management programmes and exercise improve quality of life, highlighting the need to evaluate the psychosocial impact of breast cancer on Malaysian women, and to design culturally-, religiously- and linguistically-appropriate psycho-education programmes to help women cope with the disease and improve their quality of life. Research done in the Caucasian populations may not necessarily apply to local settings and it is important to embark on local studies particularly prevention, screening, diagnostic, prognostic, therapeutic and psychosocial research.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14460, title = {The prevalence of colorectal adenomas in asymptomatic Korean men and women}, author = {M H Yang and S Rampal and J Sung and Y H Choi and H J Son and J H Lee and Y H Kim and D K Chang and P L Rhee and J C Rhee and E Guallar and J Cho}, doi = {10.1158/1055-9965.epi-13-0682}, issn = {1055-9965}, year = {2014}, date = {2014-01-01}, journal = {Cancer Epidemiol Biomarkers Prev}, volume = {23}, number = {3}, pages = {499-507}, abstract = {BACKGROUND: Colorectal cancer incidence is rapidly rising in many Asian countries, with rates approaching those of Western countries. This study aimed to evaluate the prevalence and trends of colorectal adenomas by age, sex, and risk strata in asymptomatic Koreans. METHODS: Cross-sectional study of 19,372 consecutive participants aged 20 to 79 years undergoing screening colonoscopy at the Center for Health Promotion of the Samsung Medical Center in Korea from January 2006 to June 2009. RESULTS: Among participants at average risk, those without a history of colorectal polyps or a family history of colorectal cancer, the prevalence of colorectal adenomas and advanced adenomas were 34.5% and 3.1%, respectively, in men and 20.0% and 1.6%, respectively, in women. The prevalence of adenomas increased with age in both men and women, with a more marked increase for advanced adenoma. Participants with a family history of colorectal cancer or with a history of colorectal polyps had significantly higher prevalence of adenomas compared with participants of average risk (36.9% vs. 26.9%; age- and sex-adjusted prevalence ratio = 1.16; 95% confidence interval, 1.09-1.22). The prevalence of adenomas increased annually in both men and women. CONCLUSIONS: In this large study of asymptomatic Korean men and women participating in a colonoscopy screening program, the prevalence of colorectal adenomas was comparable and possibly higher than previously reported in Western countries. IMPACT: Cost-effectiveness studies investigating the optimal age for starting colonoscopy screening and etiological studies to identify the reasons for the increasing trend in colorectal adenomas in Koreans are needed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14446, title = {Community knowledge, health beliefs, practices and experiences related to dengue fever and its association with IgG seropositivity}, author = {L P Wong and S AbuBakar and K Chinna}, doi = {10.1371/journal.pntd.0002789}, issn = {1935-2727}, year = {2014}, date = {2014-01-01}, journal = {PLoS Negl Trop Dis}, volume = {8}, number = {5}, pages = {e2789}, abstract = {BACKGROUND: Demographic, economic and behavioural factors are central features underpinning the successful management and biological control of dengue. This study aimed to examine these factors and their association with the seroprevalence of this disease. METHODOLOGY: We conducted a cross-sectional telephone survey of households in a 3 km radius of the schools where we had conducted serological tests on the student population in a previous study. Households were surveyed about their socio-demographics, knowledge, practices, and Health Belief Model (HBM) constructs. The results were then associated with the prevalence rate of dengue in the community, as marked by IgG seropositivity of the students who attended school there. RESULTS: A total of 1,400 complete responses were obtained. The community's IgG seropositivity was significantly positively associated with high household monthly income, high-rise residential building type, high surrounding vegetation density, rural locality, high perceived severity and susceptibility, perceived barriers to prevention, knowing that a neighbour has dengue, frequent fogging and a higher level of knowledge about dengue. In the multivariate analyses, three major correlates of the presence of IgG seropositivity in the community: (1) high-rise residential apartment house type or condominium buildings; (2) the main construct of the HBM, perceived severity and susceptibility; and (3) the additional constructs of the HBM, lack of preventive measures from the community level and having a neighbour with dengue as a cue to action. Weak correlations were found between self-practices to prevent dengue and the level of dengue seropositivity in the community, and between HBM constructs and knowledge (r = 0.09). CONCLUSIONS: The residential environment factor and the constructs of the HBM are useful and important elements in developing interventions to prevent and control dengue. The study also sheds light on the importance of the need for approaches that ensure the translation of knowledge into practice.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15864, title = {Risk factors of malnutrition among preschool children in Terengganu, Malaysia: a case control study}, author = {H J Wong and F M Moy and S Nair}, doi = {10.1186/1471-2458-14-785}, issn = {1471-2458}, year = {2014}, date = {2014-01-01}, journal = {BMC Public Health}, volume = {14}, pages = {785}, abstract = {BACKGROUND: Childhood malnutrition is a multi-dimensional problem. An increase in household income is not sufficient to reduce childhood malnutrition if children are deprived of food security, education, access to water, sanitation and health services. The aim of this study is to identify the characteristics of malnourished children below five years of age and to ascertain the risk factors of childhood malnutrition in a state in Malaysia. METHODS: A case control study was conducted in the maternal and child health clinics in five districts of Terengganu, Malaysia from April to August 2012. Case was a child with moderate to severe malnutrition with z-scores \< -2SD from the median of WHO reference. Control was a child without malnutrition with z-scores between -2SD and +2SD and the age matched with case's. Face to face interviews with the respective child's mother and measurements of the respective child's weight and height were carried out. Information on socio-economic characteristics, household food security status, child's dietary intake, caregivers' practices and resources were enquired. Univariate and multivariate logistic regression analyses were conducted. Crude odds ratio and adjusted odds ratio with 95% confidence interval were calculated. RESULTS: A total of 274 children with 137 cases and 137 controls were recruited. All respondents were Malays. Among the cases, a larger proportion of them was female and originated from low income families. After adjusting all confounders, childhood malnutrition was significantly associated with number of children (aOR: 5.86, 95% CI: 1.96, 17.55), child hunger (aOR: 16.38, 95% CI: 1.34,199.72), dietary energy intake (aOR: 0.99, 95% CI: 0.98, 0.99), protein intake (aOR: 1.06, 95% CI: 1.01, 1.12), vitamin A intake (aOR: 0.999, 95% CI: 0.997, 1.00), low birth weight (aOR: 6.83, 95% CI: 1.62, 28.89), frequent illness (aOR: 2.79, 95% CI: 1.06, 7.31), and history of worm infection (aOR: 3.48, 95% CI: 1.25, 9.70). CONCLUSIONS: Lower socio-economic status, household food insecurity, and poor child caring practices were associated with childhood malnutrition. Besides implementation of programmes focusing on poverty reduction, community based nutrition and hygiene education with extensive family planning and de-worming programmes should be intensified to improve both mother and children's nutritional status.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15960, title = {Pre-emptive intraperitoneal local anaesthesia: an effective method in immediate post-operative pain management and metabolic stress response in laparoscopic appendicectomy, a randomized, double-blinded, placebo-controlled study}, author = {M R Thanapal and M D Tata and A J Tan and T Subramaniam and J M Tong and K Palayan and S Rampal and R Gurunathan}, url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1445-2197.2012.06210.x/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 = {10.1111/j.1445-2197.2012.06210.x}, issn = {1445-1433}, year = {2014}, date = {2014-01-01}, journal = {ANZ J Surg}, volume = {84}, number = {1-2}, pages = {47-51}, abstract = {BACKGROUND: Although laparoscopic surgeries are associated with reduced surgical stress response and shortened post-operative recovery, intense pain and high analgesia requirements in the immediate post-operative period are often the chief complaints. AIM: The aim of this study was to evaluate the effect of pre-emptive intraperitoneal local anaesthetic drugs on post-operative pain management and metabolic stress response in laparoscopic appendicectomy. METHOD: The method used was a randomized double-blinded placebo-controlled study. Patients with clinical diagnosis of acute appendicitis who fulfil the criteria, were taken into this study. Primary outcomes investigated were consumption of patient-controlled analgesia during the immediate post-operative period (first 6 h) and subsequent 18 h as well as serum cortisol sampling. RESULTS: Total of 120 patients were recruited into three different treatment groups (placebo, ropivacaine, levobupivacaine). In order to maintain visual analogue score of 0-1 during the immediate post-operative period, patients in the placebo group required significantly (P \< 0.001) higher dose of analgesia (morphine/mg) - 11 mg (8.3-15.5) as compared with ropivacaine - 4 mg (3.0-6.0) and levobupivacaine - 3.5 mg (2.0-5.0). The immediate post-operative serum cortisol showed a significant increase in serum cortisol in the placebo group (P = 0.001) as compared with ropivacaine and levobupivacaine groups. CONCLUSION: Pre-emptive intraperitoneal local anaesthesia in laparoscopy surgery is a safe, non-invasive procedure that can benefit patients by reducing the immediate post-operative pain intensity and metabolic stress response of the body.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15915, title = {Association of glucokinase regulatory gene polymorphisms with risk and severity of non-alcoholic fatty liver disease: an interaction study with adiponutrin gene}, author = {H L Tan and S M Zain and R Mohamed and S Rampal and K F Chin and R C Basu and P L Cheah and S Mahadeva and Z Mohamed}, doi = {10.1007/s00535-013-0850-x}, issn = {0944-1174}, year = {2014}, date = {2014-01-01}, journal = {J Gastroenterol}, volume = {49}, number = {6}, pages = {1056-64}, abstract = {BACKGROUND: Recent genome-wide association studies demonstrated an association between single nucleotide polymorphisms (SNPs) on the glucokinase regulatory gene (GCKR) with hepatic steatosis. This study attempted to investigate the association of GCKR rs780094 and rs1260326 with susceptibility to non-alcoholic fatty liver disease (NAFLD) and its severity. METHODS: The genotypes were assessed on 144 histologically confirmed NAFLD patients and 198 controls using a Sequenom MassARRAY platform. RESULTS: The GCKR rs1260326 and rs780094 allele T were associated with susceptibility to NAFLD (OR 1.49, 95 % CI 1.09-2.05}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14455, title = {"Taking my breath away by keeping stress at bay" - an employee assistance program in the automotive assembly plant}, author = {B M Sundram and M Dahlui and K Chinna}, issn = {2251-6085 (Print) 2251-6085}, year = {2014}, date = {2014-01-01}, journal = {Iran J Public Health}, volume = {43}, number = {3}, pages = {263-72}, abstract = {BACKGROUND: The aim of this study was to evaluate the effectiveness of individual-focused stress management training namely Deep Breathing Exercise (DBE) on self-perceived occupational stress among male automotive assembly-line workers. METHODS: A quasi-experimental study was conducted at 2 automotive assembly plants in Malaysia over 9 months, from January 2012 to September 2012. Assembly-line workers from Plant A received DBE training while Plant B acted as a control by receiving pamphlets on stress and its ill-effects. Intention-to-treat analysis was conducted among the self-voluntary respondents in Plant A (n=468) and Plant B (n=293). The level of stress was measured using Depression Anxiety Stress Scales-21 (DASS-21) stress subscale. RESULTS: Significant favorable intervention effects were found in Plant A (Effect size=0.6) as compared to Plant B (Effect size=0.2) at the end of the study in those receiving DBE. Time and group interaction effects were examined using the repeated measure ANOVA test in which there was a significant group *time interaction effect [F (1, 1) = 272.45, P\<0.001]. CONCLUSION: The improvement in stress levels showed the potential of DBE training as part of Employee Assistance Program in the automotive assembly plant. Future studies should be carried out to assess the long term effects of an on-site relaxation training to provide stronger evidence for the introduction of DBE among assembly-line workers as a coping strategy to alleviate occupational stress.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15929, title = {The risk and associated factors of methamphetamine psychosis in methamphetamine-dependent patients in Malaysia}, author = {A H Sulaiman and M A Said and M H Habil and R Rashid and A Siddiq and N C Guan and M Midin and N R Nik Jaafar and H Sidi and S Das}, url = {https://www.sciencedirect.com/science/article/pii/S0010440X13000308?via%3Dihub}, doi = {10.1016/j.comppsych.2013.01.003}, issn = {0010-440x}, year = {2014}, date = {2014-01-01}, journal = {Compr Psychiatry}, volume = {55 Suppl 1}, pages = {S89-94}, abstract = {OBJECTIVE: The objective of this study was to determine the risk of lifetime and current methamphetamine-induced psychosis in patients with methamphetamine dependence. The association between psychiatric co-morbidity and methamphetamine-induced psychosis was also studied. METHODS: This was a cross-sectional study conducted concurrently at a teaching hospital and a drug rehabilitation center in Malaysia. Patients with the diagnosis of methamphetamine based on DSM-IV were interviewed using the Mini International Neuropsychiatric Interview (M.I.N.I.) for methamphetamine-induced psychosis and other Axis I psychiatric disorders. The information on sociodemographic background and drug use history was obtained from interview or medical records. RESULTS: Of 292 subjects, 47.9% of the subjects had a past history of psychotic symptoms and 13.0% of the patients were having current psychotic symptoms. Co-morbid major depressive disorder (OR=7.18, 95 CI=2.612-19.708), bipolar disorder (OR=13.807, 95 CI=5.194-36.706), antisocial personality disorder (OR=12.619, 95 CI=6.702-23.759) and heavy methamphetamine uses were significantly associated with lifetime methamphetamine-induced psychosis after adjusted for other factors. Major depressive disorder (OR=2.870}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14419, title = {Pain experience and satisfaction with postoperative pain control among surgical patients}, author = {P Subramanian and S Ramasamy and K H Ng and K Chinna and R Rosli}, doi = {10.1111/ijn.12363}, issn = {1322-7114}, year = {2014}, date = {2014-01-01}, journal = {Int J Nurs Pract}, abstract = {Alleviating acute pain and providing pain relief are central to caring for surgical patients as pain can lead to many adverse medical consequences. This study aimed to explore patients' experience of pain and satisfaction with postoperative pain control. A cross-sectional survey was carried out among 107 respondents who had undergone abdominal surgery in the surgical ward of an urban hospital using the Revised American Pain Society's Patient Outcome and Satisfaction Survey Questionnaires (APS-POQ-R). Data were analysed using descriptive statistics and chi-square test. Chi-square test showed significant association between race (P = 0.038), education level (P \</= 0.001), previous operation status (P = 0.032) and operation status (P \</= 0.001). Further analysis on nominal regression, association between dissatisfaction with factors of operation status (46.09 (95% CI 7.456, 284.947)) and previous operation status (13.38 (95% CI 1.39, 128.74)) was found to be significant. Moderate to high levels of pain intensity in the last 24 h after surgery, as well as moderate to high rates of pain-related interference with care activities were most reported. Pain still remains an issue among surgical patients, and effective pain management and health education are needed to manage pain more effectively after surgery.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14277, title = {Association between self-reported physical activity and indicators of body composition in Malaysian adolescents}, author = {T T Su and P Y Sim and A M Nahar and H A Majid and L J Murray and M M Cantwell and N Al-Sadat and M Y Jalaludin}, url = {http://ac.els-cdn.com/S0091743514002369/1-s2.0-S0091743514002369-main.pdf?_tid=12e84174-66a7-11e5-bff4-00000aab0f01\&acdnat=1443530526_0047976b68b9ed1bf57fde5b42d974fa}, doi = {10.1016/j.ypmed.2014.07.001}, issn = {0091-7435}, year = {2014}, date = {2014-01-01}, journal = {Prev Med}, volume = {67}, pages = {100-5}, abstract = {BACKGROUND: Obesity and lack of physical activity are fast becoming a concern among Malaysian adolescents. OBJECTIVE: This study aims to assess physical activity levels among Malaysian adolescents and investigate the association between physical activity levels and body composition such as body mass index (BMI), waist circumference (WC) and percentage of body fat. SUBJECTS AND METHODS: 1361 school-going 13 year old multi-ethnic adolescents from population representative samples in Malaysia were involved in our study. Self-reported physical activity levels were assessed using the validated Malay version of the Physical Activity Questionnaire for Older Children (PAQ-C). Height, weight, body fat composition and waist circumference (WC) were measured. Data collection period was from March to May 2012. RESULTS: 10.8% of the males and 7.4% of the females were obese according to the International Obesity Task Force standards. A majority of the adolescents (63.9%) were physically inactive. There is a weak but significant correlation between physical activity scores and the indicators of obesity. The adjusted coefficient for body fatness was relatively more closely correlated to physical activity scores followed by waist circumference and lastly BMI. CONCLUSION: This study demonstrates that high physical activity scores were associated with the decreased precursor risk factors of obesity.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN12549, title = {A Comparison of Hand-arm Vibration Syndrome between Malaysian and Japanese Workers}, author = {A T Su and J Fukumoto and A Darus and V C Hoe and N Miyai and M Isahak and S Takemura and A Bulgiba and K Yoshimasu and S Maeda and K Miyashita}, issn = {1341-9145}, year = {2014}, date = {2014-01-01}, journal = {J Occup Health}, volume = {55}, number = {6}, pages = {468-78}, abstract = {Objectives: The aim of this study was to investigate the clinical characteristics of HAVS in a tropical environment in comparison with a temperate environment. Methods: We conducted a series medical examinations among the forestry, construction and automobile industry workers in Malaysia adopting the compulsory medical examination procedure used by Wakayama Medical University for Japanese vibratory tools workers. We matched the duration of vibration exposure and compared our results against the Japanese workers. We also compared the results of the Malaysian tree fellers against a group of symptomatic Japanese tree fellers diagnosed with HAVS. Results: Malaysian subjects reported a similar prevalence of finger tingling, numbness and dullness (Malaysian=25.0%}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14427, title = {A comparison study of portable foot-to-foot bioelectrical impedance scale to measure body fat percentage in asian adults and children}, author = {P Y Sim and T T Su and H Abd Majid and A M Nahar and M Y Jalaludin}, doi = {10.1155/2014/475659}, year = {2014}, date = {2014-01-01}, journal = {Biomed Res Int}, volume = {2014}, pages = {475659}, abstract = {OBJECTIVE: To compare the measurements of body fat percentage (BF%) using the foot-to-foot bioelectrical impedance analysis (FTF-BIA) with the direct segmental multifrequency BIA (DSM-BIA). METHODS: There were 36 men and 52 women (37.1 +/- 14.3 years) with 57% Malays, 30% Chinese, and 13% Indian. For children, there were 45 boys and 26 girls (11.5 +/- 2.5 years) with 52% Malay, 15% Chinese, and 33% Indian. RESULTS: Mean height for men was 168.4 cm, 11 cm taller than women. Men were 10 kg heavier than women at 70 kg. BF% in women was 32% and 33% whereas BF% in men was 23% and 25% when measured using FTF-BIA and DSM-BIA, respectively. In children, BF% measured with FTF-BIA and DSM-BIA was 49% and 46%, respectively. The correlations were significant for men (r = 0.92}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14412, title = {A qualitative study on hypertensive care behavior in primary health care settings in Malaysia}, author = {R Shima and M H Farizah and H A Majid}, doi = {10.2147/ppa.s69680}, issn = {1177-889x}, year = {2014}, date = {2014-01-01}, journal = {Patient Prefer Adherence}, volume = {8}, pages = {1597-609}, abstract = {PURPOSE: The aim of this study was to explore patients' experiences with their illnesses and the reasons which influenced them in not following hypertensive care recommendations (antihypertensive medication intake, physical activity, and diet changes) in primary health clinic settings. PATIENTS AND METHODS: A qualitative methodology was applied. The data were gathered from in-depth interviews with 25 hypertensive patients attending follow-up in nine government primary health clinics in two districts (Hulu Langat and Klang) in the state of Selangor, Malaysia. The transcribed data were analyzed using thematic analysis. RESULTS: There was evidence of lack of patient self-empowerment and community support in Malaysian society. Most of the participants did not take their antihypertensive medication or change their physical activity and diet after diagnosis. There was an agreement between the patients and the health care professionals before starting the treatment recommendation, but there lacked further counseling and monitoring. Most of the reasons given for not taking antihypertensive medication, not doing physical activity and not following diet recommendations were due to side effects or fear of the side effects of antihypertensive medication, patients' attitudes, lack of information from health care professionals and insufficient social support from their surrounding environment. We also observed the differences on these reasons for nonadherence among the three ethnic groups. CONCLUSION: Health care professionals should move toward supporting adherence in the management of hypertensive patients by maintaining a dialogue. Patients need to be given time to enable them to overcome their inhibition of asking questions and to accept the recommendations. A self-management approach must be responsive to the needs of individuals, ethnicities, and communities.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14437, title = {Comparison of the Framingham Risk Score, SCORE and WHO/ISH cardiovascular risk prediction models in an Asian population}, author = {S Selvarajah and G Kaur and J Haniff and K C Cheong and T G Hiong and Y Graaf and M L Bots}, doi = {10.1016/j.ijcard.2014.07.066}, issn = {0167-5273}, year = {2014}, date = {2014-01-01}, journal = {Int J Cardiol}, volume = {176}, number = {1}, pages = {211-8}, abstract = {BACKGROUND: Cardiovascular risk-prediction models are used in clinical practice to identify and treat high-risk populations, and to communicate risk effectively. We assessed the validity and utility of four cardiovascular risk-prediction models in an Asian population of a middle-income country. METHODS: Data from a national population-based survey of 14,863 participants aged 40 to 65 years, with a follow-up duration of 73,277 person-years was used. The Framingham Risk Score (FRS), SCORE (Systematic COronary Risk Evaluation)-high and -low cardiovascular-risk regions and the World Health Organization/International Society of Hypertension (WHO/ISH) models were assessed. The outcome of interest was 5-year cardiovascular mortality. Discrimination was assessed for all models and calibration for the SCORE models. RESULTS: Cardiovascular risk factors were highly prevalent; smoking 20%, obesity 32%, hypertension 55%, diabetes mellitus 18% and hypercholesterolemia 34%. The FRS and SCORE models showed good agreement in risk stratification. The FRS, SCORE-high and -low models showed good discrimination for cardiovascular mortality, areas under the ROC curve (AUC) were 0.768, 0.774 and 0.775 respectively. The WHO/ISH model showed poor discrimination}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15820, title = {The Impact of Different Permissible Exposure Limits on Hearing Threshold Levels Beyond 25 dBA}, author = {B S Sayapathi and A T Su and D Koh}, doi = {10.5812/ircmj.15520}, issn = {2074-1804 (Print) 2074-1804}, year = {2014}, date = {2014-01-01}, journal = {Iran Red Crescent Med J}, volume = {16}, number = {10}, pages = {e15520}, abstract = {BACKGROUND: Development of noise-induced hearing loss is reliant on a few factors such as frequency, intensity, and duration of noise exposure. The occurrence of this occupational malady has doubled from 120 million to 250 million in a decade. Countries such as Malaysia, India, and the US have adopted 90 dBA as the permissible exposure limit. According to the US Occupational Safety and Health Administration (OSHA), the exposure limit for noise is 90 dBA, while that of the US National Institute of Occupational Safety and Health (NIOSH) is 85 dBA for 8 hours of noise exposure. OBJECTIVES: This study aimed to assess the development of hearing threshold levels beyond 25 dBA on adoption of 85 dBA as the permissible exposure limit compared to 90 dBA. PATIENTS AND METHODS: This is an intervention study done on two automobile factories. There were 203 employees exposed to noise levels beyond the action level. Hearing protection devices were distributed to reduce noise levels to a level between the permissible exposure limit and action level. The permissible exposure limits were 90 and 85 dBA in factories 1 and 2, respectively, while the action levels were 85 and 80 dBA, respectively. The hearing threshold levels of participants were measured at baseline and at first month of postshift exposure of noise. The outcome was measured by a manual audiometer. McNemar and chi-square tests were used in the statistical analysis. RESULTS: We found that hearing threshold levels of more than 25 dBA has changed significantly from pre-intervention to post-intervention among participants from both factories (3000 Hz for the right ear and 2000 Hz for the left ear). There was a statistically significant association between participants at 3000 Hz on the right ear at 'deteriorated' level ( chi(2) (1) = 4.08}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14629, title = {The effectiveness of applying different permissible exposure limits in preserving the hearing threshold level: a systematic review}, author = {B S Sayapathi and A T Su and D Koh}, url = {https://www.jstage.jst.go.jp/article/joh/56/1/56_13-0135-RA/_pdf}, issn = {1341-9145}, year = {2014}, date = {2014-01-01}, journal = {J Occup Health}, volume = {56}, number = {1}, pages = {1-11}, abstract = {OBJECTIVES: A systematic review was conducted to identify the effectiveness of different permissible exposure limits in preserving the hearing threshold level. This review compared the limits of the US National Institute of Occupational Safety and Health with those of the US Occupational Safety and Health Administration. The prevalence of occupational noise-induced hearing loss is on an increasing trend globally. This review was performed to reduce the prevalence of noise-induced hearing loss. METHODS: We searched 3 major databases, i.e., PubMed, Embase and Lippincott Williams \& Wilkins Journals@Ovid, for studies published up until 1May 2013 without language restrictions. All study designs were included in this review. The studies were identified and retrieved by two independent authors. RESULTS: Of 118 titles scanned, 14 duplicates were removed, and a total of 13 abstracts from all three databases were identified for full-text retrieval. From the full text, eight articles met the inclusion criteria for this systematic review. These articles showed acceptable quality based on our scoring system. Most of the studies indicated that temporary threshold shifts were much lower when subjects were exposed to a noise level of 85 dBA or lower. CONCLUSIONS: There were more threshold shifts in subjects adopting 90 dBA compared with 85 dBA. These temporary threshold shifts may progress to permanent shifts over time. Action curtailing noise exposure among employees would be taken earlier on adoption of 85 dBA as the permissible exposure limit, and hence prevalence of noise-induced hearing loss may be reduced.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15893, title = {Association of ADRA2A and MTHFR gene polymorphisms with weight loss following antipsychotic switching to aripiprazole or ziprasidone}, author = {S N Roffeei and G P Reynolds and N Z Zainal and M A Said and A Hatim and S A Aida and Z Mohamed}, doi = {10.1002/hup.2366}, issn = {0885-6222}, year = {2014}, date = {2014-01-01}, journal = {Hum Psychopharmacol}, volume = {29}, number = {1}, pages = {38-45}, abstract = {OBJECTIVES: Various genetic polymorphisms have been reported to be associated with antipsychotic-induced weight gain. In this study, we aimed to determine whether risk polymorphisms in 12 candidate genes are associated with reduction in body mass index (BMI) of patients following switching of antipsychotics to aripiprazole or ziprasidone. METHODS: We recruited 115 schizophrenia patients with metabolic abnormalities and who have been on at least 1 year treatment with other antipsychotics; they were then switched to either aripiprazole or ziprasidone. They were genotyped, and their BMI monitored for 6 months. RESULTS: Significant associations with reduction in BMI at 6 months following switching were found in two of these genes: with rs1800544 of the ADRA2A gene (CC + CG [-0.32 +/- 1.41 kg/m(2)] vs GG [-1.04 +/- 1.63 kg/m(2)]}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15885, title = {Association of FTO, LEPR and MTHFR gene polymorphisms with metabolic syndrome in schizophrenia patients receiving antipsychotics}, author = {S N Roffeei and Z Mohamed and G P Reynolds and M A Said and A Hatim and E H Mohamed and S A Aida and N Z Zainal}, doi = {10.2217/pgs.13.220}, issn = {1462-2416}, year = {2014}, date = {2014-01-01}, journal = {Pharmacogenomics}, volume = {15}, number = {4}, pages = {477-85}, abstract = {AIM: The occurrence of metabolic syndrome (MS) in schizophrenia patients receiving long-term antipsychotics (APs) contributes to their high mortality rate. We aimed to determine whether genetic polymorphisms of identified candidate genes are associated with MS in our study population. MATERIALS \& METHODS: We recruited 206 schizophrenia patients receiving AP treatment for at least a year. Cross-sectional measurements of weight, height, blood pressure, waist and hip circumference, and other lipid profiles were recorded. Patient DNA was genotyped for 16 candidate gene polymorphisms. RESULTS: Of these patients, 59.7% were found to have MS while 40.3% did not. All metabolic parameters were significantly different between the two groups. Only three of the 16 polymorphisms studied showed significant association with MS; rs9939609 of the FTO gene confers risk for MS (odds ratio [OR]: 1.73, 95% CI: 1.07-2.78}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14600, title = {Infanticide and illegal infant abandonment in Malaysia}, author = {S Razali and M Kirkman and S H Ahmad and J Fisher}, url = {http://ac.els-cdn.com/S014521341400221X/1-s2.0-S014521341400221X-main.pdf?_tid=2724ba2c-670c-11e5-a0d2-00000aacb360\&acdnat=1443573939_d67441207f31381fc2eb4b73fb4331fb}, doi = {10.1016/j.chiabu.2014.06.008}, issn = {0145-2134}, year = {2014}, date = {2014-01-01}, journal = {Child Abuse Negl}, volume = {38}, number = {10}, pages = {1715-24}, abstract = {Infant abandonment and infanticide are poorly understood in Malaysia. The information available in the public arena comes predominantly from anecdotal sources. The aim of this study was to describe the prevalence and characteristics of infanticide and illegal infant abandonment in Malaysia and to estimate annual rates for the most recent decade. Summaries of data about infanticide and illegal infant abandonment were gathered from police records; the annual number of live births was ascertained from the national registry. The estimated inferred infanticide rates for Malaysia were compared with the infanticide rates among countries of very high, high, medium, and low rankings on the Human Development, Gender Inequality, and Gini indices. From 1999 to 2011, 1,069 cases of illegal infant abandonment were recorded and 1,147 people were arrested as suspected perpetrators. The estimated inferred infanticide rate fluctuated between 4.82 and 9.11 per 100,000 live births, a moderate rate relative to the infanticide rates of other countries. There are substantial missing data, with details undocumented for about 78-87% of cases and suspected perpetrators. Of the documented cases, it appeared that more boys than girls were victims and that suspected perpetrators were predominantly Malays who were women, usually mothers of the victim; the possibility of arrest bias must be acknowledged. Economic and social inequality, particularly gender inequality, might contribute to the phenomena of infanticide and abandonment. Strategies to reduce rates of infanticide and illegal infant abandonment in Malaysia will require strengthening of the surveillance system and attention to the gender-based inequalities that underpin human development.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14440, title = {Cost effective analysis of recall methods for cervical cancer screening in Selangor--results from a prospective randomized controlled trial}, author = {R M Rashid and S Ramli and J John and M Dahlui}, issn = {1513-7368 (Print) 1513-7368}, year = {2014}, date = {2014-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {15}, number = {13}, pages = {5143-7}, abstract = {Cervical cancer screening in Malaysia is by opportunistic Pap smear which contributes to the low uptake rate. To overcome this, a pilot project called the SIPPS program (translated as information system of Pap smear program) had been introduced whereby women aged 20-65 years old are invited for Pap smear and receive recall to repeat the test. This study aimed at determining which recall method is most cost-effective in getting women to repeat Pap smear. A randomised control trial was conducted where one thousand women were recalled for repeat smear either by registered letter, phone messages, phone call or the usual postal letter. The total cost applied for cost-effectiveness analysis includes the cost of sending letter for first invitation, cost of the recall method and cost of two Pap smears. Cost-effective analysis (CEA) of Pap smear uptake by each recall method was then performed. The uptake of Pap smear by postal letter, registered letters, SMS and phone calls were 18.8%, 20.0%, 21.6% and 34.4%, respectively (p\<0.05). The CER for the recall method was lowest by phone call compared to other interventions; RM 69.18 (SD RM 0.14) compared to RM 106.53 (SD RM 0.13), RM 134.02 (SD RM 0.15) and RM 136.38 (SD RM 0.11) for SMS, registered letter and letter, respectively. ICER showed that it is most cost saving if the usual method of recall by postal letter be changed to recall by phone call. The possibility of letter as a recall for repeat Pap smear to reach the women is higher compared to sending SMS or making phone call. However, getting women to do repeat Pap smear is better with phone call which allows direct communication. Despite the high cost of the phone call as a recall method for repeat Pap smear, it is the most cost-effective method compared to others.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14313, title = {Association between markers of glucose metabolism and risk of colorectal adenoma}, author = {S Rampal and M H Yang and J Sung and H J Son and Y H Choi and J H Lee and Y H Kim and D K Chang and P L Rhee and J C Rhee and E Guallar and J Cho}, url = {http://ac.els-cdn.com/S0016508514003072/1-s2.0-S0016508514003072-main.pdf?_tid=d015c150-66a6-11e5-be79-00000aacb35f\&acdnat=1443530414_d505d2600c8b686d151ed14cd53ba700}, doi = {10.1053/j.gastro.2014.03.006}, issn = {0016-5085}, year = {2014}, date = {2014-01-01}, journal = {Gastroenterology}, volume = {147}, number = {1}, pages = {78-87.e3}, abstract = {BACKGROUND \& AIMS: Diabetes is a risk factor for colorectal cancer. We studied the association between markers of glucose metabolism and metabolic syndrome and the presence of colorectal adenomas in a large number of asymptomatic men and women attending a health screening program in South Korea. We also investigated whether these associations depend on adenoma location. METHODS: In a cross-sectional study, we measured fasting levels of glucose, insulin, hemoglobin A1c, and C-peptide and calculated homeostatic model assessment (HOMA) values (used to quantify insulin resistance) for 19,361 asymptomatic South Korean subjects who underwent colonoscopy examinations from January 2006 to June 2009. Participants completed a standardized self-administered health questionnaire and a validated semiquantitative food frequency questionnaire. Blood samples were collected on the day of the colonoscopy; fasting blood samples were also collected. Robust Poisson regression was used to model the associations of glucose markers with the prevalence of any adenoma. RESULTS: Using detailed multivariable-adjusted dose-response models, the prevalence ratios (aPR, 95% confidence interval [CI]) for any adenoma, comparing the 90th with the 10th percentile, were 1.08 (1.00-1.16; P = .04) for fasting glucose, 1.07 (0.99-1.15; P = .10) for insulin, 1.09 (1.02-1.18}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14420, title = {Effect of vitamin D supplementation on cardiometabolic risks and health-related quality of life among urban premenopausal women in a tropical country--a randomized controlled trial}, author = {M Ramly and M F Ming and K Chinna and S Suboh and R Pendek}, doi = {10.1371/journal.pone.0110476}, issn = {1932-6203}, year = {2014}, date = {2014-01-01}, journal = {PLoS One}, volume = {9}, number = {10}, pages = {e110476}, abstract = {BACKGROUND: Many observational studies linked vitamin D to cardiometabolic risks besides its pivotal role in musculoskeletal diseases, but evidence from trials is lacking and inconsistent. AIM: To determine whether Vitamin D supplementation in urban premenopausal women with vitamin D deficiency can improve cardiometabolic risks and health-related quality of life (HRQOL). DESIGN: A double-blind randomized controlled trial was conducted in Kuala Lumpur, Malaysia. A total of 192 vitamin D deficient (\<50 nmol/l) premenopausal women were randomized to receive either vitamin D 50,000 IU or placebo once a week for 2 months and then monthly for 10 months. Primary outcomes were serum 25(OH)D, serum lipid profiles, blood pressure and HOMA-IR measured at baseline, 6 months and 12 months. HRQOL was assessed with SF-36 at baseline and 12 months. RESULTS: Ninety three and ninety-nine women were randomised into intervention and placebo groups respectively. After 12 months, there were significant differences in the serum 25(OH)D concentration (mean difference: 49.54; 95% CI: 43.94 to 55.14) nmol/l) and PTH levels (mean difference: -1.02; 95% CI: -1.67 to -0.38 pmol/l) in the intervention group compared to placebo group. There was significant difference between treatment group in both serum 25(OH)D and PTH. There was no effect of supplementation on HOMA-IR, serum lipid profiles and blood pressure (all p\>0.05) between two groups. There was a small but significant improvement in HRQOL in the components of vitality (mean difference: 5.041; 95% CI: 0.709 to 9.374) and mental component score (mean difference: 2.951; 95% CI: 0.573 to 5.329) in the intervention group compared to placebo group. CONCLUSION: Large and less frequent dosage vitamin D supplementation was safe and effective in the achievement of vitamin D sufficiency. However, there was no improvement in measured cardiometabolic risk factors in premenopausal women. Conversely vitamin D supplementation improves some components of HRQOL. TRIAL REGISTRATION: Australian New Zealand Clinical Trial Registry ACTRN12612000452897.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14430, title = {Medical tourism in Malaysia: how can we better identify and manage its advantages and disadvantages?}, author = {M Ormond and W K Mun and C C Khoon}, doi = {10.3402/gha.v7.25201}, issn = {1654-9880}, year = {2014}, date = {2014-01-01}, journal = {Glob Health Action}, volume = {7}, pages = {25201}, abstract = {Following the identification of medical tourism as a growth sector by the Malaysian government in 1998, significant government sector and private-sector investments have been channeled into its development over the past 15 years. This is unfolding within the broader context of social services being devolved to for-profit enterprises and 'market-capable' segments of society becoming sites of intensive entrepreneurial investment by both the private sector and the state. Yet, the opacity and paucity of available medical tourism statistics severely limits the extent to which medical tourism's impacts can be reliably assessed, forcing us to consider the real effects that the resulting speculation itself has produced and to reevaluate how the real and potential impacts of medical tourism are--and should be--conceptualized, calculated, distributed, and compensated for. Contemporary debate over the current and potential benefits and adverse effects of medical tourism for destination societies is hamstrung by the scant empirical data currently publicly available. Steps are proposed for overcoming these challenges in order to allow for improved identification, planning, and development of resources appropriate to the needs, demands, and interests of not only medical tourists and big business but also local populations.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15838, title = {Criofolinine and vernavosine, new pentacyclic indole alkaloids incorporating pyrroloazepine and pyridopyrimidine moieties derived from a common yohimbine precursor}, author = {C E Nge and C Y Gan and K H Lim and K N Ting and Y Y Low and T S Kam}, doi = {10.1021/ol503072g}, issn = {1523-7052}, year = {2014}, date = {2014-01-01}, journal = {Org Lett}, volume = {16}, number = {24}, pages = {6330-3}, abstract = {Two new indole alkaloids characterized by previously unencountered natural product skeletons, viz., criofolinine (1), incorporating a pyrroloazepine motif within a pentacyclic ring system, and vernavosine (2, isolated as its ethyl ether derivative 3, which on hydrolysis regenerated the putative precursor alkaloid 2), incorporating a pyridopyrimidine moiety embedded within a pentacyclic carbon framework, were isolated from a Malayan Tabernaemontana species. The structures and absolute configuration of these alkaloids were determined on the basis of NMR and MS analysis and confirmed by X-ray diffraction analysis.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14435, title = {Obesogenic television food advertising to children in Malaysia: sociocultural variations}, author = {S H Ng and B Kelly and C H Se and K Chinna and M J Sameeha and S Krishnasamy and M N Ismail and T Karupaiah}, doi = {10.3402/gha.v7.25169}, issn = {1654-9880}, year = {2014}, date = {2014-01-01}, journal = {Glob Health Action}, volume = {7}, pages = {25169}, abstract = {BACKGROUND: Food advertising on television (TV) is well known to influence children's purchasing requests and models negative food habits in Western countries. Advertising of unhealthy foods is a contributor to the obesogenic environment that is a key driver of rising rates of childhood obesity. Children in developing countries are more at risk of being targeted by such advertising, as there is a huge potential for market growth of unhealthy foods concomitant with poor regulatory infrastructure. Further, in developing countries with multi-ethnic societies, information is scarce on the nature of TV advertising targeting children. OBJECTIVES: To measure exposure and power of TV food marketing to children on popular multi-ethnic TV stations in Malaysia. DESIGN: Ethnic-specific popular TV channels were identified using industry data. TV transmissions were recorded for each channel from November 2012 to August 2013 (16 hr/day) for randomly selected weekdays and weekend days during normal days and repeated during school holidays (n=88 days). Coded food/beverage advertisements were grouped into core (healthy), non-core (non-healthy), or miscellaneous (unclassified) food categories. Peak viewing time (PVT) and persuasive marketing techniques were identified. RESULTS: Non-core foods were predominant in TV food advertising, and rates were greater during school holidays compared to normal days (3.51 vs 1.93 food ads/hr/channel, p\<0.001). During normal days' PVT, the ratio of non-core to core food advertising was higher (3.25 food ads/hr/channel), and this more than trebled during school holidays to 10.25 food ads/hr/channel. Popular channels for Indian children had the lowest rate of food advertising relative to other ethnic groups. However, sugary drinks remained a popular non-core product advertised across all broadcast periods and channels. Notably, promotional characters doubled for non-core foods during school holidays compared to normal days (1.91 vs 0.93 food ads/hr/channel, p\<0.001). CONCLUSIONS: This study highlights non-core food advertising, and predominantly sugary drinks are commonly screened on Malaysian TV channels. The majority of these sugary drinks were advertised by multinational companies, and this observation warrants regulatory attention.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14418, title = {Clinical risk factors for life-threatening lower respiratory tract infections in children: a retrospective study in an urban city in Malaysia}, author = {A M Nathan and F Rani and R J Lee and R Zaki and C Westerhout and I C Sam and L C Lum and J Bruyne}, doi = {10.1371/journal.pone.0111162}, issn = {1932-6203}, year = {2014}, date = {2014-01-01}, journal = {PLoS One}, volume = {9}, number = {10}, pages = {e111162}, abstract = {AIM: Lower respiratory tract infections (LRTIs) are an important cause of morbidity and mortality, especially in low income countries. The aim of this study was to determine risk factors of life-threatening LRTIs in hospitalised children in Malaysia. METHODS: This retrospective study included children aged less than 18 years admitted for LRTIs over 13 months in a tertiary referral centre in Kuala Lumpur, Malaysia. Neonates, children with asthma and those with either no or a normal chest radiograph were excluded. Life-threatening infection was defined as that needing non-invasive ventilation or admission to the paediatric intensive care unit. Routine blood investigations and nasopharyngeal secretion results (bacterial and viral) were obtained. Chest radiographs were reviewed by a designated radiologist. Environmental data (rainfall, particulate matter \</= 10 microm [PM10] and air pollution index [API]) was obtained from the respective government departments. RESULTS: Three hundred and ninety-one episodes of LRTIs were included. Viruses were implicated in 48.5% of LRTIs, with respiratory syncytial virus (RSV) being detected in 44% of viral LRTIs. Forty-six (11.8%) children had life-threatening disease and the overall mortality rate was 1.3% (5 children). RSV was detected in 26% of children with life-threatening LRTIs. In multivariate logistic regression, chronic lung disease, presenting history of apnoea and signs of hypoxia, was associated with life threatening LRTIs. Increased LRTI admissions were associated with low rainfall but not PM10 nor API. Of those on follow-up, 39% had persistent respiratory symptoms. CONCLUSION: One in nine children admitted with LRTI had a life-threatening LRTI. The aetiology was viral in almost half of admitted children. RSV was detected in a quarter of children with life-threatening LRTIs. Children who present with LRTIs and either have chronic lung disease, presenting history of apnoea or signs of hypoxia, should be observed carefully as the risk of deterioration to life-threatening illness is high.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14378, title = {Burden and nutritional deficiencies in opiate addiction- systematic review article}, author = {S Nabipour and M Ayu Said and M Hussain Habil}, issn = {2251-6085 (Print) 2251-6085}, year = {2014}, date = {2014-01-01}, journal = {Iran J Public Health}, volume = {43}, number = {8}, pages = {1022-32}, abstract = {Addiction to the illicit and prescribed use of opiate is an alarming public health issue. Studies on addictive disorders have demonstrated severe nutritional deficiencies in opiate abusers with behavioral, physiological and cognitive symptoms. Opiate addiction is also link with a significant number of diseases including Human Immunodeficiency Virus (HIV), Hepatitis C Virus (HCV) and other blood borne diseases generally stem from the use of needles to inject heroin. The use of medication assisted treatment for opioid addicts in combination with behavioural therapies has been considered as a highly effective treatment. Methadone is a long-lasting mu-opioid agonist and a pharmacological tool which attenuates withdrawal symptoms effectively replacement therapies. This review article aims to explain opiate addiction mechanisms, epidemiology and disease burden with emphasis on dietary and nutritional status of opiate dependent patients in methadone maintenance therapy.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14449, title = {Techniques of monitoring blood glucose during pregnancy for women with pre-existing diabetes}, author = {F M Moy and A Ray and B S Buckley}, doi = {10.1002/14651858.CD009613.pub2}, issn = {1361-6137}, year = {2014}, date = {2014-01-01}, journal = {Cochrane Database Syst Rev}, volume = {4}, pages = {Cd009613}, abstract = {BACKGROUND: Self-monitoring of blood glucose is recommended as a key component of the management plan for diabetes therapy during pregnancy. No existing systematic reviews consider the benefits/effectiveness of various 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. 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: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (6 August 2013), searched reference lists of retrieved studies and contacted trial authors. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing techniques of blood glucose monitoring including self blood glucose monitoring, continuous glucose monitoring (CGM) 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 included. Quasi-RCTs and 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. MAIN RESULTS: The search of the Pregnancy and Childbirth Group's Trials Register identified 21 trial reports. Following application of eligibility criteria, nine trials were included in this review. The included trials involved a total of 506 women (436 women with Type 1 diabetes and 70 women with Type 2 diabetes). All trials originated from European countries and the USA. None of the studies included women with gestational diabetes. Five of the nine included studies were at moderate risk of bias and four studies were at low to moderate risk of bias. Primary outcomes were maternal glycaemic control (fasting blood glucose and HbA1c) and infant birthweight or macrosomia.Various methods of glucose monitoring were compared in the trials. The following comparisons were included in the review: (1) self-monitoring versus standard care, (2) self-monitoring versus hospitalisation, (3) pre-prandial versus post-prandial glucose monitoring, (4) automated telemedicine monitoring versus conventional system, (5) CGM versus intermittent monitoring and (6) constant CGM versus intermittent CGM.Neither pooled analyses nor individual trial analyses showed any significant advantages of one monitoring technique over another for primary outcomes (maternal glycaemic control and infant birthweight) and secondary outcomes such as gestational age at birth or preterm birth, frequency of neonatal hypoglycaemia, death of baby including stillbirth, and neonatal intensive care admission. Primary outcome data on macrosomia were reported by one trial but at a different cut-off value than that pre-specified for the review. Secondary outcomes such as shoulder dystocia, major and minor anomalies were not reported by any of the trials. AUTHORS' CONCLUSIONS: This review found no evidence that any glucose monitoring technique is superior to any other technique among pregnant women with pre-existing Type 1 or Type 2 diabetes. The evidence base for the effectiveness of monitoring techniques is weak and additional evidence from large well-designed randomised trials is required to inform choices of glucose monitoring techniques.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14444, title = {Cohort study on clustering of lifestyle risk factors and understanding its association with stress on health and wellbeing among school teachers in Malaysia (CLUSTer)--a study protocol}, author = {F M Moy and V C Hoe and N N Hairi and B Buckley and P A Wark and D Koh and H B Bueno-de-Mesquita and A M Bulgiba}, doi = {10.1186/1471-2458-14-611}, issn = {1471-2458}, year = {2014}, date = {2014-01-01}, journal = {BMC Public Health}, volume = {14}, pages = {611}, abstract = {BACKGROUND: The study on Clustering of Lifestyle risk factors and Understanding its association with Stress on health and wellbeing among school Teachers in Malaysia (CLUSTer) is a prospective cohort study which aims to extensively study teachers in Malaysia with respect to clustering of lifestyle risk factors and stress, and subsequently, to follow-up the population for important health outcomes. METHOD/DESIGN: This study is being conducted in six states within Peninsular Malaysia. From each state, schools from each district are randomly selected and invited to participate in the study. Once the schools agree to participate, all teachers who fulfilled the inclusion criteria are invited to participate. Data collection includes a questionnaire survey and health assessment. Information collected in the questionnaire includes socio-demographic characteristics, participants' medical history and family history of chronic diseases, teaching characteristics and burden, questions on smoking, alcohol consumption and physical activities (IPAQ); a food frequency questionnaire, the job content questionnaire (JCQ); depression, anxiety and stress scale (DASS21); health related quality of life (SF12-V2); Voice Handicap Index 10 on voice disorder, questions on chronic pain, sleep duration and obstetric history for female participants. Following blood drawn for predefined clinical tests, additional blood and urine specimens are collected and stored for future analysis. Active follow up of exposure and health outcomes will be carried out every two years via telephone or face to face contact. Data collection started in March 2013 and as of the end of March 2014 has been completed for four states: Kuala Lumpur, Selangor, Melaka and Penang. Approximately 6580 participants have been recruited. The first round of data collection and blood sampling is expected to be completed by the end of 2014 with an expected 10,000 participants recruited. DISCUSSION: Our study will provide a good basis for exploring the clustering of lifestyle risk factors and stress and its association with major chronic medical conditions such as obesity, hypertension, impaired glucose tolerance, diabetes mellitus, coronary heart diseases, kidney failure and cancers among teachers.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14243, title = {Reliability and validity of the Nigerian (Hausa) version of the Stroke Impact Scale (SIS) 3.0 index}, author = {A H Mohammad and N Al-Sadat and L Siew Yim and K Chinna}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4170699/pdf/BMRI2014-302097.pdf}, doi = {10.1155/2014/302097}, year = {2014}, date = {2014-01-01}, journal = {Biomed Res Int}, volume = {2014}, pages = {302097}, abstract = {This study aims to test the translated Hausa version of the stroke impact scale SIS (3.0) and further evaluate its psychometric properties. The SIS 3.0 was translated from English into Hausa and was tested for its reliability and validity on a stratified random sample adult stroke survivors attending rehabilitation services at stroke referral hospitals in Kano, Nigeria. Psychometric analysis of the Hausa-SIS 3.0 involved face, content, criterion, and construct validity tests as well as internal and test-retest reliability. In reliability analyses, the Cronbach's alpha values for the items in Strength, Hand function, Mobility, ADL/IADL, Memory and thinking, Communication, Emotion, and Social participation domains were 0.80, 0.92, 0.90, 0.78, 0.84, 0.89, 0.58, and 0.74, respectively. There are 8 domains in stroke impact scale 3.0 in confirmatory factory analysis; some of the items in the Hausa-SIS questionnaire have to be dropped due to lack of discriminate validity. In the final analysis, a parsimonious model was obtained with two items per construct for the 8 constructs (Chi-square/df \< 3, TLI and CFI \> 0.9, and RMSEA \< 0.08). Cross validation with 1000 bootstrap samples gave a satisfactory result (P = 0.011). In conclusion, the shorter 16-item Hausa-SIS seems to measure adequately the QOL outcomes in the 8 domains.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14428, title = {Chronic pain and pattern of health care utilization among Malaysian elderly population: National Health and Morbidity Survey III (NHMS III, 2006)}, author = {L R Mohamed Zaki and N N Hairi}, doi = {10.1016/j.maturitas.2014.08.014}, issn = {0378-5122}, year = {2014}, date = {2014-01-01}, journal = {Maturitas}, volume = {79}, number = {4}, pages = {435-41}, abstract = {OBJECTIVE: The aims of this study were to report prevalence of chronic pain and to examine whether chronic pain influence healthcare usage among elderly Malaysian population. METHODS: This was a sub-population analysis of the elderly sample in the Malaysia's Third National Health and Morbidity Survey (NHMS III) 2006, a nation-wide population based survey. A subset of 4954 elderly aged 60 years and above was used in the analysis. Chronic pain, pain's interference and outcome variables of healthcare utilization (hospital admission and ambulatory care service) were all measured and determined by self-report. RESULTS: Prevalence of chronic pain among elderly Malaysian was 15.2% (95% CI: 14.5, 16.8). Prevalence of chronic pain increased with advancing age, and the highest prevalence was seen among the old-old group category (21.5%). Across young-old and old-old groups, chronic pain was more prevalent among females, Indian ethnicity, widows/widowers, rural residency and those with no educational background. Our study showed that chronic pain alone increased hospitalization but not visits to ambulatory facilities. Presence of chronic pain was significantly associated with the frequency of hospitalization (aIRR 1.11; 95% CI 1.02, 1.38) but not ambulatory care service. CONCLUSIONS: Chronic pain is a prevalent health problem among the elderly in Malaysia and is associated with higher hospitalization rate among the elderly population. This study provides insight into the distribution of chronic pain among the elderly and its relationship with the patterns of healthcare utilization.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14625, title = {Predicting survival of de novo metastatic breast cancer in Asian women: systematic review and validation study}, author = {H Miao and M Hartman and N Bhoo-Pathy and S C Lee and N A Taib and E Y Tan and P Chan and K G Moons and H S Wong and J Goh and S M Rahim and C H Yip and H M Verkooijen}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3973579/pdf/pone.0093755.pdf}, doi = {10.1371/journal.pone.0093755}, issn = {1932-6203}, year = {2014}, date = {2014-01-01}, journal = {PLoS One}, volume = {9}, number = {4}, pages = {e93755}, abstract = {BACKGROUND: In Asia, up to 25% of breast cancer patients present with distant metastases at diagnosis. Given the heterogeneous survival probabilities of de novo metastatic breast cancer, individual outcome prediction is challenging. The aim of the study is to identify existing prognostic models for patients with de novo metastatic breast cancer and validate them in Asia. MATERIALS AND METHODS: We performed a systematic review to identify prediction models for metastatic breast cancer. Models were validated in 642 women with de novo metastatic breast cancer registered between 2000 and 2010 in the Singapore Malaysia Hospital Based Breast Cancer Registry. Survival curves for low, intermediate and high-risk groups according to each prognostic score were compared by log-rank test and discrimination of the models was assessed by concordance statistic (C-statistic). RESULTS: We identified 16 prediction models, seven of which were for patients with brain metastases only. Performance status, estrogen receptor status, metastatic site(s) and disease-free interval were the most common predictors. We were able to validate nine prediction models. The capacity of the models to discriminate between poor and good survivors varied from poor to fair with C-statistics ranging from 0.50 (95% CI, 0.48-0.53) to 0.63 (95% CI, 0.60-0.66). CONCLUSION: The discriminatory performance of existing prediction models for de novo metastatic breast cancer in Asia is modest. Development of an Asian-specific prediction model is needed to improve prognostication and guide decision making.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14459, title = {Prior autoimmune disease and risk of monoclonal gammopathy of undetermined significance and multiple myeloma: a systematic review}, author = {C M McShane and L J Murray and O Landgren and M A O'Rorke and N Korde and A T Kunzmann and M R Ismail and L A Anderson}, doi = {10.1158/1055-9965.epi-13-0695}, issn = {1055-9965}, year = {2014}, date = {2014-01-01}, journal = {Cancer Epidemiol Biomarkers Prev}, volume = {23}, number = {2}, pages = {332-42}, abstract = {BACKGROUND: Several observational studies have investigated autoimmune disease and subsequent risk of monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma. Findings have been largely inconsistent and hindered by the rarity and heterogeneity of the autoimmune disorders investigated. A systematic review of the literature was undertaken to evaluate the strength of the evidence linking prior autoimmune disease and risk of MGUS/multiple myeloma. METHODS: A broad search strategy using key terms for MGUS, multiple myeloma, and 50 autoimmune diseases was used to search four electronic databases (PubMed, Medline, Embase, and Web of Science) from inception through November 2011. RESULTS: A total of 52 studies met the inclusion criteria, of which 32 were suitably comparable to perform a meta-analysis. "Any autoimmune disorder" was associated with an increased risk of both MGUS [n = 760 patients; pooled relative risk (RR) 1.42; 95% confidence interval (CI), 1.14-1.75] and multiple myeloma (n\>2,530 patients; RR 1.13, 95% CI, 1.04-1.22). This risk was disease dependent with only pernicious anemia showing an increased risk of both MGUS (RR 1.67; 95% CI, 1.21-2.31) and multiple myeloma (RR 1.50; 95% CI, 1.25-1.80). CONCLUSIONS: Our findings, based on the largest number of autoimmune disorders and patients with MGUS/multiple myeloma reported to date, suggest that autoimmune diseases and/or their treatment may be important in the etiology of MGUS/multiple myeloma. The strong associations observed for pernicious anemia suggest that anemia seen in plasma cell dyscrasias may be of autoimmune origin. IMPACT: Underlying mechanisms of autoimmune diseases, general immune dysfunction, and/or treatment of autoimmune diseases may be important in the pathogenesis of MGUS/multiple myeloma.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14622, title = {Bridging the data gaps in the epidemiology of hepatitis C virus infection in Malaysia using multi-parameter evidence synthesis}, author = {S A McDonald and R Mohamed and M Dahlui and H Naning and A Kamarulzaman}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4229598/pdf/12879_2014_Article_564.pdf}, doi = {10.1186/s12879-014-0564-6}, issn = {1471-2334}, year = {2014}, date = {2014-01-01}, journal = {BMC Infect Dis}, volume = {14}, pages = {564}, abstract = {BACKGROUND: Collecting adequate information on key epidemiological indicators is a prerequisite to informing a public health response to reduce the impact of hepatitis C virus (HCV) infection in Malaysia. Our goal was to overcome the acute data shortage typical of low/middle income countries using statistical modelling to estimate the national HCV prevalence and the distribution over transmission pathways as of the end of 2009. METHODS: Multi-parameter evidence synthesis methods were applied to combine all available relevant data sources - both direct and indirect - that inform the epidemiological parameters of interest. RESULTS: An estimated 454,000 (95% credible interval [CrI]: 392,000 to 535,000) HCV antibody-positive individuals were living in Malaysia in 2009; this represents 2.5% (95% CrI: 2.2-3.0%) of the population aged 15-64 years. Among males of Malay ethnicity, for 77% (95% CrI: 69-85%) the route of probable transmission was active or a previous history of injecting drugs. The corresponding proportions were smaller for male Chinese and Indian/other ethnic groups (40% and 71%, respectively). The estimated prevalence in females of all ethnicities was 1% (95% CrI: 0.6 to 1.4%); 92% (95% CrI: 88 to 95%) of infections were attributable to non-drug injecting routes of transmission. CONCLUSIONS: The prevalent number of persons living with HCV infection in Malaysia is estimated to be very high. Low/middle income countries often lack a comprehensive evidence base; however, evidence synthesis methods can assist in filling the data gaps required for the development of effective policy to address the future public health and economic burden due to HCV.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14465, title = {Additional oligofructose/inulin does not increase faecal bifidobacteria in critically ill patients receiving enteral nutrition: a randomised controlled trial}, author = {H A Majid and J Cole and P W Emery and K Whelan}, doi = {10.1016/j.clnu.2013.11.008}, issn = {0261-5614}, year = {2014}, date = {2014-01-01}, journal = {Clin Nutr}, volume = {33}, number = {6}, pages = {966-72}, abstract = {BACKGROUND \& AIMS: Patients with diarrhoea during enteral nutrition (EN) have been shown to have low faecal bifidobacteria concentrations. Oligofructose/inulin selectively stimulate the growth of bifidobacteria in healthy humans. This study investigates the effect of additional oligofructose/inulin on the gastrointestinal microbiota, short-chain fatty acids (SCFA) and faecal output in patients receiving EN. METHODS: Adult patients in the intensive care unit (ICU) who were starting EN with a formula containing fibre were randomised to receive 7 g/d of additional oligofructose/inulin or an identically packaged placebo (maltodextrin). A fresh faecal sample was collected at baseline and following at least 7 days of supplementation. Faecal microbiota were analysed using fluorescent in-situ hybridisation and faecal output was monitored daily. RESULTS: Twenty-two patients (mean age 71 years) completed at least 7 days of intervention (mean 12 days). At the end of the intervention, there were no significant differences in the concentrations of bifidobacteria between the groups, after adjusting for baseline values (oligofructose/inulin 6.9 + 1.4, placebo 7.8 + 1.3 log10 cells/g dry faeces, P \> 0.05), but there were significantly lower concentrations of Faecalibacterium prausnitzii (7.0 + 1.0 vs. 8.4 + 1.3 log10 cells/g}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14436, title = {Descriptive epidemiology of colorectal cancer in University Malaya Medical Centre, 2001 to 2010}, author = {B A Magaji and F M Moy and A C Roslani and C W Law}, issn = {1513-7368 (Print) 1513-7368}, year = {2014}, date = {2014-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {15}, number = {15}, pages = {6059-64}, abstract = {BACKGROUND: Colorectal cancer is the second most frequent cancer in Malaysia. Nevertheless, there is little information on treatment and outcomes nationally. We aimed to determine the demographic, clinical and treatment characteristics of colorectal cancer patients treated at the University Malaya Medical Centre (UMMC) as part of a larger project on survival and quality of life outcomes. MATERIALS AND METHODS: Medical records of 1,212 patients undergoing treatment in UMMC between January 2001 and December 2010 were reviewed. A retrospective-prospective cohort study design was used. Research tools included the National Cancer Patient Registration form. Statistical analysis included means, standard deviations (SD), proportions, chi square, t-test/ ANOVA. P-value significance was set at 0.05. RESULTS: The male: female ratio was 1.2:1. The mean age was 62.1 (SD12.4) years. Patients were predominantly Chinese (67%), then Malays (18%), Indians (13%) and others (2%). Malays were younger than Chinese and Indians (mean age 57 versus 62 versus 62 years, p\<0.001). More females (56%) had colon cancers compared to males (44%) (p=0.022). Malays (57%) had more rectal cancer compared to Chinese (45%) and Indians (49%) (p=0.004). Dukes' stage data weres available in 67%, with Dukes' C and D accounting for 64%. Stage was not affected by age, gender, ethnicity or tumor site. Treatment modalities included surgery alone (40%), surgery and chemo/radiotherapy 32%, chemo and radiotherapy (8%) and others (20%). CONCLUSIONS: Significant ethnic differences in age and site distribution, if verified in population-based settings, would support implementation of preventive measures targeting those with the greatest need, at the right age.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15875, title = {Andransinine: an unusual case of spontaneous resolution in an indole alkaloid derivative}, author = {Y Y Low and C Y Gan and T S Kam}, doi = {10.1021/np500289t}, issn = {0163-3864}, year = {2014}, date = {2014-01-01}, journal = {J Nat Prod}, volume = {77}, number = {6}, pages = {1532-5}, abstract = {Racemic andransinine (1), an indole alkaloid derivative obtained during isolation of alkaloids from Alstonia angustiloba and Kopsia pauciflora, was found to undergo spontaneous resolution when crystallized in EtOAc, forming racemic conglomerates (an equimolar mechanical mixture of enantiomerically pure individual crystals). X-ray analyses of the enantiomers (obtained from crystals from EtOAc solution and from chiral-phase HPLC) provided the absolute configuration of each enantiomer as (15R,16S,21R)-(+)-andransinine (1a or I+) and (15S,16R,21S)-(-)-andransinine (1b or I-).}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14624, title = {Ethnicity is an independent determinant of age-specific PSA level: findings from a multiethnic Asian setting}, author = {J Lim and N Bhoo-Pathy and S Sothilingam and R Malek and M Sundram and B Hisham Bahadzor and T A Ong and K L Ng and S Sivalingam and A H Razack}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4128728/pdf/pone.0104917.pdf}, doi = {10.1371/journal.pone.0104917}, issn = {1932-6203}, year = {2014}, date = {2014-01-01}, journal = {PLoS One}, volume = {9}, number = {8}, pages = {e104917}, abstract = {OBJECTIVES: To study the baseline PSA profile and determine the factors influencing the PSA levels within a multiethnic Asian setting. MATERIALS AND METHODS: We conducted a cross-sectional study of 1054 men with no clinical evidence of prostate cancer, prostate surgery or 5alpha-reductase inhibitor treatment of known prostate conditions. The serum PSA concentration of each subject was assayed. Potential factors associated with PSA level including age, ethnicity, height, weight, family history of prostate cancer, lower urinary tract voiding symptoms (LUTS), prostate volume and digital rectal examination (DRE) were evaluated using univariable and multivariable analysis. RESULTS: There were 38 men (3.6%) found to have a PSA level above 4 ng/ml and 1016 (96.4%) with a healthy PSA (\</=4 ng/ml). The median PSA level of Malay, Chinese and Indian men was 1.00 ng/ml, 1.16 ng/ml and 0.83 ng/ml, respectively. Indians had a relatively lower median PSA level and prostate volume than Malays and Chinese, who shared a comparable median PSA value across all 10-years age groups. The PSA density was fairly similar amongst all ethnicities. Further analysis showed that ethnicity, weight and prostate volume were independent factors associated with age specific PSA level in the multivariable analysis (p\<0.05). CONCLUSION: These findings support the concept that the baseline PSA level varies between different ethnicities across all age groups. In addition to age and prostate volume, ethnicity may also need to be taken into account when investigating serum PSA concentrations in the multiethnic Asian population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14445, title = {Genetic variation at CYP3A is associated with age at menarche and breast cancer risk: a case-control study}, author = {N Johnson and F Dudbridge and N Orr and L Gibson and M E Jones and M J Schoemaker and E J Folkerd and B P Haynes and J L Hopper and M C Southey and G S Dite and C Apicella and M K Schmidt and A Broeks and L J Van't Veer and F Atsma and K Muir and A Lophatananon and P A Fasching and M W Beckmann and A B Ekici and S P Renner and E Sawyer and I Tomlinson and M Kerin and N Miller and B Burwinkel and F Marme and A Schneeweiss and C Sohn and P Guenel and T Truong and E Cordina and F Menegaux and S E Bojesen and B G Nordestgaard and H Flyger and R Milne and M P Zamora and J I Arias Perez and J Benitez and L Bernstein and H Anton-Culver and A Ziogas and C Clarke Dur and H Brenner and H Muller and V Arndt and A K Dieffenbach and A Meindl and J Heil and C R Bartram and R K Schmutzler and H Brauch and C Justenhoven and Y D Ko and H Nevanlinna and T A Muranen and K Aittomaki and C Blomqvist and K Matsuo and T Dork and N V Bogdanova and N N Antonenkova and A Lindblom and A Mannermaa and V Kataja and V M Kosma and J M Hartikainen and G Chenevix-Trench and J Beesley and A H Wu and D Van Berg and C C Tseng and D Lambrechts and D Smeets and P Neven and H Wildiers and J Chang-Claude and A Rudolph and S Nickels and D Flesch-Janys and P Radice and P Peterlongo and B Bonanni and V Pensotti and F J Couch and J E Olson and X Wang and Z Fredericksen and V S Pankratz and G G Giles and G Severi and L Baglietto and C Haiman and J Simard and M S Goldberg and F Labreche and M Dumont and P Soucy and others}, doi = {10.1186/bcr3662}, issn = {1465-5411}, year = {2014}, date = {2014-01-01}, journal = {Breast Cancer Res}, volume = {16}, number = {3}, pages = {R51}, abstract = {INTRODUCTION: We have previously shown that a tag single nucleotide polymorphism (rs10235235), which maps to the CYP3A locus (7q22.1), was associated with a reduction in premenopausal urinary estrone glucuronide levels and a modest reduction in risk of breast cancer in women age \</=50 years. METHODS: We further investigated the association of rs10235235 with breast cancer risk in a large case control study of 47,346 cases and 47,570 controls from 52 studies participating in the Breast Cancer Association Consortium. Genotyping of rs10235235 was conducted using a custom Illumina Infinium array. Stratified analyses were conducted to determine whether this association was modified by age at diagnosis, ethnicity, age at menarche or tumor characteristics. RESULTS: We confirmed the association of rs10235235 with breast cancer risk for women of European ancestry but found no evidence that this association differed with age at diagnosis. Heterozygote and homozygote odds ratios (ORs) were OR = 0.98 (95% CI 0.94, 1.01; P = 0.2) and OR = 0.80 (95% CI 0.69, 0.93; P = 0.004), respectively (P(trend) = 0.02). There was no evidence of effect modification by tumor characteristics. rs10235235 was, however, associated with age at menarche in controls (P(trend) = 0.005) but not cases (P(trend) = 0.97). Consequently the association between rs10235235 and breast cancer risk differed according to age at menarche (P(het) = 0.02); the rare allele of rs10235235 was associated with a reduction in breast cancer risk for women who had their menarche age \>/=15 years (OR(het) = 0.84, 95% CI 0.75, 0.94; OR(hom) = 0.81, 95% CI 0.51, 1.30; P(trend) = 0.002) but not for those who had their menarche age \</=11 years (OR(het) = 1.06, 95% CI 0.95, 1.19, OR(hom) = 1.07, 95% CI 0.67, 1.72; P(trend) = 0.29). CONCLUSIONS: To our knowledge rs10235235 is the first single nucleotide polymorphism to be associated with both breast cancer risk and age at menarche consistent with the well-documented association between later age at menarche and a reduction in breast cancer risk. These associations are likely mediated via an effect on circulating hormone levels.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14433, title = {Modified technique of Wolbachia removal from Malaysian Aedes albopictus}, author = {S Joanne and I Vythilingam and N Yugavathy and J I Doss}, doi = {10.12980/apjtb.4.2014apjtb-2014-0020}, issn = {2221-1691 (Print) 2221-1691}, year = {2014}, date = {2014-01-01}, journal = {Asian Pac J Trop Biomed}, volume = {4}, number = {7}, pages = {557-60}, abstract = {OBJECTIVE: To develop an artificial and modified Wolbachia removal technique using tetracycline from naturally Wolbachia infected Aedes albopictus (Ae. albopictus) so as to be able to produce generations of Wolbachia free offsprings. METHODS: In this study, seven different tetracycline treatment methods were conducted to obtain the best removal method. Four methods focused on larvae tetracycline treatment, one method on both larvae and adult tetracycline treatment and the last two methods on adult mosquito sucrose treatment. RESULTS: All larval tetracycline treatments resulted in either high larvae mortality, sterile F0 adult mosquitoes or unsuccessful Wolbachia removal. Treatment of both larvae and adults resulted in reduced larvae mortality, successful Wolbachia removal but slow mosquito fecundity. As for the adult treatment, 1.0 mg/mL as previously published was not able to completely remove Wolbachia in F1 generation whereas 1.25 mg/mL successfully removed Wolbachia from F1 and F2 mosquitoes in 2 weeks. CONCLUSIONS: This method is different from the previously published methods as it provides an improved Wolbachia removal technique from Ae. albopictus with high egg hatchability, low larvae mortality, increased fecundity and better Wolbachia removal rate.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14453, title = {The health-related quality of life among pre-diabetics and its association with body mass index and physical activity in a semi-urban community in Malaysia--a cross sectional study}, author = {N Ibrahim and F M Moy and I A Awalludin and Z Ali and I S Ismail}, doi = {10.1186/1471-2458-14-298}, issn = {1471-2458}, year = {2014}, date = {2014-01-01}, journal = {BMC Public Health}, volume = {14}, pages = {298}, abstract = {BACKGROUND: People with pre-diabetes are at high risk of developing type 2 diabetes and cardiovascular diseases. Measurements of health-related quality of life (HRQOL) among pre-diabetics enable the health care providers to understand their overall health status and planning of interventions to prevent type 2 diabetes. Therefore we aimed to determine the HRQOL and physical activity level; and its association with Body Mass Index (BMI) among pre-diabetics. METHODS: This was a cross sectional study carried out in two primary care clinics in a semi-urban locality of Ampangan, Negeri Sembilan, Malaysia. Data was collected through self-administered questionnaires assessing the demographic characteristics, medical history, lifestyle and physical activity. The Short Form 36-items health survey was used to measure HRQOL among the pre-diabetics. Data entry and analysis were performed using the SPSS version 19. RESULTS: A total of 268 eligible pre-diabetics participated in this study. The prevalence of normal weight, overweight and obesity were 7.1%, 21.6% and 71.3% respectively. Their mean (SD) age was 52.5 (8.3) years and 64.2% were females. Among the obese pre-diabetics, 42.2% had both IFG and IGT, 47.0% had isolated IFG and 10.8% had isolated IGT, 36.2% had combination of hypertension, dyslipidemia and musculoskeletal diseases. More than 53.4% of the obese pre-diabetics had family history of diabetes, 15.7% were smokers and 60.8% were physically inactive with mean PA of \<600 MET-minutes/week. After adjusted for co-variants, Physical Component Summary (PCS) was significantly associated with BMI categories [F (2,262)=11.73, p\<0.001] where pre-diabetics with normal weight and overweight had significantly higher PCS than those obese; normal vs obese [Mdiff=9.84}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15785, title = {Neighborhood-Level Stress and Circadian Cortisol: A Systematic Review and Meta-Analysis}, author = {F Hosseini and N Adha and R Zainol and M Isahak and N Nemati}, issn = {2251-6085 (Print) 2251-6085}, year = {2014}, date = {2014-01-01}, journal = {Iran J Public Health}, volume = {43}, number = {10}, pages = {1324-34}, abstract = {The main objective was to find association between basal cortisol and neighborhood-level stress. Systematic searches, including electronic and hand searches, were conducted. The most recent date of the search was July 26, 2013. Primary observational studies included if they considered stress related outcomes in the neighborhood context. Using the EndNote X7 advanced search option; the authors examined the abstracts and titles of the 18,092 articles to exclude obviously irrelevant studies, gray literature, discussion papers, reviews and, studies with no complete data. Two authors independently extracted data from the original reports into pre-designed data extraction forms based on the Data Extraction Template of the Cochrane Consumer and Communication Review Group (CCCRG). Ten studies with a total of 2,134 participants were synthesized and analyzed. Two studies out of ten received expanded meta-analysis. The overall effect size (95% CI) for cortisol level for residents in neighborhoods with lower stress compared to inhabitants from higher was 0.12 (0.01, 0.23). This review is demonstrating a link between psychosocial or physical stress and cortisol obtained from saliva. However, living in high disorder neighborhoods results in higher level of cortisol. This represents a biological indicator of psychosocial/physical stress exposure (i.e., neighborhood disorder) that reflects variances in stress exposure levels.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14442, title = {Predictors of poststroke health-related quality of life in Nigerian stroke survivors: a 1-year follow-up study}, author = {A M Hamza and N Al-Sadat and S Y Loh and N K Jahan}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4058476/pdf/BMRI2014-350281.pdf}, doi = {10.1155/2014/350281}, year = {2014}, date = {2014-01-01}, journal = {Biomed Res Int}, volume = {2014}, pages = {350281}, abstract = {This study aims to identify the predictors in the different aspects of the health-related quality of life (HRQoL) and to measure the changes of functional status over time in a cohort of Nigerian stroke survivors. A prospective observational study was conducted in three hospitals of Kano state of Nigeria where stroke survivors receive rehabilitation. The linguistic-validated Hausa versions of the stroke impact scale 3.0, modified Rankin scale, Barthel index and Beck depression inventory scales were used. Paired samples t-test was used to calculate the amount of changes that occur over time and the forward stepwise linear regression model was used to identify the predictors. A total of 233 stroke survivors were surveyed at 6 months, and 93% (217/233) were followed at 1 year after stroke. Functional disabilities were significantly reduced during the recovery phase. Motor impairment, disability, and level of depression were independent predictors of HRQoL in the multivariate regression analysis. The involvement of family members as caregivers is the key factor for those survivors with improved functional status. Thus, to enhance the quality of poststroke life, it is proposed that a holistic stroke rehabilitation service and an active involvement of family members are established at every possible level.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14429, title = {Evidence that breast cancer risk at the 2q35 locus is mediated through IGFBP5 regulation}, author = {M Ghoussaini and S L Edwards and K Michailidou and S Nord and R Cowper-Sal Lari and K Desai and S Kar and K M Hillman and S Kaufmann and D M Glubb and J Beesley and J Dennis and M K Bolla and Q Wang and E Dicks and Q Guo and M K Schmidt and M Shah and R Luben and J Brown and K Czene and H Darabi and M Eriksson and D Klevebring and S E Bojesen and B G Nordestgaard and S F Nielsen and H Flyger and D Lambrechts and B Thienpont and P Neven and H Wildiers and A Broeks and L J Van't Veer and E J Th Rutgers and F J Couch and J E Olson and E Hallberg and C Vachon and J Chang-Claude and A Rudolph and P Seibold and D Flesch-Janys and J Peto and I Dos-Santos-Silva and L Gibson and H Nevanlinna and T A Muranen and K Aittomaki and C Blomqvist and P Hall and J Li and J Liu and K Humphreys and D Kang and J Y Choi and S K Park and D Y Noh and K Matsuo and H Ito and H Iwata and Y Yatabe and P Guenel and T Truong and F Menegaux and M Sanchez and B Burwinkel and F Marme and A Schneeweiss and C Sohn and A H Wu and C C Tseng and D Van Den Berg and D O Stram and J Benitez and M P Zamora and J I Perez and P Menendez and X O Shu and W Lu and Y T Gao and Q Cai and A Cox and S S Cross and M W Reed and I L Andrulis and J A Knight and G Glendon and S Tchatchou and E J Sawyer and I Tomlinson and M J Kerin and N Miller and C A Haiman and B E Henderson and F Schumacher and L Le Marchand and A Lindblom and S Margolin and S H Teo and others}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321900/pdf/nihms654459.pdf}, doi = {10.1038/ncomms5999}, issn = {2041-1723}, year = {2014}, date = {2014-01-01}, journal = {Nat Commun}, volume = {4}, pages = {4999}, abstract = {GWAS have identified a breast cancer susceptibility locus on 2q35. Here we report the fine mapping of this locus using data from 101,943 subjects from 50 case-control studies. We genotype 276 SNPs using the 'iCOGS' genotyping array and impute genotypes for a further 1,284 using 1000 Genomes Project data. All but two, strongly correlated SNPs (rs4442975 G/T and rs6721996 G/A) are excluded as candidate causal variants at odds against \>100:1. The best functional candidate, rs4442975, is associated with oestrogen receptor positive (ER+) disease with an odds ratio (OR) in Europeans of 0.85 (95% confidence interval=0.84-0.87; P=1.7 x 10(-43)) per t-allele. This SNP flanks a transcriptional enhancer that physically interacts with the promoter of IGFBP5 (encoding insulin-like growth factor-binding protein 5) and displays allele-specific gene expression, FOXA1 binding and chromatin looping. Evidence suggests that the g-allele confers increased breast cancer susceptibility through relative downregulation of IGFBP5, a gene with known roles in breast cell biology.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14456, title = {The influence of fasting insulin level in post-gestational diabetes mellitus women receiving low-glycaemic-index diets}, author = {R A Ghani and S Shyam and F Arshad and N A Wahab and K Chinna and N S Safii and M Y Nisak and N A Kamaruddin}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3940829/pdf/nutd20145a.pdf}, doi = {10.1038/nutd.2014.5}, issn = {2044-4052}, year = {2014}, date = {2014-01-01}, journal = {Nutr Diabetes}, volume = {4}, pages = {e107}, abstract = {Post-gestational diabetes mellitus (GDM) women are recommended weight loss to manage increased cardio-metabolic risks. We investigated the effects of lowering diet glycaemic index (GI) on fasting blood glucose (FBG), serum lipids, body weight and composition of post-GDM women with varying fasting insulin levels (INS). Seventy-seven Asian, non-diabetic women with previous GDM (aged 20-40 years, mean BMI: 26.4+/-4.6 kg m(-2)) were recruited. At baseline, 20 subjects with INS \<2 muIU ml(-1) and 18 with INS \>/=2 muIU ml(-1) received conventional dietary recommendations (CHDR) only. CHDR emphasised energy and fat intake restriction and encouraged increase in dietary fibre intakes. Twenty-four subjects with INS \<2 muIU ml(-1) and 15 with INS \>/=2 muIU ml(-1), in addition to CHDR, received low-GI education (LGI). Changes in FBG, serum lipids, body weight and body composition were evaluated. Subjects with INS \<2 muIU ml(-1) had similar outcomes with both diets. After 1 year, subjects with INS \>/=2 muIU ml(-1) who received LGI education had reductions in FBG and triglycerides. Subjects who received CHDR observed increase in both FBG and triglycerides (P\<0.05). Among all subjects, diet GI was lower and dietary fibre intakes were higher in LGI compared with CHDR subjects (all P\<0.05). Thus, in Asian post-GDM women with normal/higher INS, adding low-GI education to CHDR improved management of FBG and triglycerides.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15839, title = {Corynanthean, eburnan, secoleuconoxine, and pauciflorine alkaloids from Kopsia pauciflora}, author = {C Y Gan and K Yoganathan and K S Sim and Y Y Low and S H Lim and T S Kam}, doi = {10.1016/j.phytochem.2014.09.014}, issn = {0031-9422}, year = {2014}, date = {2014-01-01}, journal = {Phytochemistry}, volume = {108}, pages = {234-42}, abstract = {Eleven indole alkaloids, comprising four corynanthean, two eburnane, one aspidofractinine, one secoleuconoxine, one andranginine, and two pauciflorine type alkaloids were isolated from the stem-bark and leaf extracts of Kopsia pauciflora. Their structures were determined using NMR and MS analyses. The catharinensine type alkaloid kopsirensine B and the secoleuconoxine alkaloid arboloscine A showed moderate to weak activity in reversing MDR in vincristine-resistant KB cells. The alkaloid content was markedly different compared to that of a sample from Malaysian Borneo.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14422, title = {The 19q12 bladder cancer GWAS signal: association with cyclin E function and aggressive disease}, author = {Y P Fu and I Kohaar and L E Moore and P Lenz and J D Figueroa and W Tang and P Porter-Gill and N Chatterjee and A Scott-Johnson and M Garcia-Closas and B Muchmore and D Baris and A Paquin and K Ylaya and M Schwenn and A B Apolo and M R Karagas and M Tarway and A Johnson and A Mumy and A Schned and L Guedez and M A Jones and M Kida and G M Hosain and N Malats and M Kogevinas and A Tardon and C Serra and A Carrato and R Garcia-Closas and J Lloreta and X Wu and M Purdue and Jr. Andriole G. L. and Grubb R. L. and A Black and M T Landi and N E Caporaso and P Vineis and A Siddiq and H B Bueno-de-Mesquita and D Trichopoulos and B Ljungberg and G Severi and E Weiderpass and V Krogh and M Dorronsoro and R C Travis and A Tjonneland and P Brennan and J Chang-Claude and E Riboli and J Prescott and C Chen and I De Vivo and E Govannucci and D Hunter and P Kraft and S Lindstrom and S M Gapstur and E J Jacobs and W R Diver and D Albanes and S J Weinstein and J Virtamo and C Kooperberg and C Hohensee and R J Rodabough and V K Cortessis and D V Conti and M Gago-Dominguez and M C Stern and M C Pike and D Van Den Berg and J M Yuan and C A Haiman and O Cussenot and G Cancel-Tassin and M Roupret and E Comperat and S Porru and A Carta and S Pavanello and C Arici and G Mastrangelo and H B Grossman and Z Wang and X Deng and C C Chung and A Hutchinson and L Burdette and W Wheeler and Jr. Fraumeni J. and S J Chanock and S M Hewitt and D T Silverman and N Rothman and L Prokunina-Olsson}, url = {http://cancerres.aacrjournals.org/content/74/20/5808.full.pdf}, doi = {10.1158/0008-5472.can-14-1531}, issn = {0008-5472}, year = {2014}, date = {2014-01-01}, journal = {Cancer Res}, volume = {74}, number = {20}, pages = {5808-18}, abstract = {A genome-wide association study (GWAS) of bladder cancer identified a genetic marker rs8102137 within the 19q12 region as a novel susceptibility variant. This marker is located upstream of the CCNE1 gene, which encodes cyclin E, a cell-cycle protein. We performed genetic fine-mapping analysis of the CCNE1 region using data from two bladder cancer GWAS (5,942 cases and 10,857 controls). We found that the original GWAS marker rs8102137 represents a group of 47 linked SNPs (with r(2) \>/= 0.7) associated with increased bladder cancer risk. From this group, we selected a functional promoter variant rs7257330, which showed strong allele-specific binding of nuclear proteins in several cell lines. In both GWASs, rs7257330 was associated only with aggressive bladder cancer, with a combined per-allele OR = 1.18 [95% confidence interval (CI), 1.09-1.27}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14417, title = {Association between lifestyle factors and quality-adjusted life years in the EPIC-NL cohort}, author = {H P Fransen and A M May and J W Beulens and E A Struijk and G A Wit and J M Boer and N C Onland-Moret and J Hoekstra and Y T Schouw and H B Bueno-de-Mesquita and P H Peeters}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219750/pdf/pone.0111480.pdf}, doi = {10.1371/journal.pone.0111480}, issn = {1932-6203}, year = {2014}, date = {2014-01-01}, journal = {PLoS One}, volume = {9}, number = {11}, pages = {e111480}, abstract = {The aim of our study was to relate four modifiable lifestyle factors (smoking status, body mass index, physical activity and diet) to health expectancy, using quality-adjusted life years (QALYs) in a prospective cohort study. Data of the prospective EPIC-NL study were used, including 33,066 healthy men and women aged 20-70 years at baseline (1993-7), followed until 31-12-2007 for occurrence of disease and death. Smoking status, body mass index, physical activity and adherence to a Mediterranean-style diet (excluding alcohol) were investigated separately and combined into a healthy lifestyle score, ranging from 0 to 4. QALYs were used as summary measure of healthy life expectancy, combining a person's life expectancy with a weight for quality of life when having a chronic disease. For lifestyle factors analyzed separately the number of years living longer in good health varied from 0.12 year to 0.84 year, after adjusting for covariates. A combination of the four lifestyle factors was positively associated with higher QALYs (P-trend \<0.0001). A healthy lifestyle score of 4 compared to a score of 0 was associated with almost a 2 years longer life in good health (1.75 QALYs [95% CI 1.37, 2.14]).}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14473, title = {Predictors of death during tuberculosis treatment in TB/HIV co-infected patients in Malaysia}, author = {I Ismail and A Bulgiba}, doi = {10.1371/journal.pone.0073250}, issn = {1932-6203}, year = {2013}, date = {2013-01-01}, journal = {PLoS One}, volume = {8}, number = {8}, pages = {e73250}, abstract = {BACKGROUND: Mortality among TB/HIV co-infected patients is still high particularly in developing countries. This study aimed to determine the predictors of death in TB/HIV co-infected patients during TB treatment. METHODS: We reviewed medical records at the time of TB diagnosis and subsequent follow-up of all newly registered TB patients with HIV co-infection at TB clinics in the Institute of Respiratory Medicine and three public hospitals in the Klang Valley between January 2010 and September 2010. We reviewed these medical records again twelve months after their initial diagnosis to determine treatment outcomes and survival. We analysed using Kaplan-Meier and conducted multivariate Cox proportional hazards analysis to identify predictors of death during TB treatment in TB/HIV co-infected patients. RESULTS: Of the 227 patients studied, 53 (23.3%) had died at the end of the study with 40% of deaths within two months of TB diagnosis. Survival at 2, 6 and 12 months after initiating TB treatment were 90.7%, 82.8% and 78.8% respectively. After adjusting for other factors, death in TB/HIV co-infected patients was associated with being Malay (aHR 4.48; 95%CI 1.73-11.64), CD4 T-lymphocytes count \< 200 cells/microl (aHR 3.89; 95% CI 1.20-12.63), three or more opportunistic infections (aHR 3.61; 95% CI 1.04-12.55), not receiving antiretroviral therapy (aHR 3.21; 95% CI 1.76-5.85) and increase per 10(3) total white blood cell count per microliter (aHR 1.12; 95% CI 1.05-1.20). CONCLUSION: TB/HIV co-infected patients had a high case fatality rate during TB treatment. Initiation of antiretroviral therapy in these patients can improve survival by restoring immune function and preventing opportunistic infections.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14482, title = {Anxiety Status and its Relationship with General Health Related Quality of Life among Prostate Cancer Patients in Two University Hospitals in Kuala Lumpur, Malaysia}, author = {M R Isa and F M Moy and A H Abdul Razack and Z Md Zainuddin and N Z Zainal}, issn = {2251-6085 (Print) 2251-6085}, year = {2013}, date = {2013-01-01}, journal = {Iran J Public Health}, volume = {42}, number = {3}, pages = {240-8}, abstract = {BACKGROUND: This study aimed to determine the prevalence of anxiety among prostate cancer patients, and to ascertain the association between stress status, socio-demographic, medical and surgical illness, current urinary problem and cancer status with general health-related quality of life (HRQOL) among these patients. METHODS: A hospital based, cross sectional study was conducted at Surgical Clinic, University Malaya Medical Centre (UMMC) and Universiti Kebangsaan Malaysia Medical Centre (UKMMC) using universal sampling. RESULT: A total of 193 patients were recruited. The prevalence of anxiety was 25.4% (95%CI: 19.2 - 31.6). The anxiety ratings were mild anxiety (10.4%), moderate anxiety (13.6%) and severe anxiety (1.6%). The total quality of life among stress group was 59.2 +/- 14.7 and among non-stress group was 73.9 +/- 12.7. There was a significant negative weak correlation between anxiety score and total quality of life (rs=-0.534, P\<0.001). In multivariable analysis, there was a significant difference in the total quality of life (QOL) among anxiety status [adj. mean diff. = -9.1 (95%CI: -15.2, -4.7)]. The adjusted mean difference was associated by age category of the patients (P\<0.001); living partner (P\<0.001); intermittency (P=0.035) and problem of hematuria during micturition (P=0.005). CONCLUSION: The prevalence of anxiety among prostate cancer was moderately high. Treating the urination problem as well as encouraging living with spouse/family may improve the quality of life among anxiety condition of these patients.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14505, title = {Chronic pain, impact of pain and pain severity with physical disability in older people--is there a gender difference?}, author = {N N Hairi and R G Cumming and F M Blyth and V Naganathan}, url = {http://ac.els-cdn.com/S0378512212003349/1-s2.0-S0378512212003349-main.pdf?_tid=f91d0942-e139-11e5-bbc3-00000aacb361\&acdnat=1457007661_43c6a2eedc826f735c36f569bf6c504c}, doi = {10.1016/j.maturitas.2012.10.001}, issn = {0378-5122}, year = {2013}, date = {2013-01-01}, journal = {Maturitas}, volume = {74}, number = {1}, pages = {68-73}, abstract = {OBJECTIVE: To establish if there is any gender difference in associations between chronic pain, impact of pain and pain severity with physical disability. METHODS: Data from the New South Wales Older People's Health Survey (OPHS), a population based survey of 8881 older people aged 65 years and above were used in the analysis. Chronic pain, pain with interference and pain severity and outcome variable of physical disability were all measured and determined by self report. RESULTS: Physical disability were more frequent in respondents reporting chronic pain, pain that interferes with activities and pain that was of moderate and strong to severe severity. Chronic pain was significantly associated with physical disability among men with adjusted prevalence ratio (PR) 1.31 (95% CI 1.19, 1.43) and women with adjusted prevalence ratio (PR) 1.34 (95% CI 1.28, 1.42). The relationships between pain with interference and pain severity with physical disability were similar in older men and older women. However, adjustment for psychological distress and self-rated health led to greater reductions in prevalence ratios for older men than women for all associations. CONCLUSION: There is no gender difference in associations between pain and physical disability among older people. However, psychological distress accounted for more pain-related physical disability in men than in women.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14504, title = {Do older people with visual impairment and living alone in a rural developing country report greater difficulty in managing stairs?}, author = {N N Hairi and A Bulgiba and D Peramalah and I Mudla}, url = {http://ac.els-cdn.com/S0091743512005415/1-s2.0-S0091743512005415-main.pdf?_tid=e4ed3226-e139-11e5-a178-00000aacb35f\&acdnat=1457007627_83bfcc8552288665117ec17fc064008f}, doi = {10.1016/j.ypmed.2012.10.016}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {56}, number = {1}, pages = {8-11}, abstract = {OBJECTIVES: Managing stairs is a challenging activity of daily living (ADL) for older people. This study aims to examine the association between visual impairment and difficulty in managing stairs among older people living alone and those living with others. METHODS: A population-based cross sectional study was conducted in rural Malaysia from 2007 till 2008. Seven hundred and sixty five older people aged 60 years and over underwent eye examination for visual impairment. Visual acuity criteria were used to define visual impairment. Presenting visual acuity was assessed using a standard metric Snellen Chart of E type. Difficulty in managing stairs was measured according to a question drawn from the Barthel Index which asks "do you need help in climbing stairs". RESULTS: Overall, the prevalence of difficulty in managing stairs among older people in our population was 135 (18.3%, 95% CI 15.7-21.2). After adjusting for important confounders the odds ratio (OR) for visual impairment and difficulty in managing stairs among older people living alone was 5.04 (95% CI 2.27, 10.62). Among older people living with others, the adjusted OR for visual impairment and difficulty in managing stairs was 3.10 (95% CI 1.52, 6.80). CONCLUSION: In a sample of older people aged 60 years and over, those living alone with visual impairment had greater difficulty in managing stairs than those living with others. Identification of these groups of older people is useful for targeting interventions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15940, title = {Concordance between hysteroscopic impression and endometrial histopathological diagnosis}, author = {D E Gan and R A Jawan and F M Moy}, url = {https://www.sciencedirect.com/science/article/pii/S0091743513000042?via%3Dihub}, doi = {10.1016/j.ypmed.2012.12.026}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {57 Suppl}, pages = {S21-3}, abstract = {OBJECTIVE: The aim of this study was to evaluate the accuracy of hysteroscopic impression for diagnosing benign and malignant endometrial pathology. METHOD: This is a retrospective cross-sectional study involving case records of 412 patients who underwent hysteroscopy with diagnostic dilatation and curettage (D\&C) at the University of Malaya Medical Centre from January 2009 to August 2011, and cases with records of previous hysteroscopies (2007-2008). Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, likelihood ratios (LR) and post-test probabilities of hysteroscopy were calculated. D\&C was set as the 'gold standard'. RESULTS: Hysteroscopy and histology results were concordant in 366 (88.8%) subjects. Sensitivity, specificity, PPV and NPV were high exceeding 80%. Moderate sensitivity for endometrial hyperplasia (64.4%, 95% CI=49.8%-76.8%) with moderate PPV for malignancy (62.1%, 95% CI=44.0%-77.3%) due to misdiagnosing hyperplasia as malignant was observed. PPV for leiomyoma was reduced (83.3%, 95% CI=60.8%-94.2%) despite 100% sensitivity, due to D\&C false negatives. High positive LR (\>10) and low negative LR (\<0.2) were observed generally except for endometrial hyperplasia (0.36). Hysteroscopy had moderate positive post-test probability for malignancy (0.62) but effective in ruling out malignancy (negative post-test probability=0.00). CONCLUSION: Hysteroscopy is accurate for diagnosing focal and malignant endometrial pathology but only moderate for hyperplasia. Endometrial sampling is recommended for all cases especially when suspecting hyperplasia or malignancy.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14630, title = {Cervical screening uptake and its predictors among rural women in Malaysia}, author = {D E Gan and M Dahlui}, issn = {0037-5675 (Print) 0037-5675}, year = {2013}, date = {2013-01-01}, journal = {Singapore Med J}, volume = {54}, number = {3}, pages = {163-8}, abstract = {INTRODUCTION: Cervical cancer is the third most common cancer among Malaysian women. However, the uptake of cervical cancer screening--Pap smear--by women in Malaysia has been low and remains a challenge. This study was conducted to assess the cervical screening practices of rural women in Malaysia and to examine the factors associated with such practices. METHODS: A cross-sectional survey was conducted in five rural districts in Perak, Malaysia. 1,000 households were selected through multistage random sampling. Women aged 20-64 years were interviewed by trained enumerators using structured questionnaires. Binomial logistic regression was used to identify predictors of cervical screening through univariate and multivariate analyses. RESULTS: Among the 959 respondents, only 48.9% had undergone Pap smear at least once in the past three years. Women in the age group 40-49 years (odds ratio 3.027, 95% confidence interval 1.546-5.925; p \< 0.005) were found to be significantly more likely to attend cervical cancer screening as compared to those in the age group 20-29 years. Other significant predictors were being married with children, having knowledge of cervical cancer symptoms, receiving relevant information regarding cervical cancer from health personnel or campaigns, being engaged in family planning and receiving encouragement from husbands. CONCLUSION: Efforts to boost the uptake of Pap smear screening among the rural population should be targeted toward the predictors of positive uptake.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15919, title = {Rhazinilam-Leuconolam-Leuconoxine Alkaloids from Leuconotis griffithii}, author = {C Y Gan and Y Y Low and N F Thomas and T S Kam}, doi = {10.1021/np400214y}, issn = {0163-3864}, year = {2013}, date = {2013-01-01}, journal = {J Nat Prod}, volume = {76}, number = {5}, pages = {957-64}, abstract = {Eight new indole alkaloids (1-8) belonging to the rhazinilam-leuconolam-leuconoxine group, in addition to 52 other alkaloids, were isolated from the stem-bark extract of Leuconotis griffithii, viz., nor-rhazinicine (1), 5,21-dihydrorhazinilam-N-oxide (2), 3,14-dehydroleuconolam (3), and leuconodines A-E (4-8). The structures of these alkaloids were determined using NMR and MS analyses and in some instances confirmed by X-ray diffraction analyses. Alkaloids 1, 5, and 7 showed only moderate to weak cytotoxicity toward KB cells (IC50 12-18 mug/mL), while 8 showed moderate activity in reversing MDR in vincristine-resistant KB cells.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14497, title = {Breast screening and health issues among rural females in Malaysia: how much do they know and practice?}, author = {M Dahlui and D E Gan and N A Taib and J N Lim}, url = {http://ac.els-cdn.com/S0091743512006275/1-s2.0-S0091743512006275-main.pdf?_tid=e3222eaa-e130-11e5-858f-00000aab0f6b\&acdnat=1457003759_ab588b521db3cb6c5491001550f29cb8}, doi = {10.1016/j.ypmed.2012.12.010}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {57 Suppl}, pages = {S18-20}, abstract = {OBJECTIVE: This study investigated rural women's knowledge of breast cancer and screening methods by ethnicity and examined the predictors of breast screening methods. METHODS: A cross-sectional survey was conducted in 2011 in five rural districts of Perak; 959 women were interviewed using a semi-structured questionnaire. ANOVA and regression analysis were used in data analysis. RESULTS: Women below 50 years old, of Malay ethnicity and who had secondary education scored better than those older, of Chinese ethnicity and had primary education (p\<0.001). The uptake of breast self-examination (BSE), clinical breast examination (CBE) and mammogram was 59%, 51% and 6.8%, respectively. Multivariate analysis revealed knowledge of breast cancer and CBE as top predictors of BSE, being married and knowledge of breast cancer as top predictors for CBE; and CBE as the top predictor of mammography uptake. Support from husbands and family members for breast cancer screening was a predictor for CBE and BSE. CONCLUSION: Knowledge of breast cancer and its screening uptake varies by ethnicity, location and the type of support received. Efforts and approaches to improve the women's knowledge of breast cancer and its screening uptake therefore should be customized to address the different influencing factors.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14498, title = {Associations of occupational, transportation, household and leisure-time physical activity patterns with metabolic risk factors among middle-aged adults in a middle-income country}, author = {A H Chu and F M Moy}, url = {http://ac.els-cdn.com/S0091743512006287/1-s2.0-S0091743512006287-main.pdf?_tid=127541da-e12f-11e5-9401-00000aacb35d\&acdnat=1457002979_19c638eaab6ce7340fb40aa535f2621a}, doi = {10.1016/j.ypmed.2012.12.011}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {57 Suppl}, pages = {S14-7}, abstract = {OBJECTIVE: This study investigates physical activity in different domains and its association with metabolic risk factors among middle-aged adults. METHOD: The study was performed in Kuala Lumpur, Malaysia from August 2010-August 2011. Body mass index (BMI), waist circumference, systolic/diastolic blood pressure, and fasting blood glucose/lipid profile were measured in 686 Malay participants (mean age 45.9 +/- 6.5 years). Self-reported physical activity was obtained with the validated IPAQ (Malay version) and categorized into low-, moderate- and high-activity levels across occupational, transportation, household and leisure-time domains. RESULTS: Participants spent most of their time on household (567.5, 95% CI: 510-630 MET-minutes/week) and occupational activities (297, 95% CI: 245-330 MET-minutes/week). After adjusted for gender and smoking, participants with low-activity levels in occupational, transport and household domains were associated with significantly higher odds for metabolic syndrome (2.02, 95% CI: 1.33-3.05; 1.49, 95% CI: 1.01-2.21; 1.96, 95% CI: 1.33-2.91). Significantly higher odds for obesity and abdominal obesity were consistently reported among those with low-activity levels across all four domains. CONCLUSION: High-activity levels in occupational, transportation and household domains were each negatively associated with metabolic syndrome among our cohort. Increase participation of physical activity across all four domains (including leisure-time activity) should be encouraged.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN13995, title = {Joint association of sitting time and physical activity with metabolic risk factors among middle-aged Malays in a developing country: a cross-sectional study}, author = {A H Chu and F M Moy}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3629118/pdf/pone.0061723.pdf}, doi = {10.1371/journal.pone.0061723}, issn = {1932-6203}, year = {2013}, date = {2013-01-01}, journal = {PLoS One}, volume = {8}, number = {4}, pages = {e61723}, abstract = {BACKGROUND: Prolonged sitting is associated with increased weight and higher risks for abdominal obesity, dyslipidaemia, hyperglycaemia and hypertension among the adult population. This has been well documented in the West, but studies on these associations are lacking in developing countries, including Malaysia. OBJECTIVE: This cross-sectional study aimed to examine the joint association of sitting time and physical activity with metabolic risk factors among middle-aged working adults. METHODOLOGY: A total of 686 Malay men and women participated (mean age 45.9 +/- 6.5 years). Metabolic syndrome was diagnosed from the modified NCEP ATP III criteria. Self-reported sitting time was obtained with the validated Malay version of the International Physical Activity Questionnaire. Participants were asked about their time spent sitting during travel in a motor vehicle, e.g., car, motorcycle or bus, over the preceding 7 days. Logistic regression was used to estimate the odds ratio with the confidence interval for the combined effects of sitting quartiles and physical activity categories with metabolic risk factors. RESULTS/SIGNIFICANCE: The prevalence of metabolic syndrome among our participants was 31.9%. Their average total sitting time (including transportation) was 7.6 +/- 2.4 h/day. After we adjusted for gender and educational level, higher sitting quartiles and physically inactive groups were associated with higher odds for metabolic syndrome compared with the referent group (sitting \<6 h/day and physically active). In the physically active stratum, the odds for metabolic syndrome in participants who sat \>/= 9.3 h/day was 3.8 times that of participants who sat \<6 h/day. Both higher sitting quartiles and insufficient physical activity were associated with adverse effects on abdominal obesity, hypertriglyceridemia and hyperglycaemia. CONCLUSION: In joint analyses of sitting time and physical activity, higher sitting time and insufficient physical activity were deleteriously associated with odds for metabolic risk factors in middle-aged Malay men and women.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15965, title = {Teacher Reporting Attitudes Scale (TRAS): confirmatory and exploratory factor analyses with a Malaysian sample}, author = {W Y Choo and K Walsh and K Chinna and N P Tey}, url = {http://journals.sagepub.com/doi/pdf/10.1177/0886260512454720}, doi = {10.1177/0886260512454720}, issn = {0886-2605}, year = {2013}, date = {2013-01-01}, journal = {J Interpers Violence}, volume = {28}, number = {2}, pages = {231-53}, abstract = {The Teacher Reporting Attitude Scale (TRAS) is a newly developed tool to assess teachers' attitudes toward reporting child abuse and neglect. This article reports on an investigation of the factor structure and psychometric properties of the short form Malay version of the TRAS. A self-report cross-sectional survey was conducted with 667 teachers in 14 randomly selected schools in Selangor state, Malaysia. Analyses were conducted in a 3-stage process using both confirmatory (stages 1 and 3) and exploratory factor analyses (stage 2) to test, modify, and confirm the underlying factor structure of the TRAS in a non-Western teacher sample. Confirmatory factor analysis did not support a 3-factor model previously reported in the original TRAS study. Exploratory factor analysis revealed an 8-item, 4-factor structure. Further confirmatory factor analysis demonstrated appropriateness of the 4-factor structure. Reliability estimates for the four factors-commitment, value, concern, and confidence-were moderate. The modified short form TRAS (Malay version) has potential to be used as a simple tool for relatively quick assessment of teachers' attitudes toward reporting child abuse and neglect. Cross-cultural differences in attitudes toward reporting may exist and the transferability of newly developed instruments to other populations should be evaluated.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14027, title = {How well does self-reported adherence fare compared to therapeutic drug monitoring in HAART?}, author = {A Bulgiba and U Y Mohammed and Z Chik and C Lee and D Peramalah}, url = {http://ac.els-cdn.com/S0091743513000066/1-s2.0-S0091743513000066-main.pdf?_tid=0da81456-66a1-11e5-aa7a-00000aacb360\&acdnat=1443527941_4a9a09571fad31747f3158fd1be90c31}, doi = {10.1016/j.ypmed.2013.01.002}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {57 Suppl}, pages = {S34-6}, abstract = {OBJECTIVE: The aim of the study was to determine how well self-reported adherence fares compared to therapeutic drug monitoring in monitoring HAART adherence. METHODS: We administered a validated self-reported adherence (SRA) questionnaire to 925 HIV patients on HAART in a large Malaysian hospital from 2010 to 11. We also performed Therapeutic Drug monitoring (TDM) by concurrently collecting and testing blood samples for Efavirenz, Nevirapine and Lamivudine using Liquid Chromatography/Mass Spectrometry. We compared the SRA against the TDM results. Sensitivity, specificity, positive (PPV) and negative predictive (NPV) and diagnostic accuracy values were computed for each drug. RESULTS: Self-reported adherence (SRA) over-estimates adherence by between 6 and 10 percentage points compared to therapeutic drug monitoring (TDM). SRA is highly sensitive with sensitivity exceeding 0.90 but is not very specific (0.56-0.63). PPV for SRA ranged between 0.76 (Lamivudine) and 0.84 (Efavirenz) while NPV ranged between 0.78 (Lamivudine) and 0.81 (Efavirenz). Overall diagnostic accuracy ranged between 0.76 (Lamivudine) and 0.84 (Nevirapine). CONCLUSION: Self-reported adherence is a surprisingly accurate instrument for measuring HAART adherence compared to TDM and can be reliably used in practice in resource-poor settings.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14628, title = {Influence of lifestyle factors on mammographic density in postmenopausal women}, author = {J S Brand and K Czene and L Eriksson and T Trinh and N Bhoo-Pathy and P Hall and F Celebioglu}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3857226/pdf/pone.0081876.pdf}, doi = {10.1371/journal.pone.0081876}, issn = {1932-6203}, year = {2013}, date = {2013-01-01}, journal = {PLoS One}, volume = {8}, number = {12}, pages = {e81876}, abstract = {BACKGROUND: Mammographic density is a strong risk factor for breast cancer. Apart from hormone replacement therapy (HRT), little is known about lifestyle factors that influence breast density. METHODS: We examined the effect of smoking, alcohol and physical activity on mammographic density in a population-based sample of postmenopausal women without breast cancer. Lifestyle factors were assessed by a questionnaire and percentage and area measures of mammographic density were measured using computer-assisted software. General linear models were used to assess the association between lifestyle factors and mammographic density and effect modification by body mass index (BMI) and HRT was studied. RESULTS: Overall, alcohol intake was positively associated with percent mammographic density (P trend = 0.07). This association was modified by HRT use (P interaction = 0.06): increasing alcohol intake was associated with increasing percent density in current HRT users (P trend = 0.01) but not in non-current users (P trend = 0.82). A similar interaction between alcohol and HRT was found for the absolute dense area, with a positive association being present in current HRT users only (P interaction = 0.04). No differences in mammographic density were observed across categories of smoking and physical activity, neither overall nor in stratified analyses by BMI and HRT use. CONCLUSIONS: Increasing alcohol intake is associated with an increase in mammography density, whereas smoking and physical activity do not seem to influence density. The observed interaction between alcohol and HRT may pose an opportunity for HRT users to lower their mammographic density and breast cancer risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14478, title = {Intake of coffee, decaffeinated coffee, or tea does not affect risk for pancreatic cancer: results from the European Prospective Investigation into Nutrition and Cancer Study}, author = {N Bhoo-Pathy and C S Uiterwaal and V K Dik and S M Jeurnink and B H Bech and K Overvad and J Halkjaer and A Tjonneland and M C Boutron-Ruault and G Fagherazzi and A Racine and V A Katzke and K Li and H Boeing and A Floegel and A Androulidaki and C Bamia and A Trichopoulou and G Masala and S Panico and P Crosignani and R Tumino and P Vineis and P H Peeters and O Gavrilyuk and G Skeie and E Weiderpass and E J Duell and M Arguelles and E Molina-Montes and C Navarro and E Ardanaz and M Dorronsoro and B Lindkvist and P Wallstrom and M Sund and W Ye and K T Khaw and N Wareham and T J Key and R C Travis and T Duarte-Salles and H Freisling and I Licaj and V Gallo and D S Michaud and E Riboli and H B Bueno-De-Mesquita}, url = {http://ac.els-cdn.com/S154235651300774X/1-s2.0-S154235651300774X-main.pdf?_tid=87a5bf70-9e13-11e5-a5f2-00000aacb361\&acdnat=1449624422_43524e7d28609201d3f73490f4619ff9}, doi = {10.1016/j.cgh.2013.05.029}, issn = {1542-3565}, year = {2013}, date = {2013-01-01}, journal = {Clin Gastroenterol Hepatol}, volume = {11}, number = {11}, pages = {1486-92}, abstract = {BACKGROUND \& AIMS: Few modifiable risk factors have been implicated in the etiology of pancreatic cancer. There is little evidence for the effects of caffeinated coffee, decaffeinated coffee, or tea intake on risk of pancreatic cancer. We investigated the association of total coffee, caffeinated coffee, decaffeinated coffee, and tea consumption with risk of pancreatic cancer. METHODS: This study was conducted within the European Prospective Investigation into Nutrition and Cancer cohort, comprising male and female participants from 10 European countries. Between 1992 and 2000, there were 477,312 participants without cancer who completed a dietary questionnaire and were followed up to determine pancreatic cancer incidence. Coffee and tea intake was calibrated with a 24-hour dietary recall. Adjusted hazard ratios (HRs) were computed using multivariable Cox regression. RESULTS: During a mean follow-up period of 11.6 y, 865 first incidences of pancreatic cancers were reported. When divided into fourths, neither total intake of coffee (HR, 1.03; 95% confidence interval [CI], 0.83-1.27; high vs low intake), decaffeinated coffee (HR, 1.12; 95% CI, 0.76-1.63; high vs low intake), nor tea were associated with risk of pancreatic cancer (HR, 1.22, 95% CI, 0.95-1.56; high vs low intake). Moderately low intake of caffeinated coffee was associated with an increased risk of pancreatic cancer (HR, 1.33; 95% CI, 1.02-1.74), compared with low intake. However, no graded dose response was observed, and the association attenuated after restriction to histologically confirmed pancreatic cancers. CONCLUSIONS: Based on an analysis of data from the European Prospective Investigation into Nutrition and Cancer cohort, total coffee, decaffeinated coffee, and tea consumption are not related to the risk of pancreatic cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15962, title = {Association of melanocortin-4 receptor gene polymorphisms with obesity-related parameters in Malaysian Malays}, author = {Y D Apalasamy and M F Ming and S Rampal and A Bulgiba and Z Mohamed}, url = {http://www.tandfonline.com/doi/full/10.3109/03014460.2012.720709}, doi = {10.3109/03014460.2012.720709}, issn = {0301-4460}, year = {2013}, date = {2013-01-01}, journal = {Ann Hum Biol}, volume = {40}, number = {1}, pages = {102-6}, abstract = {BACKGROUND: Melanocortin-4 receptor (MC4R) is an important regulator of body weight and energy intake. Genetic polymorphisms of the MC4R gene have been found to be linked to obesity in many recent studies across the globe. AIM: This study aimed to examine the effects of MC4R polymorphisms on obesity parameters, Linkage disequilibrium (LD) pattern and haplotypes in Malaysian Malays. METHODS: The study subjects were 652 Malaysian Malays. Genomic DNA was extracted from buccal swabs. Genotyping was performed using Sequenom MassARRAY(R) iPLEX platform. Anthropometric and blood lipid profiles were measured. RESULTS: MC4R rs571312 SNP was associated with logBMI (p = 0.008) and systolic blood pressure (p = 0.005), while MC4R rs2229616 SNP was associated with total cholesterol (TC) levels (p = 0.016). The MC4R rs7227255 SNP did not show any association with obesity parameters. CONCLUSIONS: The strength of LD of the MC4R gene region is low and the haplotypes were not associated with obesity in Malaysian Malays.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14463, title = {The correlates of body composition with heart rate recovery after step test: an exploratory study of Malaysian adolescents}, author = {R Abu Hanifah and M N Mohamed and Z Jaafar and N A Mohsein and M Y Jalaludin and H A Majid and L Murray and M Cantwell and T T Su}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3857804/pdf/pone.0082893.pdf}, doi = {10.1371/journal.pone.0082893}, issn = {1932-6203}, year = {2013}, date = {2013-01-01}, journal = {PLoS One}, volume = {8}, number = {12}, pages = {e82893}, abstract = {BACKGROUND: In adults, heart rate recovery is a predictor of mortality, while in adolescents it is associated with cardio-metabolic risk factors. The aim of this study was to examine the relationship between body composition measures and heart rate recovery (HRR) after step test in Malaysian secondary school students. METHODS: In the Malaysian Health and Adolescents Longitudinal Research Team (MyHEART) study, 1071 healthy secondary school students, aged 13 years old, participated in the step test. Parameters for body composition measures were body mass index z-score, body fat percentage, waist circumference, and waist height ratio. The step test was conducted by using a modified Harvard step test. Heart rate recovery of 1 minute (HRR1min) and heart rate recovery of 2 minutes (HRR2min) were calculated by the difference between the peak pulse rate during exercise and the resting pulse rate at 1 and 2 minutes, respectively. Analysis was done separately based on gender. Pearson correlation analysis was used to determine the association between the HRR parameters with body composition measures, while multiple regression analysis was used to determine which body composition measures was the strongest predictor for HRR. RESULTS: For both gender groups, all body composition measures were inversely correlated with HRR1min. In girls, all body composition measures were inversely correlated with HRR2min, while in boys all body composition measures, except BMI z-score, were associated with HRR2min. In multiple regression, only waist circumference was inversely associated with HRR2min (p=0.024) in boys, while in girls it was body fat percentage for HRR2min (p=0.008). CONCLUSION: There was an inverse association between body composition measurements and HRR among apparently healthy adolescents. Therefore, it is important to identify cardio-metabolic risk factors in adolescent as an early prevention of consequent adulthood morbidity. This reiterates the importance of healthy living which should start from young.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14487, title = {Applying the Transtheoretical Model to evaluate the effect of a call-recall program in enhancing Pap smear practice: a cluster randomized trial}, author = {F Abdullah and T T Su}, url = {http://ac.els-cdn.com/S0091743513000340/1-s2.0-S0091743513000340-main.pdf?_tid=4b6a46b0-9e0f-11e5-92f0-00000aab0f6c\&acdnat=1449622603_4556f7391ee322e15d67cbe7003cf136}, doi = {10.1016/j.ypmed.2013.02.001}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {57 Suppl}, pages = {S83-6}, abstract = {OBJECTIVE: The objective of this study was to evaluate the effect of a call-recall approach in enhancing Pap smear practice by changes of motivation stage among non-compliant women. METHODS: A cluster randomized controlled trial with parallel and un-blinded design was conducted between January and November 2010 in 40 public secondary schools in Malaysia among 403 female teachers who never or infrequently attended for a Pap test. A cluster randomization was applied in assigning schools to both groups. An intervention group received an invitation and reminder (call-recall program) for a Pap test (20 schools with 201 participants), while the control group received usual care from the existing cervical screening program (20 schools with 202 participants). Multivariate logistic regression was performed to determine the effect of the intervention program on the action stage (Pap smear uptake) at 24 weeks. RESULTS: In both groups, pre-contemplation stage was found as the highest proportion of changes in stages. At 24 weeks, an intervention group showed two times more in the action stage than control group (adjusted odds ratio 2.44, 95% CI 1.29-4.62). CONCLUSION: The positive effect of a call-recall approach in motivating women to change the behavior of screening practice should be appreciated by policy makers and health care providers in developing countries as an intervention to enhance Pap smear uptake.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14471, title = {Evaluation of a worksite cervical screening initiative to increase Pap smear uptake in Malaysia: a cluster randomized controlled trial}, author = {F Abdullah and M O'Rorke and L Murray and T T Su}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3773923/pdf/BMRI2013-572126.pdf}, doi = {10.1155/2013/572126}, year = {2013}, date = {2013-01-01}, journal = {Biomed Res Int}, volume = {2013}, pages = {572126}, abstract = {BACKGROUND: Despite the significant burden of cervical cancer, Malaysia like many middle-income countries relies on opportunistic cervical screening as opposed to a more organized population-based program. The aim of this study was to ascertain the effectiveness of a worksite screening initiative upon Papanicolaou smear test (Pap test) uptake among educated working women in Malaysia. METHODS: 403 female teachers who never or infrequently attended for a Pap test from 40 public secondary schools in Kuala Lumpur were recruited into a cluster randomized trial conducted between January and November 2010. The intervention group participated in a worksite cervical screening initiative whilst the control group received usual care from the existing cervical screening program. Multivariate logistic regression was performed to determine the impact of the intervention program on Pap smear uptake after 24 weeks of followup. RESULTS: The proportion of women attending for a Pap test was significantly higher in the intervention than in the control group (18.1% versus 10.1%, P value \< 0.05) with the worksite screening initiative doubling the Pap smear uptake, adjusted odds ratio 2.44 (95% CI: 1.29-4.62). CONCLUSION: Worksite health promotion interventions can effectively increase cervical smear uptake rates among eligible workers in middle-income countries. Policy makers and health care providers in these countries should include such interventions in strategies for reducing cervical cancer burden. This trial is registered with IRCT201103186088N1.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14466, title = {Is the phone call the most effective method for recall in cervical cancer screening?--results from a randomised control trial}, author = {R M Abdul Rashid and M Mohamed and Z A Hamid and M Dahlui}, issn = {1513-7368 (Print) 1513-7368}, year = {2013}, date = {2013-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {14}, number = {10}, pages = {5901-4}, abstract = {OBJECTIVE: To compare the effectiveness of different methods of recall for repeat Pap smear among women who had normal smears in the previous screening. DESIGN: Prospective randomized controlled study. SETTING: All community clinics in Klang under the Ministry of Health Malaysia. PARTICIPANTS: Women of Klang who attended cervical screening and had a normal Pap smear in the previous year, and were due for a repeat smear were recruited and randomly assigned to four different methods of recall for repeat smear. INTERVENTION: The recall methods given to the women to remind them for a repeat smear were either by postal letter, registered letter, short message by phone (SMS) or phone call. MAIN OUTCOME MEASURES: Number and percentage of women who responded to the recall within 8 weeks after they had received the recall, irrespective whether they had Pap test conducted. Also the numbers of women in each recall method that came for repeat Pap smear. RESULTS: The rates of recall messages reaching the women when using letter, registered letter, SMS and phone calls were 79%, 87%, 66% and 68%, respectively. However, the positive responses to recall by letter, registered letter, phone messages and telephone call were 23.9%, 23.0%, 32.9% and 50.9%, respectively (p\<0.05). Furthermore, more women who received recall by phone call had been screened (p\<0.05) compared to those who received recall by postal letter (OR=2.38}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14467, title = {Study protocol for the most effective recall method in a cervical cancer screening program in Klang, Malaysia}, author = {R M Abdul Rashid and M Dahlui}, issn = {1513-7368 (Print) 1513-7368}, year = {2013}, date = {2013-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {14}, number = {10}, pages = {5867-70}, abstract = {BACKGROUND: Cervical cancer is the second most common cancer among Malaysian women with an ASR of 17.9 and a mortality rate of 5.6 per 100,000 population in 2008 (GLOBOCAN, 2008). The 5 year prevalence was estimated to be 14.5 per 100,000 population. As the second most common cancer affecting productive females, cervical cancer imposes an impact to the socioeconomic aspect of the country. However, the poor uptake of cervical cancer screening is a major problem in detecting early pre-cancerous lesions and thus, delay in initiating treatment for cervical cancer. Realizing the urgency to increase the uptake of PAP smear, besides enhancing the promotion of PAP smear screening for women above 35 years old, the call-recall system for pap smear screening had been piloted in one of the suburban districts which aimed to improve regular participation of women for cervical and breast cancer screening. This is of public health importance as identifying the best feasible option to increase patient's respond to participate in the screening program effectively in our setting will be helpful in implementing an organized regular population based screening program tailored to our setting. The pilot program of cervical cancer screening in Klang was an opportunity to assess different options in recalling patients for a repeat pap smear to increase their participation and adherence to the program. METHODS AND RESULTS: This was a population based randomized control trial. Women aged 20-65 years in the population that matched the inclusion and exclusion criteria were re-called for a repeat smear. There are four different intervention groups; letter, registered letters, short messages services (SMS) and phone calls where 250 subjects were recruited into each group. Samples were generated randomly from the same population in Klang into four different groups. The first group received a recall letter for a repeat smear similar to the one that has been given during the first invitation. The intervention groups were either be given a registered letter, an SMS or a phone call to re-call them. The socio-demographic data of the patients who came for uptake were collected for further analysis. All the groups were followed up after 8 weeks to assess their compliance to the recall. CONCLUSIONS: The study will provide recommendations about the most effective methods for recall in a population based pap smear screening program on two outcomes: i) patients response; ii) uptake for repeat pap smear.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @book{RN751, title = {Brief Guide on EndNote X6}, author = {V C Hoe}, url = {https://spm.um.edu.my/wp-content/uploads/2018/02/BriefGuidetoUsingEndNoteX6.pdf}, year = {2013}, date = {2013-01-01}, publisher = {Centre for Occupational and Environmental Health}, address = {Kuala Lumpur, Malaysia}, keywords = {}, pubstate = {published}, tppubtype = {book} } @book{RN762, title = {Southeast Asian Rain-Forest and Its Impacts on Climate Change}, author = {N Agha Mohammadi}, isbn = {978-3-659-41804-4}, year = {2013}, date = {2013-01-01}, publisher = {Lap Lambert Academic Publishing}, keywords = {}, pubstate = {published}, tppubtype = {book} } @article{RN13964, title = {A systematic review of statistical methods used to test for reliability of medical instruments measuring continuous variables}, author = {R Zaki and A Bulgiba and N Nordin and N Azina Ismail}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3758037/pdf/ijbms-16-803.pdf}, issn = {2008-3866 (Print) 2008-3866}, year = {2013}, date = {2013-01-01}, journal = {Iran J Basic Med Sci}, volume = {16}, number = {6}, pages = {803-7}, abstract = {OBJECTIVE(S): Reliability measures precision or the extent to which test results can be replicated. This is the first ever systematic review to identify statistical methods used to measure reliability of equipment measuring continuous variables. This studyalso aims to highlight the inappropriate statistical method used in the reliability analysis and its implication in the medical practice. MATERIALS AND METHODS: In 2010, five electronic databases were searched between 2007 and 2009 to look for reliability studies. A total of 5,795 titles were initially identified. Only 282 titles were potentially related, and finally 42 fitted the inclusion criteria. RESULTS: The Intra-class Correlation Coefficient (ICC) is the most popular method with 25 (60%) studies having used this method followed by the comparing means (8 or 19%). Out of 25 studies using the ICC, only 7 (28%) reported the confidence intervals and types of ICC used. Most studies (71%) also tested the agreement of instruments. CONCLUSION: This study finds that the Intra-class Correlation Coefficient is the most popular method used to assess the reliability of medical instruments measuring continuous outcomes. There are also inappropriate applications and interpretations of statistical methods in some studies. It is important for medical researchers to be aware of this issue, and be able to correctly perform analysis in reliability studies.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14026, title = {Testing the agreement of medical instruments: overestimation of bias in the Bland-Altman analysis}, author = {R Zaki and A Bulgiba and N A Ismail}, url = {http://ac.els-cdn.com/S0091743513000078/1-s2.0-S0091743513000078-main.pdf?_tid=21f35562-66a4-11e5-bd5a-00000aacb35e\&acdnat=1443529263_f29ce2608845e12e056ffc837aa5f25f}, doi = {10.1016/j.ypmed.2013.01.003}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {57 Suppl}, pages = {S80-2}, abstract = {OBJECTIVES: The Bland-Altman method is the most popular method used to assess the agreement of medical instruments. The main concern about this method is the presence of proportional bias. The slope of the regression line fitted to the Bland-Altman plot should be tested to exclude proportional bias. The aim of this study was to determine whether the overestimation of bias in the Bland-Altman analysis is still present even when the proportional bias has been excluded. METHODS: Data were collected from participants attending a workplace health screening program in a public university in Malaysia between 2009 and 2010. Variables collected were blood glucose level, body weight and systolic blood pressure (n=300 per variable). Readings from the original clinical dataset were compared with twenty randomly generated datasets for each variable. The Bland-Altman limits of agreement was used to determine the agreement. The presence of proportional bias was excluded for all datasets using the recommended method. RESULTS: The range of predicted bias was higher than the simulated bias for all datasets. The overestimation of bias increased as the range of actual bias increased. CONCLUSION: Testing the slope of regression line of the Bland-Altman plot does not remove the artifactual bias in the prediction.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15928, title = {Susceptibility and gene interaction study of the angiotensin II type 1 receptor (AGTR1) gene polymorphisms with non-alcoholic fatty liver disease in a multi-ethnic population}, author = {S M Zain and Z Mohamed and S Mahadeva and S Rampal and R C Basu and P L Cheah and A Salim and R Mohamed}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3590220/pdf/pone.0058538.pdf}, doi = {10.1371/journal.pone.0058538}, issn = {1932-6203}, year = {2013}, date = {2013-01-01}, journal = {PLoS One}, volume = {8}, number = {3}, pages = {e58538}, abstract = {Angiotensin II type 1 receptor (AGTR1) has been reported to play a fibrogenic role in non-alcoholic fatty liver disease (NAFLD). In this study, five variants of the AGTR1 gene (rs3772622, rs3772627, rs3772630, rs3772633, and rs2276736) were examined for their association with susceptibility to NAFLD. Subjects made up of 144 biopsy-proven NAFLD patients and 198 controls were genotyped using TaqMan assays. The liver biopsy specimens were histologically graded and scored according to the method of Brunt. Single locus analysis in pooled subjects revealed no association between each of the five variants with susceptibility to NAFLD. In the Indian ethnic group, the rs2276736, rs3772630 and rs3772627 appear to be protective against NAFLD (p = 0.010}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15947, title = {Impact of leptin receptor gene variants on risk of non-alcoholic fatty liver disease and its interaction with adiponutrin gene}, author = {S M Zain and Z Mohamed and S Mahadeva and P L Cheah and S Rampal and K F Chin and A S Mahfudz and R C Basu and H L Tan and R Mohamed}, url = {http://onlinelibrary.wiley.com/doi/10.1111/jgh.12104/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 = {10.1111/jgh.12104}, issn = {0815-9319}, year = {2013}, date = {2013-01-01}, journal = {J Gastroenterol Hepatol}, volume = {28}, number = {5}, pages = {873-9}, abstract = {BACKGROUND AND AIM: Genetic polymorphism has been implicated as a factor for the occurrence of non-alcoholic fatty liver disease (NAFLD). This study attempted to assess whether polymorphisms in the leptin receptor (LEPR) gene and its combined effect with patatin-like phospholipase domain-containing protein 3 (PNPLA3/adiponutrin) are associated with risk of NAFLD. METHODS: A total of 144 biopsy-proven NAFLD and 198 controls were genotyped using the Sequenom MassARRAY platform. RESULTS: We observed a significant association between the LEPR rs1137100 and rs1137101 with susceptibility to NAFLD (odds ratio [OR] 1.64, 95% confidence interval [CI] 1.18-2.28}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14492, title = {Correlates between risk perceptions of cervical cancer and screening practice}, author = {Y L Wong and K Chinna and J Mariapun and L P Wong and E M Khoo and W Y Low and R Shuib}, doi = {10.1016/j.ypmed.2013.01.004}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {57 Suppl}, pages = {S24-6}, abstract = {OBJECTIVES: To identify the correlates between risk perceptions and cervical cancer screening among urban Malaysian women. METHOD: A cross-sectional household survey was conducted among 231 women in Petaling Jaya city in 2007. The association of risk perceptions of cervical cancer and screening practice was analyzed using Poisson regression. RESULTS: 56% of the respondents ever had a Pap smear test. Knowledge of signs and symptoms (aPR=1.11, 95% CI=1.03-1.19), age (aPR=1.02, 95% CI=1.01-1.03), number of pregnancies (aPR=1.06, 95% CI=1.01-1.11), marital status, education level and religion were found to be significant correlates of Pap smear screening. Respondents who were never married were less likely to have had a Pap smear. Those who had no education or primary education were less likely to have had a Pap smear compared to those with degree qualification. The prevalence of screening was significantly higher among Christians and others (aPR=1.35; 95% CI=1.01-1.81) and Buddhists (aPR=1.38; 95% CI=1.03-1.84), compared to Muslims. CONCLUSION: Eliminating anecdotal beliefs as risks via targeted knowledge on established risk factors and culturally sensitive screening processes are strategic for increasing and sustaining uptake of Pap smear screening versus current opportunistic screening practices.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14477, title = {Health beliefs and practices related to dengue fever: a focus group study}, author = {L P Wong and S AbuBakar}, doi = {10.1371/journal.pntd.0002310}, issn = {1935-2727}, year = {2013}, date = {2013-01-01}, journal = {PLoS Negl Trop Dis}, volume = {7}, number = {7}, pages = {e2310}, abstract = {BACKGROUND: This qualitative study aimed to provide an in-depth understanding of the meaning of dengue fever (DF) amongst people living in a dengue endemic region, dengue prevention and treatment-seeking behaviours. The Health Belief Model was used as a framework to explore and understand dengue prevention behaviours. METHODS: A total of 14 focus group discussions were conducted with 84 Malaysian citizens of different socio-demographic backgrounds between 16(th) December, 2011 and 12(th) May, 2012. RESULTS: The study revealed that awareness about DF and prevention measures were high. The pathophysiology of dengue especially dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) were rarely known; as a result, it was seen as deadly by some but was also perceived as easily curable by others without a basis of understanding. Young adults and elderly participants had a low perception of susceptibility to DF. In general, the low perceived susceptibility emerged as two themes, namely a perceived natural ability to withstand infection and a low risk of being in contact with the dengue virus vector, Aedes spp. mosquitoes. The barriers to sustained self-prevention against dengue prevention that emerged in focus groups were: i) lack of self-efficacy, ii) lack of perceived benefit, iii) low perceived susceptibility, and iv) unsure perceived susceptibility. Low perceived benefit of continued dengue prevention practices was a result of lack of concerted action against dengue in their neighborhood. Traditional medical practices and home remedies were widely perceived and experienced as efficacious in treating DF. CONCLUSION: Behavioural change towards attaining sustainability in dengue preventive practices may be enhanced by fostering comprehensive knowledge of dengue and a change in health beliefs. Wide use of unconventional therapy for DF warrants the need to enlighten the public to limit their reliance on unproven alternative treatments.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14488, title = {Multi-ethnic perspective of uptake of HIV testing and HIV-related stigma: a cross-sectional population-based study}, author = {L P Wong}, doi = {10.1080/09540121.2013.766302}, issn = {0954-0121}, year = {2013}, date = {2013-01-01}, journal = {AIDS Care}, volume = {25}, number = {11}, pages = {1356-69}, abstract = {The objective of this study was to identify demographic characteristics and correlates of the uptake of HIV testing, willingness to be tested and perceived HIV-related stigma of Malaysian lay public. A cross-sectional computer-assisted telephone interview survey of a representative sample of multiracial Malaysians aged 18 years and above was conducted between December and July 2011. The survey collected information on demographics, knowledge about HIV transmission and religious beliefs on attitudes to HIV/AIDS. A total of 2271 households were successfully interviewed. The response rate was 48.65%. The HIV transmission knowledge score ranged from 0 to 15 (mean =10.56; SD+/-2.42). Three of the most common misconceptions about HIV transmission were mosquito bite (42.8%), eating in a restaurant where the cook is HIV positive (20.4%) and using a public toilet (20.1%). Only 20.6% reported ever having been tested for HIV, 49.1% reported a willingness to be tested for HIV and 30.3% had no intention of getting an HIV test. Low-risk perception (63.7%) constitutes a major barrier to HIV testing. Being Malay and Chinese (relative to Indian) were the strongest predictors of low-risk perception. Other significant predictors of low-risk perception were being male, being married and living in an urban locality. Perceived self-stigma if tested positive for HIV was prevalent (78.8%). Multivariate findings showed that being female, Malay, low income, living in rural localities and public stigma were significant correlates of self-stigma. These findings warrant interventions to reduce the disproportionate HIV transmission misconception, barriers to HIV testing and stigma and discriminative attitudes to involve considerations of sociocultural economic and demographic characteristics.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14486, title = {Prevalence and factors associated with HIV/AIDS-related stigma and discriminatory attitudes: a cross-sectional nationwide study}, author = {L P Wong}, doi = {10.1016/j.ypmed.2013.03.013}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {57 Suppl}, pages = {S60-3}, abstract = {OBJECTIVE: The prime purpose of this study is to assess HIV/AIDS-related self-stigma and discrimination (S\&D) attitudes and associated factors using multivariate analysis of data from the 2010-11 National Survey of Understanding the Root of HIV/AIDS Related Stigma and Discrimination. METHOD: A national telephone survey was carried out with 2271 of the Malaysian public aged 18-60 years. The sample was contacted by random digit dialing covering the whole of Peninsular Malaysia from December 2010 to May 2011. The HIV-transmission knowledge, HIV-related self-stigma, and public stigma were investigated. RESULTS: Despite high level of HIV-transmission knowledge [mean (SD)=10.56 (2.42), mean score at 70th percentile] the respondents in this study had moderate levels (mean scores near midpoints) of self-stigma and public stigma attitudes. HIV-transmission knowledge score was not significantly correlated with self-stigma score, but showed a significantly small positive effect (r\<0.2) for public stigma scores. Ethnicity is the strongest correlate of HIV-transmission knowledge, self-stigma, and public stigma attitudes in the multivariate analyses. Other significant correlates were age, socioeconomic group, and urban-rural setting. CONCLUSIONS: The root causes of HIV stigma and discriminatory attitudes were not associated with knowledge deficiency. Interventions should be oriented towards promoting de-stigmatization of HIV/AIDS, and tailored socio-culturally.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN11918, title = {Are Psychosocial Factors Associated With Low Back Pain and Work Absence for Low Back Pain in an Occupational Cohort?}, author = {D M Urquhart and H L Kelsall and V C Hoe and F M Cicuttini and A B Forbes and M R Sim}, doi = {10.1097/AJP.0b013e31827ff0c0}, issn = {1536-5409 (Electronic) 0749-8047 (Linking)}, year = {2013}, date = {2013-01-01}, journal = {Clin J Pain}, volume = {29}, number = {12}, pages = {1015-1020}, abstract = {OBJECTIVES:: To examine the relationship between individual and work-related psychosocial factors and low back pain (LBP) and associated time off work in an occupational cohort. METHODS:: A self-administered questionnaire was completed by nurses working across 3 major public hospitals. Participants provided sociodemographic data and information on the occurrence of LBP, time off work, and psychosocial factors. RESULTS:: One thousand one hundred eleven participants (response rate 38.6%) were included in the study. Fifty-six percent of participants reported LBP in the previous year. When individual psychosocial factors were examined in the same model, the relationship between somatization and LBP persisted [OR 1.64; 95% confidence interval (CI), 1.35, 2.01]. Low job security was also significantly associated with LBP independent of the other work-related factors (OR 0.82; 95% CI, 0.69, 0.98). Of those participants with LBP, 30% reported absence from work due to LBP. When absence from work was examined, negative beliefs (OR 0.97; 95% CI, 0.94, 1.00) and pain catastrophizing (OR 1.33; 95% CI, 1.04, 1.71) were independently associated with time off work, along with low job satisfaction (OR 0.71; 95% CI, 0.51, 0.97) and high job support (OR 1.35; 95% CI, 1.04, 1.75). CONCLUSIONS:: Somatization and low job security were found to be independently associated with occupational LBP, whereas negative beliefs, pain catastrophizing, reduced job satisfaction, and high job support were independently related to time off work. Longitudinal studies are needed to determine whether these individual and work-related psychosocial factors predict, or alternatively, are outcomes of pain and time off work associated with LBP.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14506, title = {Does telephone lactation counselling improve breastfeeding practices? A randomised controlled trial}, author = {N M Tahir and N Al-Sadat}, doi = {10.1016/j.ijnurstu.2012.09.006}, issn = {0020-7489}, year = {2013}, date = {2013-01-01}, journal = {Int J Nurs Stud}, volume = {50}, number = {1}, pages = {16-25}, abstract = {BACKGROUND: Exclusive breastfeeding rates in Malaysia remains low despite the implementation of the Baby Friendly Hospital Initiative (BFHI) policy in government hospitals. It has been suggested that any form of postnatal lactation support will lead to an increase in exclusive breastfeeding rates. OBJECTIVE: To study the effectiveness of telephone lactation counselling on breastfeeding practices. DESIGN: Single blinded, randomised controlled trial (RCT). SETTING: Maternity wards in a public hospital in Kuala Lumpur, Malaysia. PARTICIPANTS: 357 mothers, each of whom had delivered a full term, healthy infant via spontaneous vaginal delivery. METHODS: Mothers were followed up for 6 months. The intervention group (n=179) received lactation counselling via telephone twice monthly by certified lactation counsellors in addition to receiving the current conventional care of postnatal breastfeeding support. The control group (n=178) received the current conventional care of postnatal breastfeeding support. Definitions of breastfeeding practices were according to World Health Organization (WHO) definitions. Participants answered a self-administered questionnaire during recruitment and were later followed up at one, four and 6-month intervals during the postpartum period via a telephone-based questionnaire. RESULTS: At 1 month, a higher percentage of mothers in the intervention group practiced exclusive breastfeeding, compared to the control group (84.3% vs. 74.7%, OR 1.825 95%}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14493, title = {Socioeconomic consequences of the 2004 tsunami: policy implications for natural disaster management}, author = {T T Su and B I Saimy and A M Bulgiba}, doi = {10.1016/j.ypmed.2012.12.024}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {57 Suppl}, pages = {S74-6}, abstract = {OBJECTIVE: The objective of the study is to assess the socioeconomic status of the households affected by the tsunami of 2004 \& to determine the factors associated with the recovery of household economic status. METHODS: The study was conducted in tsunami-affected areas in Malaysia in 2010-2011. A total of 193 households were included in the survey. Multivariate logistic regression was performed to determine the factors related to the recovery of households' economic status. FINDINGS: Among 193 households, 37% were in a better condition, 40% were unchanged and 22% had not recovered. It took 2.2 years to get back to pre-disaster economic status. Factors leading to successful household economic recovery were "household resided in Sungai Petani", "belong to highest income quartile" and "age of household head". In contrast, "extended family type" and "unemployed household head" reduced the odds of recovery. Households which lost their fishing boats during the tsunami had less chance to recover their previous status. CONCLUSION: The findings of our study would be useful for policy consideration and planning of post disaster management in order to enhance the recovery of household economic status in the short period.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN13969, title = {Level of colorectal cancer awareness: a cross sectional exploratory study among multi-ethnic rural population in Malaysia}, author = {T T Su and J Y Goh and J Tan and A R Muhaimah and Y Pigeneswaren and N S Khairun and A W Normazidah and D K Tharisini and H A Majid}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3750380/pdf/1471-2407-13-376.pdf}, doi = {10.1186/1471-2407-13-376}, issn = {1471-2407}, year = {2013}, date = {2013-01-01}, journal = {BMC Cancer}, volume = {13}, pages = {376}, abstract = {BACKGROUND: This paper presents the level of colorectal cancer awareness among multi-ethnic rural population in Malaysia. METHODS: A rural-based cross sectional survey was carried out in Perak state in Peninsular Malaysia in March 2011. The survey recruited a population-representative sample using multistage sampling. Altogether 2379 participants were included in this study. Validated bowel/colorectal cancer awareness measure questionnaire was used to assess the level of colorectal cancer awareness among study population. Analysis of variance (ANOVA) was done to identify socio-demographic variance of knowledge score on warning signs and risk factors of colorectal cancer. RESULTS: Among respondents, 38% and 32% had zero knowledge score for warning signs and risk factors respectively. Mean knowledge score for warning signs and risk factors were 2.89 (SD 2.96) and 3.49 (SD 3.17) respectively. There was a significant positive correlation between the knowledge score of warning signs and level of confidence in detecting a warning sign. Socio-demographic characteristics and having cancer in family and friends play important role in level of awareness. CONCLUSIONS: Level of awareness on colorectal cancer warning signs and risk factors in the rural population of Malaysia is very low. Therefore, it warrants an extensive health education campaign on colorectal cancer awareness as it is one of the commonest cancer in Malaysia. Health education campaign is urgently needed because respondents would seek medical attention sooner if they are aware of this problem.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14521, title = {Determinants of household direct and indirect costs: an insight for health-seeking behaviour in Burkina Faso}, author = {T T Su and S Flessa}, doi = {10.1007/s10198-011-0354-7}, issn = {1618-7598}, year = {2013}, date = {2013-01-01}, journal = {Eur J Health Econ}, volume = {14}, number = {1}, pages = {75-84}, abstract = {The objective of the study is to identify the determinants of household direct and indirect costs in the Nouna District, Burkina Faso. The data used were from a household survey conducted during 2000-2001. The multinominal logit models were applied to investigate the determinants of direct and indirect costs. The respondents who were sick in the rainy season and severity of illness significantly increased the probability of having high direct and indirect household costs. Acute illness occured in an adult was positively associated with magnitude of household indirect costs. Household economic status and utilization of western medical care played an important role in magnitude of direct cost. The information on determinants of household direct and indirect costs is necessary in order to get a complete picture of household costs for seeking health care and identification of vulnerable social groups and households.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14484, title = {Clinical Epidemiology (CE) and Evidence-Based Medicine (EBM) in the Asia Pacific region (Round Table Forum)}, author = {T T Su and A M Bulgiba and P Sampatanukul and S Sastroasmoro and P Chang and P Tharyan and V Lin and Y L Wong}, doi = {10.1016/j.ypmed.2013.04.009}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {57 Suppl}, pages = {S5-7}, abstract = {Clinical Epidemiology (CE) and Evidence-Based Medicine (EBM) have become increasingly important in an era of rising costs, patient safety concerns and evidence-based health care. CE and EBM research in the Asia Pacific region have grown significantly. However, there are three main challenges such as linking evidence to practice and policy; developing a strong collaborative network; and a need for resources and technical expertise to produce evidence. The Cochrane Collaboration is a possible solution to resolve above challenges identified, particularly the challenge of transforming evidence to practice. In addition, training can be carried out to enhance technical expertise in the region and there is also the promising potential that collaborations could extend beyond systematic reviews. To improve the adoption of evidence-based health policy, selection of the best evidence for the right audience and focusing on the relevant issues through appropriate methodology are essential. Information on effectiveness and cost effectiveness needs to be highlighted for policy makers. The way forward to strengthen research and capacity building is to establish the Asia Pacific Consortium for CE and EBM. The consortium would help to create mutually rewarding scientific research and collaborations that will augur well for advances in CE and EBM.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN13992, title = {Dose-response relationship between hand-transmitted vibration and hand-arm vibration syndrome in a tropical environment}, author = {A T Su and S Maeda and J Fukumoto and A Darus and V C Hoe and N Miyai and M Isahak and S Takemura and A Bulgiba and K Yoshimasu and K Miyashita}, url = {http://oem.bmj.com/content/70/7/498.long}, doi = {10.1136/oemed-2012-101321}, issn = {1351-0711}, year = {2013}, date = {2013-01-01}, journal = {Occup Environ Med}, volume = {70}, number = {7}, pages = {498-504}, abstract = {OBJECTIVES: The dose-response relationship for hand-transmitted vibration has been investigated extensively in temperate environments. Since the clinical features of hand-arm vibration syndrome (HAVS) differ between the temperate and tropical environment, we conducted this study to investigate the dose-response relationship of HAVS in a tropical environment. METHODS: A total of 173 male construction, forestry and automobile manufacturing plant workers in Malaysia were recruited into this study between August 2011 and 2012. The participants were interviewed for history of vibration exposure and HAVS symptoms, followed by hand functions evaluation and vibration measurement. Three types of vibration doses-lifetime vibration dose (LVD), total operating time (TOT) and cumulative exposure index (CEI)-were calculated and its log values were regressed against the symptoms of HAVS. The correlation between each vibration exposure dose and the hand function evaluation results was obtained. RESULTS: The adjusted prevalence ratio for finger tingling and numbness was 3.34 (95% CI 1.27 to 8.98) for subjects with lnLVD\>/=20 ln m(2) s(-4) against those \<16 ln m(2) s(-4). Similar dose-response pattern was found for CEI but not for TOT. No subject reported white finger. The prevalence of finger coldness did not increase with any of the vibration doses. Vibrotactile perception thresholds correlated moderately with lnLVD and lnCEI. CONCLUSIONS: The dose-response relationship of HAVS in a tropical environment is valid for finger tingling and numbness. The LVD and CEI are more useful than TOT when evaluating the dose-response pattern of a heterogeneous group of vibratory tools workers.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15901, title = {A comparison of hand-arm vibration syndrome between Malaysian and Japanese workers}, author = {A T Su and J Fukumoto and A Darus and V C Hoe and N Miyai and M Isahak and S Takemura and A Bulgiba and K Yoshimasu and S Maeda and K Miyashita}, issn = {1341-9145}, year = {2013}, date = {2013-01-01}, journal = {J Occup Health}, volume = {55}, number = {6}, pages = {468-78}, abstract = {OBJECTIVES: The aim of this study was to investigate the clinical characteristics of HAVS in a tropical environment in comparison with a temperate environment. METHODS: We conducted a series medical examinations among the forestry, construction and automobile industry workers in Malaysia adopting the compulsory medical examination procedure used by Wakayama Medical University for Japanese vibratory tools workers. We matched the duration of vibration exposure and compared our results against the Japanese workers. We also compared the results of the Malaysian tree fellers against a group of symptomatic Japanese tree fellers diagnosed with HAVS. RESULTS: Malaysian subjects reported a similar prevalence of finger tingling, numbness and dullness (Malaysian=25.0%}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14476, title = {A review on the prevalence and measurement of elder abuse in the community}, author = {R Sooryanarayana and W Y Choo and N N Hairi}, doi = {10.1177/1524838013495963}, issn = {1524-8380}, year = {2013}, date = {2013-01-01}, journal = {Trauma Violence Abuse}, volume = {14}, number = {4}, pages = {316-25}, abstract = {OBJECTIVES: Aging is a rising phenomenon globally and elder abuse is becoming increasingly recognized as a health and social problem. This review aimed to identify the prevalence of elder abuse in community settings, and discuss issues regarding measurement tools and strategies to measure elderly abuse by systematically reviewing all community-based studies conducted worldwide. METHOD: Articles on elder abuse from 1990 to 2011 were reviewed. A total of 1,832 articles referring to elders residing at home either in their own or at relatives' houses were searched via CINAHL and MEDLINE electronic databases, in addition to a hand search of the latest articles in geriatric textbooks and screening references, choosing a total of 26 articles for review. RESULTS: Highest prevalence was reported in developed countries, with Spain having 44.6% overall prevalence of suspicion of abuse and developing countries exhibiting lower estimates, from 13.5% to 28.8%. Physical abuse was among the least encountered, with psychological abuse and financial exploitation being the most common types of maltreatment reported. To date, there is no single gold standard test to ascertain abuse, with numerous tools and different methods employed in various studies, coupled with varying definitions of thresholds for age. CONCLUSION: Current evidences show that elder abuse is a common problem in both developed and developing countries. It is important that social, health care, and legal systems take these findings into consideration in screening for abuse or reforming existing services to protect the health and welfare of the elderly.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14491, title = {Metabolic syndrome and antipsychotic monotherapy treatment among schizophrenia patients in Malaysia}, author = {M A Said and A Hatim and M H Habil and W Zafidah and M Y Haslina and Y Badiah and M A Ramli and S Ananjit and Y Sapini and M Shah and B Mahmud and A Bulgiba and N N Hairi}, doi = {10.1016/j.ypmed.2013.01.005}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {57 Suppl}, pages = {S50-3}, abstract = {OBJECTIVE: The objective of this study is to determine the prevalence of metabolic syndrome among schizophrenia patients receiving antipsychotic monotherapy in Malaysia. METHOD: A cross-sectional study was conducted at multiple centres between June 2008 and September 2011. Two hundred and five patients who fulfilled the DSM IV-TR diagnostic criteria for schizophrenia and who had been on antipsychotic medication for at least one year, were screened for metabolic syndrome. Patients receiving a mood stabilizer were excluded from the study. Metabolic syndrome was defined by using the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults Treatment Panel III (ATP III) modified for Asian waist circumference. RESULTS: In the first-generation antipsychotic (FGA) group, the highest prevalence of metabolic syndrome was among patients treated with trifluoperazine and flupenthixol decanoate (66.7% each). For the second-generation antipsychotic (SGA) group, the highest prevalence of metabolic syndrome was among patients treated with clozapine (66.7%). The component with the highest prevalence in metabolic syndrome was waist circumference in both FGA and SGA groups except for aripiprazole in SGA. CONCLUSION: The prevalence of metabolic syndrome in schizophrenia patients receiving antipsychotic monotherapy in Malaysia was very high. Intervention measures are urgently needed to combat these problems.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14479, title = {Adapting the Australian system: is an organized screening program feasible in Malaysia?--an overview of cervical cancer screening in both countries}, author = {R M Rashid and M Dahlui and M Mohamed and D Gertig}, issn = {1513-7368 (Print) 1513-7368}, year = {2013}, date = {2013-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {14}, number = {3}, pages = {2141-6}, abstract = {Cervical cancer is the third most common form of cancer that strikes Malaysian women. The National Cancer Registry in 2006 and 2007 reported that the age standardized incidence (ASR) of cervical cancer was 12.2 and 7.8 per 100,000 women, respectively. The cumulative risk of developing cervical cancer for a Malaysian woman is 0.9 for 74 years. Among all ethnic groups, the Chinese experienced the highest incidence rate in 2006, followed by Indians and Malays. The percentage cervical cancer detected at stage I and II was 55% (stage I: 21.0%, stage II: 34.0%, stage III: 26.0% and stage IV: 19.0%). Data from Ministry of Health Malaysia (2006) showed a 58.9% estimated coverage of pap smear screening conducted among those aged 30-49 years. Only a small percentage of women aged 50-59 and 50-65 years old were screened, 14% and 13.8% coverage, respectively. Incidence of cervical cancer was highest (71.6%) among those in the 60-65 age group (MOH, 2003). Currently, there is no organized population-based screening program available for the whole of Malaysia. A pilot project was initiated in 2006, to move from opportunistic cervical screening of women who attend antenatal and postnatal visits to a population based approach to be able to monitor the women through the screening pathway and encourage women at highest risk to be screened. The project was modelled on the screening program in Australia with some modifications to suit the Malaysian setting. Substantial challenges have been identified, particularly in relation to information systems for call and recall of women, as well as laboratory reporting and quality assurance. A cost-effective locally-specific approach to organized screening, that will provide the infrastructure for increasing participation in the cervical cancer screening program, is urgently required.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14483, title = {Study protocol: the effect of vitamin D supplements on cardiometabolic risk factors among urban premenopausal women in a tropical country -- a randomized controlled trial}, author = {M Ramly and F M Moy and R Pendek and S Suboh and A Tan Tong Boon}, doi = {10.1186/1471-2458-13-416}, issn = {1471-2458}, year = {2013}, date = {2013-01-01}, journal = {BMC Public Health}, volume = {13}, pages = {416}, abstract = {BACKGROUND: Besides its classical role in musculoskeletal diseases, vitamin D deficiency has recently been found to be associated with cardiometabolic risks such as hypertension, diabetes mellitus and hypercholesterolemia. Although Malaysia is a sunshine-abundant country, recent studies found that vitamin D deficiency prevalence was significantly high. However, few published studies that measured its effect on cardiometabolic risk factors were found in Malaysia. There are also limited clinical trials carried out globally that tried to establish the causality of vitamin D and cardiometabolic risks. Therefore, a double blind, parallel, randomized controlled trial on vitamin D and cardiometabolic risks is planned to be carried out.The objective of this study is to investigate whether vitamin D supplements can reduce the cardiometabolic risk and improve the quality of life in urban premenopausal women with vitamin D deficiency. METHODS/DESIGN: Three hundred and twenty premenopausal women working in a public university in Kuala Lumpur, Malaysia will be randomized to receive either vitamin D supplement (50,000 IU weekly for 8 weeks and 50,000 IU monthly for 10 months) or placebo for 12 months. At baseline, all participants are vitamin D deficient (\</= 20 ng/ml or 50 nmol/l). Both participants and researchers will be blinded. The serum vitamin D levels of all participants collected at various time points will only be analysed at the end of the trial. Outcome measures such as 25(OH) D3, HOMA-IR, blood pressure, full lipid profiles will be taken at baseline, 6 months and 12 months. Health related quality of life will be measured at baseline and 12 months. The placebo group will be given delayed treatment for six months after the trial. DISCUSSION: This trial will be the first study investigating the effect of vitamin D supplements on both the cardiometabolic risk and quality of life among urban premenopausal women in Malaysia. Our findings will contribute to the growing body of knowledge in the role of vitamin D supplements in the primary prevention for cardiometabolic disease. TRIAL REGISTRATION: ACTRN12612000452897.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15933, title = {Low nocturnal ocular perfusion pressure as a risk factor for normal tension glaucoma}, author = {N Ramli and B S Nurull and N N Hairi and Z Mimiwati}, url = {https://www.sciencedirect.com/science/article/pii/S0091743513000200?via%3Dihub}, doi = {10.1016/j.ypmed.2013.01.007}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {57 Suppl}, pages = {S47-9}, abstract = {OBJECTIVES: In the absence of raised intraocular pressure (IOP), haemodynamic parameters have been implicated in the development of normal tension glaucoma (NTG). The purpose of this study is to compare 24-hour IOP and haemodynamic parameters in NTG patients and non-glaucoma patients. METHODS: This is a cross sectional study involving 72 NTG patients from University of Malaya Medical Centre eye clinic glaucoma registry. The non-glaucoma patients were volunteers selected from eye clinic patients. All enrolled patients underwent 24-hour IOP and blood pressure monitoring via 2-hourly IOP and blood pressure (BP) measurements. All readings were taken in the sitting position during the diurnal period and in the supine position during the nocturnal period RESULTS: Comparison of the haemodynamic parameters, the nocturnal mean systolic BP, nocturnal mean diastolic BP and nocturnal mean arterial pressure (MAP) were significantly lower in the NTG group. The systemic ocular perfusion pressures (OPP), diastolic OPP and mean OPP taken at night were also significantly lower in the NTG group. The differences between the groups were still manifest after controlling for age and presence of hypertension. CONCLUSION: Our findings show that the nocturnal supine blood pressure parameters (systolic, diastolic and mean) and OPP were significantly lower in the NTG group compared to normals. This may reflect defective autoregulatory mechanisms in NTG patients.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14458, title = {Breast cancer awareness of rural women in Malaysia: is it the same as in the cities?}, author = {A A Norlaili and M A Fatihah and N F Daliana and D Maznah}, issn = {1513-7368 (Print) 1513-7368}, year = {2013}, date = {2013-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {14}, number = {12}, pages = {7161-4}, abstract = {Breast cancer is the most common cancer among women globally. This study was conducted to compare the awareness of breast cancer and the practice of breast self-examination (BSE), clinical breast examination (CBE) and mammography screening among rural females in Pahang and Perak. A cross-sectional study was carried out in five selected rural districts of Pahang and Perak. Two hundred and fifty households were randomly selected and interviewed face to face using a semi-structured questionnaire. The majority of residents from both states were Malay, aged between 50 and 60 years and had a secondary level of education. Malay women aged 40-49 years and women with a higher level of education were significantly more aware of breast cancer (p\<0.05). About half of these women practiced BSE (60.7%) and CBE (56.1%), and 7% had underwent mammography screening. The results of this study suggest that women in Pahang and Perak have good awareness of breast cancer and that more than half practice BSE and CBE. The women's level of education appears to contribute to their level of knowledge and health behaviour. However, more effort is needed to encourage all women in rural areas to acquire further knowledge on breast cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14462, title = {Determinants of sexual intercourse initiation among incarcerated adolescents: a mixed-method study}, author = {N D Nik Farid and S Che' Rus and M Dahlui and N Al-Sadat}, issn = {0037-5675 (Print) 0037-5675}, year = {2013}, date = {2013-01-01}, journal = {Singapore Med J}, volume = {54}, number = {12}, pages = {695-701}, abstract = {INTRODUCTION: This study aimed to investigate the determinants of sexual intercourse initiation among incarcerated adolescents aged 12-19 years in Malaysia. METHODS: This was a sequential mixed-method research project that was conducted in two phases. Quantitative and qualitative methods were used in the first and second phases, respectively. Data was collected via a survey using self-reported questionnaires from 1,082 adolescents, and from in-depth interviews and the written essays of 29 participants. The participants were recruited from 22 welfare institutions in peninsular Malaysia. RESULTS: Among the study participants, 483 were male and 599 were female. Overall, 62.3% of the incarcerated adolescents had initiated sexual intercourse at least once. The mean age at first sexual intercourse for both genders was 14.0 years. Individual factors found to be associated with previous sexual intercourse were the female gender (odds ratio [OR] 1.75; 95% confidence interval [CI] 1.11-2.74), previous alcohol use (OR 1.80; 95% CI 1.10-2.94), previous illicit drug use (OR 1.85; 95% CI 1.07-3.22), permissive attitude toward premarital sex (OR 4.34; 95% CI 2.17-8.70), and sexual abuse during childhood (OR 5.41; 95% CI 3.52-8.32). Qualitative findings revealed that the reasons for initiation of sexual intercourse among these adolescents were partner influence, inability to control sex drive, family issues, and the perception of sex as an expression of love. CONCLUSION: The determinants of sexual intercourse initiation among incarcerated Malaysian adolescents are comparable to those of developed countries. However, in Malaysia, sexual and reproductive health programmes for such adolescents should be tailored to address their specific needs.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15907, title = {Voatinggine and tabertinggine, pentacyclic indole alkaloids derived from an iboga precursor via a common cleavamine-type intermediate}, author = {C E Nge and C Y Gan and Y Y Low and N F Thomas and T S Kam}, doi = {10.1021/ol4021404}, issn = {1523-7052}, year = {2013}, date = {2013-01-01}, journal = {Org Lett}, volume = {15}, number = {18}, pages = {4774-7}, abstract = {Two new indole alkaloids, voatinggine (1) and tabertinggine (2), which are characterized by previously unencountered natural product skeletons, were isolated from a Malayan Tabernaemontana species. The structures and absolute configuration of these alkaloids were determined using NMR and MS analysis, and X-ray diffraction analysis. A possible biogenetic pathway to these novel alkaloids from an iboga precursor, and via a common cleavamine-type intermediate, is presented.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14501, title = {Delays in time to primary treatment after a diagnosis of breast cancer: does it impact survival?}, author = {M Mujar and M Dahlui and C H Yip and N A Taib}, doi = {10.1016/j.ypmed.2012.12.001}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {56}, number = {3-4}, pages = {222-4}, abstract = {OBJECTIVE: Treatment delays in breast cancer are generally thought to affect prognosis but the impact on survival remains unclear. Indicators for breast cancer care include time to primary treatment. The purpose of this study was to evaluate whether time to primary treatment (TPT) in breast cancer impacts survival. METHOD: A total of 648 breast cancer patients treated in the University Malaya Medical Center (UMMC), Malaysia between 2004 and 2005 were included in the study. TPT was calculated from the date of pathological diagnosis to the date of primary treatment. Mortality data was obtained from the National Registry of Births and Deaths. Last date of follow-up was November 2010. RESULTS: Median TPT was 18 days. Majority 508 (69.1%) of the patients received treatment within 30 days after diagnosis. The majority was surgically treated. Ethnicity (p=0.002) and stage at presentation (p=0.007) were significantly associated with delayed TPT. Malay ethnicity had delayed TPT compared to the Chinese; Hazard Ratio (HR) 1.9 (Confidence Interval (CI) 1.237, 2.987). Delayed TPT did not affect overall survival on univariate and multivariate analyses. CONCLUSION: Time to primary treatment after a diagnosis of breast cancer had no impact on overall survival. Further studies on care before diagnosis are important in drawing up meaningful quality indicators.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14632, title = {Prevalence and associated factors of stress in the Malaysian Police Force}, author = {R Masilamani and A Bulgiba and K Chinna and A Darus and M Isahak and S Kandiben and D Koh}, url = {http://ac.els-cdn.com/S0091743513000212/1-s2.0-S0091743513000212-main.pdf?_tid=d739446c-673b-11e5-833c-00000aab0f6c\&acdnat=1443594421_ba7b10755199f034df5aff44c980ba2e}, doi = {10.1016/j.ypmed.2013.01.008}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {57 Suppl}, pages = {S57-9}, abstract = {OBJECTIVE: This study aims to determine the prevalence of stress and the associated socio-demographic and work factors among police personnel in Metropolitan Kuala Lumpur, Malaysia. METHOD: A cross-sectional study was conducted in two randomly selected police districts in Kuala Lumpur from 2009 to 2011. A total of 579 police officers from 11 police stations and two headquarters participated in this study. The 21-item Depression, Anxiety and Stress questionnaire was used. Multinomial logistic regression analyses were carried out to examine the effect of socio-demographic and work factors on stress. RESULTS: The overall prevalence of stress was 38.8% (95% CI 34.2, 43.6) with 5.9% (3.9, 8.8), 14.9% (11.6, 18.8) and 18.0% (14.5, 22.2) for severe, moderate and mild stress, respectively. Inspectors were more likely to suffer from severe stress (aOR 10.68, 95% CI 3.51, 32.53) compared to junior officers. Those who complained that their salaries were not commensurate with their jobs were more likely to suffer from moderate levels of stress (aOR 2.73, 95% CI 1.43, 5.22) compared to those who were happy with their salaries. CONCLUSIONS: This study strengthens findings that police job is stressful. Special attention needs to be paid to Inspector-level ranks and the remuneration structure of police officers to address this issue.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15944, title = {Psychometric properties of DAPonDEN: definitions, attitudes and practices in relation to diarrhea during enteral nutrition questionnaire}, author = {H A Majid and M A Bin Sidek and K Chinna}, url = {https://www.sciencedirect.com/science/article/pii/S009174351200638X?via%3Dihub}, doi = {10.1016/j.ypmed.2012.12.021}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {57 Suppl}, pages = {S64-6}, abstract = {OBJECTIVES: To investigate the psychometric properties of the developed 21 item questionnaire to measure definitions, attitudes and management practices in relation to diarrhea during enteral nutrition (DAPonDEN). METHODS: Data were analyzed using exploratory factor analysis from a cross sectional study of 102 nurses aged 18 and over, conducted from December 2011 to February 2012 in Malaysia. Face and content validity of DAPonDEN were first evaluated by few expert panels and patients. For this study, adult nurses were recruited from the adult wards. RESULTS: In the final model, three items in DAPonDEN were dropped. In the exploratory factor analysis, five factors were extracted that explained a total of 55% of the variation in the remaining 18 items. The Kaiser-Meyer-Olkin (KMO) value was 0.723. For definition, there were two underlying factors: 'Key items in defining diarrhea' and 'non-key items in defining diarrhea'. For attitude there was a single factor. For practice, there were two underlying factors: 'enteral nutrition (EN) related' and 'awareness related'. CONCLUSION: The items in each of the underlying dimensions seem to measure the respective concepts for definition, attitude and practices adequately. The 18-items DAPonDEN instrument can be a suitable education tool to be used in relation to diarrhea during EN.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14490, title = {Predictors of death in Malaysian HIV-infected patients on anti-retroviral therapy}, author = {R Lubis and A Bulgiba and A Kamarulzaman and N N Hairi and M Dahlui and D Peramalah}, doi = {10.1016/j.ypmed.2013.01.006}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {57 Suppl}, pages = {S54-6}, abstract = {OBJECTIVE: To determine the predictors of death in Malaysian HIV-infected patients undergoing antiretroviral therapy (ART). METHODS: Data from 845 HIV-infected patients aged \>/= 20 years on ART in a large teaching hospital in Malaysia from 1989 to 2009 were analyzed using Kaplan-Meier and Cox regression analyses. RESULTS: 72.7% of the patients survived. Multivariate Cox regression showed that significant predictors of death were age \>/= 50 years (HR 1.76; 95% CI 1.18-2.64), secondary education (HR 3.57; 95% CI 1.12-11.37), tertiary education (HR 3.57; 95% CI 1.09-11.70), being unemployed (HR 1.49; 95% CI 1.07-2.09), AIDS on initial presentation (HR 5.75; 95% CI 3.29-10.07), single-drug ART (HR 1.84; 95% CI 1.27, 2.66), double-drug ART (HR 1.63; 95% CI 1.19-2.25) and inability to achieve viral load \</= 50 copies/ml (HR 10.22; 95% CI 7.26-14.37). CONCLUSION: Every effort needs to be made to ensure that all HIV patients have access to triple drug ART, to lower viral load to \</= 50 copies/ml and to treat HIV patients before they progress to AIDS as these are significant modifiable predictors of death in Malaysian HIV patients.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15927, title = {Effectiveness of a patient self-management programme for breast cancer as a chronic illness: a non-randomised controlled clinical trial}, author = {S Y Loh and T Packer and K Chinna and K F Quek}, url = {https://link.springer.com/article/10.1007%2Fs11764-013-0274-x}, doi = {10.1007/s11764-013-0274-x}, issn = {1932-2259}, year = {2013}, date = {2013-01-01}, journal = {J Cancer Surviv}, volume = {7}, number = {3}, pages = {331-42}, abstract = {PURPOSE: Patient self-management enables living with a chronic disease effectively. This study examines the effectiveness of a 4-week self-management programme to enable self-management of the numerous after-effects and with breast cancer as a chronic disease. METHODS: Upon ethical approval, 147 multiethnic survivors (stages I-III breast cancer) received either a 4-week self-management intervention (n = 68) or usual care (n = 78) on a controlled clinical trial in a medical centre. The facilitator-led group intervention provides self-management support and skills for managing the medical, emotional and role tasks. Survivors completed the pre- and post-intervention measures on quality of life, distress and participation inventory. RESULTS: Multiple analyses of covariance (adjusted for baseline measures) showed significant differences between groups [F(6, 129) = 2.26}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14470, title = {The association between risk factors and hypertension in perak, malaysia}, author = {K W Loh and F Rani and T C Chan and H Y Loh and C W Ng and F M Moy}, issn = {0300-5283 (Print) 0300-5283}, year = {2013}, date = {2013-01-01}, journal = {Med J Malaysia}, volume = {68}, number = {4}, pages = {291-6}, abstract = {INTRODUCTION: Hypertension is a major public health problem in Malaysia. A survey was initiated to examine the association of modifiable and non-modifiable risk factors for hypertension in Perak, Malaysia. METHODS: A total of 2025 respondents aged 30 years and above were recruited using a multi-stage sampling method. Hypertension was defined as self-reported hypertension and/or average of two blood pressure readings at single occasion with SBP \>/= 140mmHg or DBP \>/= 90 mmHg. Body mass index (BMI) was defined using the Asian criteria and International Physical Activity Questionnaire (IPAQ) was used to evaluate physical activity. Body weight, height and blood pressure were obtained using standard procedures. Univariate analyses were conducted to examine the associations between risk factors and hypertension. Multiple logistic regression was used to examine each significant risk factor on hypertension after adjusted for confounders. RESULTS: In total, 1076 (54.9%) respondents were found to be hypertensive. Significant associations (p \<0.001) with hypertension were noted for increasing age, low physical activity, obese BMI, no education background and positive family history of hypertension. After adjusting for age, sex, ethnicity, education background, family history, BMI, physical activity, smoking and diet, respondents who were obese and had positive family history had higher odds for hypertension (OR:2.34; 95% CI:1.84-3.17 and 1.96 (1.59-2.42) respectively. A significant increase (p \<0.001) in risk for hypertension was noted for age. Those with moderate physical activities were 1.40 (1.04-1.78) times more of having hypertension than those active. Poor diet score and smoking were not significantly associated with increased risk for hypertension. CONCLUSION: In conclusion, modifiable risk factors such as BMI and physical activity are important risk factors to target in reducing the risk for hypertension.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15911, title = {Sociodemographic predictors of recall and recognition of colorectal cancer symptoms and anticipated delay in help- seeking in a multiethnic Asian population}, author = {K W Loh and H A Majid and M Dahlui and A C Roslani and T T Su}, issn = {1513-7368}, year = {2013}, date = {2013-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {14}, number = {6}, pages = {3799-804}, abstract = {BACKGROUND: Colorectal cancer is the second most common cancer in Malaysia. The prognosis of the disease is excellent if detected at an early stage, but the majority of Malaysian patients present at late stages. We aimed to assess the awareness of cancer warning signs and anticipated delay in help-seeking as possible contributors to this phenomenon. MATERIALS AND METHODS: A population-based cross-sectional survey using the Colorectal Cancer Awareness Measure was initiated in Perak, Malaysia. A total of 2,379 respondents aged 18 years and above were recruited using a multi-stage sampling in five locations. Analysis of covariance was used to examine independent sociodemographic predictors of scores for symptom awareness. RESULTS: Younger age, being female, a higher education, and higher income were significantly associated with better scores for both recall and recognition of warning symptoms. Among the ethnic groups, Malays had better recognition of symptoms whereas Chinese recalled the most symptoms. Passing bloody stool was associated with the least anticipated delay and unexplained anal pain had the highest anticipated delay. CONCLUSIONS: The level of awareness across all ethnicities in Malaysia is generally low, especially among minorities. Targeted public education, which is culturally and linguistically appropriate, should be developed to encourage early help-seeking and improve clinical outcomes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14335, title = {Eating behaviour among multi-ethnic adolescents in a middle-income country as measured by the self-reported Children's Eating Behaviour Questionnaire}, author = {D A Loh and F M Moy and N L Zaharan and Z Mohamed}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3857802/pdf/pone.0082885.pdf}, doi = {10.1371/journal.pone.0082885}, issn = {1932-6203}, year = {2013}, date = {2013-01-01}, journal = {PLoS One}, volume = {8}, number = {12}, pages = {e82885}, abstract = {BACKGROUND: Escalating weight gain among the Malaysian paediatric population necessitates identifying modifiable behaviours in the obesity pathway. OBJECTIVES: This study describes the adaptation and validation of the Children's Eating Behaviour Questionnaire (CEBQ) as a self-report for adolescents, investigates gender and ethnic differences in eating behaviour and examines associations between eating behaviour and body mass index (BMI) z-scores among multi-ethnic Malaysian adolescents. METHODOLOGY: This two-phase study involved validation of the Malay self-reported CEBQ in Phase 1 (n = 362). Principal Axis Factoring with Promax rotation, confirmatory factor analysis and reliability tests were performed. In Phase 2, adolescents completed the questionnaire (n = 646). Weight and height were measured. Gender and ethnic differences in eating behaviour were investigated. Associations between eating behaviour and BMI z-scores were examined with complex samples general linear model (GLM) analyses, adjusted for gender, ethnicity and maternal educational level. RESULTS: Exploratory factor analysis revealed a 35-item, 9-factor structure with 'food fussiness' scale split into two. In confirmatory factor analysis, a 30-item, 8-factor structure yielded an improved model fit. Reliability estimates of the eight factors were acceptable. Eating behaviours did not differ between genders. Malay adolescents reported higher Food Responsiveness, Enjoyment of Food, Emotional Overeating, Slowness in Eating, Emotional Undereating and Food Fussiness 1 scores (p\<0.05) compared to Chinese and Indians. A significant negative association was observed between BMI z-scores and Food Fussiness 1 ('dislike towards food') when adjusted for confounders. CONCLUSION: Although CEBQ is a valuable psychometric instrument, adjustments were required due to age and cultural differences in our sample. With the self-report, our findings present that gender, ethnic and weight status influenced eating behaviours. Obese adolescents were found to display a lack of dislike towards food. Future longitudinal and qualitative studies are warranted to further understand behavioural phenotypes of obesity to guide prevention and intervention strategies.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15939, title = {A web-based survey of attitudes toward epilepsy in secondary and tertiary students in Malaysia, using the Public Attitudes Toward Epilepsy (PATE) scale}, author = {K S Lim and M D Hills and W Y Choo and M H Wong and C Wu and C T Tan}, url = {http://www.epilepsybehavior.com/article/S1525-5050(12)00749-4/fulltext}, doi = {10.1016/j.yebeh.2012.12.001}, issn = {1525-5050}, year = {2013}, date = {2013-01-01}, journal = {Epilepsy Behav}, volume = {26}, number = {2}, pages = {158-61}, abstract = {BACKGROUND: Students' attitudes toward epilepsy have been studied in several countries, but none of the studies used a quantitative scale. We aimed to determine the validity and reliability of the Public Attitudes Toward Epilepsy (PATE) scale in a homogenous population consisting of secondary and tertiary students in Malaysia and to quantify their attitudes toward epilepsy, using a web-based survey. RESULTS: A total of 227 respondents with a mean age of 19.6+/-2.07 years, predominantly Chinese (85%), female (62%), and in a pre-university education level (71%) completed the web-based survey. Psychometric testing showed that the PATE is a valid and reliable scale to be applied in a homogenous population. The mean score in the personal domain was significantly higher than that in the general domain (2.73+/-0.61 vs. 2.12+/-0.60, respectively, p\<0.001). Compared with a study previously performed on a general population (Lim et al., 2012 [10]), the mean score in the general domain was significantly lower (p\<0.01), whereas there was no significant difference between the mean scores in the personal domain. The mean scores in the general domain were significantly lower for those with tertiary education (p\<0.001) but did not correlate with gender and ethnicity. CONCLUSION: The attitudes of secondary and tertiary students are more positive than those of the general population in the general domain but not in the personal domain.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15910, title = {Attitudes toward epilepsy among the primary and secondary school teachers in Malaysia, using the public attitudes toward epilepsy (PATE) scale}, author = {K S Lim and M D Hills and W Y Choo and M H Wong and C Wu and C T Tan}, doi = {10.1016/j.eplepsyres.2013.06.014}, issn = {0920-1211}, year = {2013}, date = {2013-01-01}, journal = {Epilepsy Res}, volume = {106}, number = {3}, pages = {433-9}, abstract = {INTRODUCTION: There is a lack of study comparing the attitudes toward epilepsy between the teachers and general population, teachers and students, using a similar quantitative scale. METHODS: This study was performed in one primary and one secondary school in Kuala Lumpur, Malaysia, using the Public Attitudes Toward Epilepsy (PATE) scale. RESULTS: A total of 186 teachers aged 39.6+/-10.4 years completed the questionnaire. The mean scores in both personal and general domains of PATE scale were significantly better in the teachers, comparing to the scores in the secondary and college students reported in previous study (Lim et al., 2013; p\<0.001 and \<0.05, respectively). The mean scores in personal domain was significantly better in the teachers, comparing to the general population reported by Lim et al. (2012; p\<0.001). This hold true when comparing teachers with general population with tertiary education, suggesting that the better attitude is specific to the job, rather than tertiary education generally. Subanalysis showed that the attitudes of teachers were significantly better than the general population and the students related to employment and social life, but were equally negative on issues directly related to education, such as placing children with epilepsy in regular classes. CONCLUSION: Teachers had more positive attitudes toward epilepsy as compared with the general population with tertiary education. Attitude to epilepsy may differ specific to types of work.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15904, title = {Malay public attitudes toward epilepsy (PATE) scale: translation and psychometric evaluation}, author = {K S Lim and W Y Choo and C Wu and C T Tan}, doi = {10.1016/j.yebeh.2013.08.027}, issn = {1525-5050}, year = {2013}, date = {2013-01-01}, journal = {Epilepsy Behav}, volume = {29}, number = {2}, pages = {395-9}, abstract = {INTRODUCTION: None of the quantitative scales for public attitudes toward epilepsy had been translated to Malay language. This study aimed to translate and test the validity and reliability of a Malay version of the Public Attitudes Toward Epilepsy (PATE) scale. METHOD: The translation was performed according to standard principles and tested in 140 Malay-speaking adults aged more than 18 years for psychometric validation. RESULTS: The items in each domain had similar standard deviations (equal item variance), ranging from 0.90 to 1.00 in the personal domain and from 0.87 to 1.23 in the general domain. The correlation between an item and its domain was 0.4 and above for all items and was higher than the correlation with the other domain. Multitrait analysis showed that the Malay PATE had a similar variance, floor and ceiling effects, and relative relationship between the domains as the original PATE. The Malay PATE scale showed a similar correlation with almost all demographic variables except age. Item means were generally clustered in the factor analysis as the hypothesized domains, except those for items 1 and 2. The Cronbach's alpha values were within acceptable range (0.757 and 0.716 for the general and personal domains, respectively). CONCLUSION: The Malay PATE scale is a validated and reliable translated version for measuring public attitudes toward epilepsy.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15946, title = {Prevalence and predictors of patient adherence to health recommendations after acute coronary syndrome: data for targeted interventions?}, author = {W L Lee and K L Abdullah and A M Bulgiba and I Zainal Abidin}, url = {http://journals.sagepub.com/doi/abs/10.1177/1474515112470056?url_ver=Z39.88-2003\&rfr_id=ori:rid:crossref.org\&rfr_dat=cr_pub%3dpubmed}, doi = {10.1177/1474515112470056}, issn = {1474-5151}, year = {2013}, date = {2013-01-01}, journal = {Eur J Cardiovasc Nurs}, volume = {12}, number = {6}, pages = {512-20}, abstract = {BACKGROUND: Poor adherence is a significant nursing and public health concern because it affects patients' quality of life. It compounds the disease burden of the growing coronary heart disease population. Promoting optimal patient adherence to cardiac-health enhancing recommendations by healthcare providers can reduce mortality and morbidity risk after acute coronary syndrome (ACS). AIM: This paper sought to examine rates and predictors of patient adherence to health recommendations after ACS. METHODS: A cross-sectional survey of 210 Malaysian patients using consecutive sampling was conducted in early 2009 at a tertiary teaching hospital. The Medical Outcome Study Specific Adherence Scale (MOSSAS) questionnaire was adapted to measure the extent of patient adherence to recalled health recommendations. Logistic regression modelling was applied to determine odds ratio and factors of suboptimal adherence. RESULTS: The suboptimal adherence rate was 65.2% (95% CI 58.8-71.7%). Recall of recommendation rates varied from 38.1% to 95.3%, whereas the adherence rates varied from 22.1% to 95.1% across the six aspects of health recommendation namely medication taking, dietary modification, regular physical exercise, stress reduction, gathering social support and avoidance of substance abuse. Those who had to adhere to more than three aspects of recommendations, active smokers and the Malay ethnic race had higher odds of suboptimal adherence. CONCLUSION: Monitoring of patient recall and adherence rate may provide information on the effectiveness of patient care management and outcomes. Identifying patients with higher risk for poor adherence is recommended for more targeted interventions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14461, title = {Incidence of adverse transition in smoking stages among adolescents of Kinta, Perak}, author = {P D Jeganathan and N N Hairi and N A Sadat and K Chinna}, issn = {1513-7368 (Print) 1513-7368}, year = {2013}, date = {2013-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {14}, number = {11}, pages = {6769-73}, abstract = {BACKGROUND: Few local studies have explored the process of adverse transition of smoking stages among adolescents. The present investigation aimed to identify adverse transitions prospectively from the early stages till the escalation of the stages after one year. MATERIALS AND METHODS: Data were collected in two waves from a cohort of 2,552 adolescents aged 12-13 years old studying in 15 secondary schools based in Kinta, Perak. A multistage sampling method was used to select the schools and a self-administered structured questionnaire was applied to help categorize the participants into five different smoking stages. Nonsmokers were divided into never smokers and susceptible never smokers. Ever-smokers were categorized as experimenters, current smokers or ex-smokers. RESULTS: Among the participants 46.8% were Malay, 33.5% Chinese and 17.1% Indians. At baseline, we had 85.3% non-smokers and 14.6% ever smokers. Incidence of adverse transition among all our participants was 24.1%, with a higher value among male participants (16.8%). A higher proportion of susceptible never smokers and experimenters progressed to current smoking stage compared to never smokers. CONCLUSIONS: This study highlights the changes and patterns of adverse transition among adolescents. Male adolescents, those who are susceptible to smoking and those who had already tried experimenting with cigarettes have a higher chance of escalating to a higher smoking stage.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14475, title = {Smoking stage relations to peer, school and parental factors among secondary school students in Kinta, Perak}, author = {P D Jeganathan and N N Hairi and N Al Sadat and K Chinna}, issn = {1513-7368 (Print) 1513-7368}, year = {2013}, date = {2013-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {14}, number = {6}, pages = {3483-9}, abstract = {BACKGROUND: To identify the prevalence of different stages of smoking and differences in associated risk factors. MATERIALS AND METHODS: Thos longitudinal study started in February 2011 and the subjects were 2552 form one students aged between twelve to thirteen years of from 15 government secondary schools of Kinta, Perak. Data on demographic, parental, school and peer factors were collected using a self-administered questionnaire. We examined the effects of peer, school and parental factors on the five stages of smoking; never smokers, susceptible never smokers, experimenters, current smokers and ex-smokers, at baseline. RESULTS: In the sample, 19.3% were susceptible never smokers, 5.5% were current smokers 6% were experimenters and 3.1% were ex-smokers. Gender, ethnicity, best friends' smoking status, high peer pressure, higher number of relatives who smoked and parental monitoring were found to be associated with smoking stages. Presence of parent-teen conflict was only associated with susceptible never smokers and experimenters whereas absence of home discussion on smoking hazards was associated with susceptible never smokers and current smokers. CONCLUSIONS: We identified variations in the factors associated with the different stages of smoking. Our results highlight that anti-smoking strategies should be tailored according to the different smoking stages.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14496, title = {Determinants of unsuccessful tuberculosis treatment outcomes in Malaysian HIV-infected patients}, author = {I Ismail and A Bulgiba}, doi = {10.1016/j.ypmed.2012.12.023}, issn = {0091-7435}, year = {2013}, date = {2013-01-01}, journal = {Prev Med}, volume = {57 Suppl}, pages = {S27-30}, abstract = {OBJECTIVES: To determine predictors of unsuccessful treatment in HIV-infected tuberculosis (TB) patients. METHODS: We reviewed medical records at the time of TB diagnosis and subsequent follow-up of all registered TB patients with HIV co-infection at TB clinics in the Institute of Respiratory Medicine and three public hospitals in Malaysia between January 2010 and September 2010. We reviewed these medical records again twelve months after their initial diagnosis to determine treatment outcomes. Multiple logistic regression was conducted to identify risk factors for unsuccessful TB treatment. RESULTS: Among the 219 patients analyzed, 53.4% achieved successful outcomes (cure, completed treatment) while 46.6% of patients had unsuccessful outcomes (default, treatment failure, died). After adjusting for other factors, unsuccessful outcome was associated with intravenous drug use (OR 2.72; 95% CI 1.44-5.16), not receiving antiretroviral therapy (OR 5.10; 95% CI 2.69-9.69), lymphadenopathy (OR 2.01; 95% CI 1.09-3.72) and low serum albumin (OR 4.61; 95% CI 1.73-12.27). CONCLUSION: Anti-retroviral treatment must be provided to all HIV-infected tuberculosis patients. Good immune and nutritional status needs to be assured in all HIV-infected tuberculosis patients. More studies are required in intravenous drug users to understand why tuberculosis treatment outcomes are poor in this group.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14077, title = {Statistical methods used to test for agreement of medical instruments measuring continuous variables in method comparison studies: a systematic review}, author = {R Zaki and A Bulgiba and R Ismail and N A Ismail}, url = {http://www.plosone.org/article/fetchObject.action?uri=info:doi/10.1371/journal.pone.0037908\&representation=PDF}, doi = {10.1371/journal.pone.0037908}, issn = {1932-6203}, year = {2012}, date = {2012-01-01}, journal = {PLoS One}, volume = {7}, number = {5}, pages = {e37908}, abstract = {BACKGROUND: Accurate values are a must in medicine. An important parameter in determining the quality of a medical instrument is agreement with a gold standard. Various statistical methods have been used to test for agreement. Some of these methods have been shown to be inappropriate. This can result in misleading conclusions about the validity of an instrument. The Bland-Altman method is the most popular method judging by the many citations of the article proposing this method. However, the number of citations does not necessarily mean that this method has been applied in agreement research. No previous study has been conducted to look into this. This is the first systematic review to identify statistical methods used to test for agreement of medical instruments. The proportion of various statistical methods found in this review will also reflect the proportion of medical instruments that have been validated using those particular methods in current clinical practice. METHODOLOGY/FINDINGS: Five electronic databases were searched between 2007 and 2009 to look for agreement studies. A total of 3,260 titles were initially identified. Only 412 titles were potentially related, and finally 210 fitted the inclusion criteria. The Bland-Altman method is the most popular method with 178 (85%) studies having used this method, followed by the correlation coefficient (27%) and means comparison (18%). Some of the inappropriate methods highlighted by Altman and Bland since the 1980s are still in use. CONCLUSIONS: This study finds that the Bland-Altman method is the most popular method used in agreement research. There are still inappropriate applications of statistical methods in some studies. It is important for a clinician or medical researcher to be aware of this issue because misleading conclusions from inappropriate analyses will jeopardize the quality of the evidence, which in turn will influence quality of care given to patients in the future.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15975, title = {A multi-ethnic study of a PNPLA3 gene variant and its association with disease severity in non-alcoholic fatty liver disease}, author = {S M Zain and R Mohamed and S Mahadeva and P L Cheah and S Rampal and R C Basu and Z Mohamed}, doi = {10.1007/s00439-012-1141-y}, issn = {0340-6717}, year = {2012}, date = {2012-01-01}, journal = {Hum Genet}, volume = {131}, number = {7}, pages = {1145-52}, abstract = {The adiponutrin (PNPLA3) rs738409 polymorphism has been found to be associated with susceptibility to non-alcoholic fatty liver disease (NAFLD) in various cohorts. We further investigated the association of this polymorphism with non-alcoholic steatohepatitis (NASH) severity and with histological features of NAFLD. A total of 144 biopsy-proven NAFLD patients and 198 controls were genotyped for PNPLA3 gene polymorphism (rs738409 C\>G). The biopsy specimens were histologically graded by a qualified pathologist. We observed an association of G allele with susceptibility to NAFLD in the pooled subjects (OR 2.34, 95% CI 1.69-3.24, p \< 0.0001), and following stratification, in each of the three ethnic subgroups, namely Chinese, Indian and Malay (OR 1.94, 95% CI 1.12-3.37}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14606, title = {Job stressors and smoking cessation among Malaysian male employees}, author = {S M Yasin and M Retneswari and F M Moy and A Darus and D Koh}, url = {http://occmed.oxfordjournals.org/content/62/3/174.full.pdf}, doi = {10.1093/occmed/kqs005}, issn = {0962-7480}, year = {2012}, date = {2012-01-01}, journal = {Occup Med (Lond)}, volume = {62}, number = {3}, pages = {174-81}, abstract = {BACKGROUND: Job stressors may reduce the likelihood of quitting smoking. AIMS: To assess the association between job strain, smoking behaviour and smoking cessation among Malaysian male employees involved in a smoking cessation programme. METHODS: The study was conducted among employees in two major public universities in Malaysia. All staff from both universities received an invitation to participate in this study. At the start of treatment, participants completed a questionnaire on sociodemographic variables, smoking habits and the Malay version of the Job Content Questionnaire (JCQ). The JCQ consists of scales of job control, job demand, supervisor support, co-worker support, job insecurity, job decision latitude and job skill discretion. Behaviour therapy with free nicotine replacement therapy (NRT) was given as treatment for two months. Participants were contacted at 1 week, 3 months and 6 months to determine their smoking status. RESULTS: One hundred and eighty five staff from both universities responded and voluntarily showed interest in quitting. At three months (OR = 8.96; 95% CI: 1.14-70.76) and six months (OR = 8.9; 95% CI: 1.15-68.65), men with higher co-workers' support demonstrated a higher likelihood of quitting. Smokers in a 'passive job' also demonstrated higher likelihood of quitting compared with those working in the 'low strain' category at six months (OR = 9.92; 95% CI: 1.20-82.68). No meaningful associations were found between other psychosocial job variables and smoking cessation. CONCLUSIONS: A positive relationship with and support from co-workers are important factors for workplace smoking cessation.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14605, title = {Can initial perceptions about quitting predict smoking cessation among Malaysian smokers?}, author = {S M Yasin and R Masilamani and M F Ming and D Koh and R A Zaki}, issn = {0125-1562 (Print) 0125-1562}, year = {2012}, date = {2012-01-01}, journal = {Southeast Asian J Trop Med Public Health}, volume = {43}, number = {2}, pages = {501-9}, abstract = {Perceived risks and benefits of quitting smoking may be important factors in successful treatment. This study examined the association between initial perceived risks and benefits of quitting smoking and outcomes during a two month smoking cessation attempt. Participants (n = 185) were treatment-seeking smokers attending two smoking cessation clinics in Klang Valley, Malaysia. They received structured behavioral therapy and free Nicotine Replacement Therapy (NRT). Prior to treatment, a 12 item Perceived Risks and Benefits Questionnaire (PRBQ) was administered. This was used to assess the smoker's initial perceptions during their quit attempt. Participants were re-contacted at the end of two months to determine their smoking status. The results show participants intending to quit demonstrated a greater understanding of the benefits of quitting smoking than the risks of quitting. Those with a higher education level had a greater understanding of the benefits of quitting (p = 0.02). PRBQ items, such as perceived risks of quitting (ie weight gain, negative affect, social ostracism, loss of enjoyment and craving) were not associated with abstinence at two months. However, those who perceived a benefit of higher physical attraction post-cessation were less likely to have stopped smoking at two months (OR 0.18; 95% CI 0.08-0.45). Other perceived benefits at baseline, such as health, general well-being, self-esteem, finances and social approval, were not associated with smoking cessation at two months. The results suggest that in our study population, smokers' baseline perceptions of the benefits of cessation of smoking prior to therapy are not associated with quit results at two months. Counseling patients regarding the advantages and disadvantages of quitting may have changed their perceptions during quitting process and should be further explored in future studies.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14502, title = {Midlife crisis perceptions, experiences, help-seeking, and needs among multi-ethnic malaysian women}, author = {L P Wong and H Awang and R Jani}, doi = {10.1080/03630242.2012.729557}, issn = {0363-0242}, year = {2012}, date = {2012-01-01}, journal = {Women Health}, volume = {52}, number = {8}, pages = {804-19}, abstract = {In the present study, researchers explored attitudes toward midlife crises, experience with midlife crises, help-seeking, and needs among multi-ethnic Malaysian women. A total of 14 focus group discussions were conducted with 89 Malaysian women of different ages and socioeconomic backgrounds. Women expressed concern over physical aging and decline in their physical functional health. Having a midlife crisis was frequently reported. Issues that were frequently reported to trigger a midlife crisis, such as empty nest syndrome, impact of aging on sexual and reproductive function, extended parenthood, caring for aging or ill parents, and career challenges were noted by the study participants (listed here in order of most to least frequently reporting of these themes across the group discussions). Overall, these issues were associated with attitudes about aging. A comparatively less open attitude toward sexual attitudes and help-seeking for sexual problems were found among the Malay and Indian women. This may imply that intervention to increase positive attitudes concerning both sexuality and help-seeking intentions should be culturally specific. The use of religious coping for comfort and consolation was frequently reported; therefore, those providing midlife crisis prevention and intervention programs should consider involving faith-based interventions in the Malaysian setting.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14507, title = {An exploration of knowledge, attitudes and behaviours of young multiethnic Muslim-majority society in Malaysia in relation to reproductive and premarital sexual practices}, author = {L P Wong}, doi = {10.1186/1471-2458-12-865}, issn = {1471-2458}, year = {2012}, date = {2012-01-01}, journal = {BMC Public Health}, volume = {12}, pages = {865}, abstract = {BACKGROUND: The increasing trend of premarital sexual experience and unintended pregnancies in Malaysia warrants sustained and serious attention. The sensitivities of sex-related issues in a Muslim-majority country create various types of barriers to sexual and reproductive health information, support and practices. This study aims to gain understanding of knowledge, attitudes and behaviours of young women in Malaysia concerning reproductive, contraception and premarital sexual practices. METHODS: A cross-sectional study was performed, using an anonymous self-administered questionnaire carried out among 1695 female university students in a public university in Malaysia. RESULTS: Respondents had low scores for knowledge of reproduction and pregnancy (median=4, of maximum score 10), contraceptive uses (median=6, of maximum score 16) and contraceptive availability (median=3, of maximum score 13). The majority of women surveyed do not have liberal values in relation to premarital sexual behaviour (median=37, of maximum 40); higher scores on this scale corresponded to opposing premarital sex. The multivariate analyses showed that ethnic group was the strongest correlate of knowledge and attitude scores; being of Malay Muslim ethnicity was associated significantly with lower knowledge scores and premarital sex permissiveness. Other significant correlates were year of study, maternal occupational groups, level of religious faith, dating status and urban-rural localities. Level of premarital sex permissiveness was inversely correlated with reproduction and pregnancy knowledge score, and contraceptive knowledge scores. CONCLUSION: Reproductive health knowledge and attitudes were intricately linked to religious values and cultural norms differences surrounding sexual issues.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14499, title = {Qualitative inquiry into premarital sexual behaviours and contraceptive use among multiethnic young women: implications for education and future research}, author = {L P Wong}, doi = {10.1371/journal.pone.0051745}, issn = {1932-6203}, year = {2012}, date = {2012-01-01}, journal = {PLoS One}, volume = {7}, number = {12}, pages = {e51745}, abstract = {BACKGROUND: This study was a qualitative investigation into sexual attitudes and behaviours, and contraceptive use among Malaysian youth, based on constructs from the health belief model, theory of reasoned action, and problem behaviour theory. METHODS: A total of 34 focus group discussions with 185 participants were conducted among the Malay (35%), Chinese (34%), and Indian (31%) young females between November, 2010 and April, 2011. The participants were secondary school students and university undergraduates from Selangor and the Federal Territory of Kuala Lumpur. RESULTS: The study found a lack of knowledge about sexual issues and contraception among the participants. Many engaged in unprotected sexual intercourse and relied on periodic abstinence, natural methods, and traditional folk pregnancy preventive practices. The findings also revealed numerous categories of factors influencing sexual attitudes and behaviours: ethnic group and religion, level of religiosity, peer pressure and norms, and parental monitoring. With regard to condom use, factors such as embarrassment about condom acquisition, low perceived susceptibility to sexually transmitted infections (STIs), and perceived efficacy of traditional and folk methods of contraception, were uncovered from the discussions. CONCLUSION: This study underscores the importance of development of culturally specific interventions that address the identified promoting factors of premarital sex. Behavioral interventions to promote condom use should increase awareness about condom effectiveness against not only unwanted pregnancies but also STIs.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15977, title = {Direct short-term effects of EBP teaching: change in knowledge, not in attitude; a cross-cultural comparison among students from European and Asian medical schools}, author = {I S Widyahening and Gjmg Heijden and F Ming Moy and Y Graaf and S Sastroasmoro and A Bulgiba}, doi = {10.3402/meo.v17i0.19623}, issn = {1087-2981}, year = {2012}, date = {2012-01-01}, journal = {Med Educ Online}, volume = {17}, number = {1}, pages = {19623}, abstract = {INTRODUCTION: We report about the direct short-term effects of a Clinical Epidemiology and Evidence-based Medicine (CE-EBM) module on the knowledge, attitude, and behavior of students in the University Medical Center Utrecht (UMCU), Universitas Indonesia (UI), and University of Malaya (UM). METHODS: We used an adapted version of a 26-item validated questionnaire, including four subscales: knowledge, attitude, behavior, and future use of evidence-based practice (EBP). The four components were compared among the students in the three medical schools before the module using one-way ANOVA. At the end of the module, we measured only knowledge and attitudes. We computed Cronbach's alpha to assess the reliability of the responses in our population. To assess the change in knowledge and attitudes, we used the paired t-test in the comparison of scores before and after the module. RESULTS: In total, 526 students (224 UI, 202 UM, and 100 UMCU) completed the questionnaires. In the three medical schools, Cronbach's alpha for the pre-module total score and the four subscale scores always exceeded 0.62. UMCU students achieved the highest pre-module scores in all subscales compared to UI and UM with the comparison of average (SD) score as the following: knowledge 5.04 (0.4) vs. 4.73 (0.69) and 4.24 (0.74), p\<0.001; attitude 4.52 (0.64) vs. 3.85 (0.68) and 3.55 (0.63), p\<0.001; behavior 2.62 (0.55) vs. 2.35 (0.71) and 2.39 (0.92)}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15938, title = {Return to work in multi-ethnic breast cancer survivors--a qualitative inquiry}, author = {F L Tan and S Y Loh and T T Su and V W Veloo and L L Ng}, issn = {1513-7368}, year = {2012}, date = {2012-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {13}, number = {11}, pages = {5791-7}, abstract = {INTRODUCTION: Return-to-work (RTW) can be a problematic occupational issue with detrimental impact on the quality of life of previously-employed breast cancer survivors. This study explored barriers and facilitators encountered during the RTW process in the area of cancer survivorship. MATERIALS AND METHODS: Six focus groups were conducted using a semi-structured interview guide on 40 informants (employed multiethnic survivors). Survivors were stratified into three groups for successfully RTW, and another three groups of survivors who were unable to return to work. Each of the three groups was ethnically homogeneous. Thematic analysis using a constant comparative approach was aided by in vivo software. RESULTS: Participants shared numerous barriers and facilitators which directly or interactively affect RTW. Key barriers were physical-psychological after-effects of treatment, fear of potential environment hazards, high physical job demand, intrusive negative thoughts and overprotective family. Key facilitators were social support, employer support, and regard for financial independence. Across ethnic groups, the main facilitators were financial-independence (for Chinese), and socialisation opportunity (for Malay). A key barrier was after-effects of treatment, expressed across all ethnic groups. CONCLUSIONS: Numerous barriers were identified in the non-RTW survivors. Health professionals and especially occupational therapists should be consulted to assist the increasing survivors by providing occupational rehabilitation to enhance RTW amongst employed survivors. Future research to identify prognostic factors can guide clinical efforts to restore cancer survivors to their desired level/type of occupational functioning for productivity and wellbeing.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14512, title = {Factors associated with success or failure of quit attempts: a clinical approach for lung cancer prevention}, author = {T T Su and B A Sallehuddin and H H Murniati and J Swinder and N Al Sadat and I Saimy}, issn = {1513-7368 (Print) 1513-7368}, year = {2012}, date = {2012-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {13}, number = {1}, pages = {175-9}, abstract = {The objective of the study is to investigate the success rate of quit attempts and identify factors associated with success or failure of quit attempts in a quit smoking clinic. A cohort study was conducted with 495 smokers who enrolled in a quit smoking clinic from 2005 to 2008. The factors leading to quit smoking successfully were "being Malay", "having high blood pressure" "type of Nicotine Replacement Therapy" and "duration of follow up". In contrast, clerical staff had negative association to quit smoking. People who started smoking in their teenage years had a high risk of relapse. Integration of active follow up and tailor-made support programmes for quitters appear necessary in order to maintain their non-smoking status and encourage them to be permanent quitters. Integration of quit smoking clinics and primary care clinics could be another potential step for the success of quit smoking programmes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15967, title = {The clinical features of hand-arm vibration syndrome in a warm environment--a review of the literature}, author = {A T Su and A Darus and A Bulgiba and S Maeda and K Miyashita}, issn = {1341-9145}, year = {2012}, date = {2012-01-01}, journal = {J Occup Health}, volume = {54}, number = {5}, pages = {349-60}, abstract = {UNLABELLED: The internationally accepted limit values and the health effects of hand-transmitted vibration exposure have been described extensively in the literature from temperate climate countries but not from a tropical climate environment. OBJECTIVES: We conducted a systematic review of the health effects of hand-transmitted vibration exposure in tropical countries to determine the characteristics of hand-arm vibration syndrome in a warm environment and compared the findings with the results of the systematic reviews published by the US NIOSH. METHODS: We searched major medical databases including MEDLINE, PubMed, Embase, CINAHL, Ovid and Cochrane based on the terms "hand arm vibration syndrome," "hand transmitted vibration," "vibration white finger" and "Raynaud" up to January 2011. Only studies conducted in a tropical or subtropical environment were selected for the review. The quality of the selected papers was assessed independently by two investigators using predefined criteria. A standard set of information was abstracted from the papers for review. RESULTS: Only six papers from tropical countries and three papers from subtropical countries were available in the literature. No vibration white finger was reported in the tropical countries. Neurological symptoms were prevalent in the vibration-exposed workers. Finger coldness seems to be an important surrogate for vascular disorder in a tropical environment. Meta-analysis could not be performed due to inadequacy of the information reported in these papers. CONCLUSIONS: The current dose-response relationship in ISO5349-1 for hand-transmitted vibration exposure is not applicable to a tropical environment. Further studies on hand-arm vibration syndromes in tropical countries are needed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14500, title = {Metabolic syndrome and cardiovascular risk among patients with schizophrenia receiving antipsychotics in Malaysia}, author = {M A Said and A H Sulaiman and M H Habil and S Das and A K Bakar and R M Yusoff and T H Loo and S A Bakar}, issn = {0037-5675 (Print) 0037-5675}, year = {2012}, date = {2012-01-01}, journal = {Singapore Med J}, volume = {53}, number = {12}, pages = {801-7}, abstract = {INTRODUCTION: This study aimed to determine the prevalence of metabolic syndrome and risk of coronary heart disease (CHD) in patients with schizophrenia receiving antipsychotics in Malaysia. METHODS: This cross-sectional study, conducted at multiple centres, involved 270 patients who fulfilled the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR diagnostic criteria for schizophrenia, were on antipsychotic medications for at least one year, and were screened for metabolic syndrome. Patients receiving mood stabilisers were excluded. Metabolic syndrome was defined according to the National Cholesterol Education Program ATP III criteria modified for Asian waist circumference. Risk for cardiovascular disease was assessed by using Framingham function (all ten-year CHD events). RESULTS: The prevalence of metabolic syndrome was 46.7% (126/270). Among all the antipsychotics used, atypical antipsychotics (monotherapy) were most commonly used in both the metabolic and non-metabolic syndrome groups (50.8% vs. 58.3%). The ten-year risk for CHD was significantly higher in patients with metabolic syndrome. The proportion of patients with high/very high risk for CHD (Framingham \>/= 10%) was greater in patients with metabolic syndrome than in those with non-metabolic syndrome (31.5% vs. 11.0%, odds ratio 3.9, 95% confidence interval 2.0-7.6; p \< 0.001). The mean body mass index was higher in patients with metabolic syndrome than in those without (29.4 +/- 5.1 kg/m2 vs. 25.0 +/- 5.6 kg/m2; p \< 0.001). CONCLUSION: Patients with schizophrenia receiving antipsychotics in Malaysia have a very high incidence of metabolic syndrome and increased cardiovascular risk. Urgent interventions are needed to combat these problems in patients.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14508, title = {Ethnic differences in the prevalence of metabolic syndrome: results from a multi-ethnic population-based survey in Malaysia}, author = {S Rampal and S Mahadeva and E Guallar and A Bulgiba and R Mohamed and R Rahmat and M T Arif and L Rampal}, doi = {10.1371/journal.pone.0046365}, issn = {1932-6203}, year = {2012}, date = {2012-01-01}, journal = {PLoS One}, volume = {7}, number = {9}, pages = {e46365}, abstract = {INTRODUCTION: The prevalence of metabolic syndrome is increasing disproportionately among the different ethnicities in Asia compared to the rest of the world. This study aims to determine the differences in the prevalence of metabolic syndrome across ethnicities in Malaysia, a multi-ethnic country. METHODS: In 2004, we conducted a national cross-sectional population-based study using a stratified two-stage cluster sampling design (N = 17,211). Metabolic syndrome was defined according to the International Diabetes Federation/National Heart, Lung and Blood Institute/American Heart Association (IDF/NHLBI/AHA-2009) criteria. Multivariate models were used to study the independent association between ethnicity and the prevalence of the metabolic syndrome. RESULTS: The overall mean age was 36.9 years, and 50.0% participants were female. The ethnic distribution was 57.0% Malay, 28.5% Chinese, 8.9% Indian and 5.0% Indigenous Sarawakians. The overall prevalence of the metabolic syndrome was 27.5%, with a prevalence of central obesity, raised triglycerides, low high density lipoprotein cholesterol, raised blood pressure and raised fasting glucose of 36.9%, 29.3%, 37.2%, 38.0% and 29.1%, respectively. Among those \<40 years, the adjusted prevalence ratios for metabolic syndrome for ethnic Chinese, Indians, and Indigenous Sarawakians compared to ethnic Malay were 0.81 (95% CI 0.67 to 0.96), 1.42 (95% CI 1.19 to 1.69) and 1.37 (95% CI 1.08 to 1.73), respectively. Among those aged \>/=40 years, the corresponding prevalence ratios were 0.86 (95% CI 0.79 to 0.92), 1.25 (95% CI 1.15 to 1.36), and 0.94 (95% CI 0.80, 1.11). The P-value for the interaction of ethnicity by age was 0.001. CONCLUSIONS: The overall prevalence of metabolic syndrome in Malaysia was high, with marked differences across ethnicities. Ethnic Chinese had the lowest prevalence of metabolic syndrome, while ethnic Indians had the highest. Indigenous Sarawakians showed a marked increase in metabolic syndrome at young ages.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14634, title = {The estrogen receptor negative-progesterone receptor positive breast carcinoma is a biological entity and not a technical artifact}, author = {C H Ng and N B Pathy and N A Taib and K S Mun and A Rhodes and C H Yip}, issn = {1513-7368 (Print) 1513-7368}, year = {2012}, date = {2012-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {13}, number = {4}, pages = {1111-3}, abstract = {The ER-/PR+ breast tumor may be the result of a false ER negative result. The aim of this study was to investigate whether there is a difference in patient and tumor characteristics of the ER-/PR+ phenotype in an Asian setting. A total of 2629 breast cancer patients were categorized on the basis of their age, ethnicity, tumor hormonal receptor phenotype, grade and histological type. There were 1230 (46.8%) ER+/PR+, 306 (11.6%) ER+/PR-, 122 (4.6%) ER-/PR+ and 972 (37%) ER-/PR-. ER-/PR+ tumors were 2.5 times more likely to be younger than 50 years at diagnosis (OR: 2.52; 95% CI: 1.72-3.67). Compared to ER+/PR+ tumors, the ER-/ PR+ phenotype was twice more likely to be associated with grade 3 tumors (OR:2.02; 95%CI: 1.00-4.10). In contrast, compared to ER-/PR- tumors, the ER-/PR+ phenotype was 90% less likely to be associated with a grade 3 tumor (OR: 0.12; 95%CI:0.05-0.26), and more likely to have invasive lobular than invasive ductal histology (OR: 3.66; 95%CI: 1.47-9.11). These results show that the ER-/PR+ phenotype occurs in a younger age group and is associated with intermediate histopathological characteristics compared to ER+/PR+ and ER-/PR- tumors. This may imply that it is a distinct entity and not a technical artifact.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15998, title = {Salivary biomarkers of stress among teachers in an urban setting}, author = {R Masilamani and A Darus and A S Ting and R Ali and A B Mahmud and K David}, doi = {10.1177/1010539510393725}, issn = {1010-5395}, year = {2012}, date = {2012-01-01}, journal = {Asia Pac J Public Health}, volume = {24}, number = {2}, pages = {278-87}, abstract = {The aim of this study was to determine the prevalence of job stress among secondary school teachers using Karasek Job Content Questionnaire (JCQ), the association between salivary cortisol, salivary IgA, and sociodemographic characteristics, and the association between log cortisol, IgA levels, and job strain categories. A cross-sectional study was undertaken using JCQ and salivary cortisol and IgA samples. Cluster sampling was done yielding 302 respondents. The prevalence of stress among all teachers was 20.2%. Being a Malay, teaching experience of 5 to 10 years, and those without a supervisor's support had higher prevalence of high job strain. Teachers in the 31 to 40 years age bracket, educating handicapped children with the absence of supervisor support exhibited higher stress levels with lower log salivary IgA levels. Further studies must be conducted using salivary biomarkers to study the in-depth relationship of stress, extending into other occupational groups.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14515, title = {Definitions, attitudes, and management practices in relation to diarrhea during enteral nutrition: a survey of patients, nurses, and dietitians}, author = {H A Majid and P W Emery and K Whelan}, doi = {10.1177/0884533611431986}, issn = {0884-5336}, year = {2012}, date = {2012-01-01}, journal = {Nutr Clin Pract}, volume = {27}, number = {2}, pages = {252-60}, abstract = {BACKGROUND: Diarrhea is a common complication in patients receiving enteral nutrition (EN), and understanding this problem among patients and healthcare professionals is required. The aim of the study was to investigate patients', nurses', and dietitians' definitions of diarrhea during EN, the attitudes of nurses and patients toward it, and the management practices of nurses and dietitians in response to diarrhea during EN. METHODS: Twenty-two patients receiving EN, 57 nurses, and 33 dietitians were recruited and interviewed in a cross-sectional study, using a questionnaire that had been developed following an extensive literature review and pretested for clarity. RESULTS: The ratings assigned by the 3 groups differed significantly for all the characteristics used to define diarrhea: frequency (P = .006), quantity (P \< .001), consistency (P = .003), color (P \< .001), odor (P \< .001), and incontinence (P \< .001). Patients gave incontinence the highest rank when defining diarrhea, whereas the healthcare professionals gave fecal consistency and frequency the highest ranks. Patients and nurses rated the unpleasantness of each characteristic of diarrhea during EN differently, with patients rating incontinence and fecal frequency and nurses rating odor and changing the patients' underwear as the most unpleasant characteristics. Nurses and dietitians differed in the frequency with which they adopted various strategies to manage patients who developed diarrhea during EN. CONCLUSIONS: Patients have different definitions and attitudes toward diarrhea during EN from those of nurses and dietitians. Patients' perceptions need to be understood and respected by healthcare professionals to improve patient-centered care.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15972, title = {Economic impact of dyspepsia in rural and urban malaysia: a population-based study}, author = {S Mahadeva and H Yadav and S M Everett and K L Goh}, doi = {10.5056/jnm.2012.18.1.43}, issn = {2093-0879}, year = {2012}, date = {2012-01-01}, journal = {J Neurogastroenterol Motil}, volume = {18}, number = {1}, pages = {43-57}, abstract = {BACKGROUND/AIMS: The economic impact of dyspepsia in regions with a diverse healthcare system remains uncertain. This study aimed to estimate the costs of dyspepsia in a rural and urban population in Malaysia. METHODS: Economic evaluation was performed based on the cost-of-illness method. Resource utilization and quality of life data over a specific time frame, were collected to determine direct, indirect and intangible costs related to dyspepsia. RESULTS: The prevalences of dyspepsia in the rural (n = 2,000) and urban (n = 2,039) populations were 14.6% and 24.3% respectively. Differences in socioeconomic status and healthcare utilisation between both populations were considerable. The cost of dyspepsia per 1,000 population per year was estimated at USD14,816.10 and USD59,282.20 in the rural and urban populations respectively. The cost per quality adjusted life year for dyspepsia in rural and urban adults was USD16.30 and USD69.75, respectively. CONCLUSIONS: The economic impact of dyspepsia is greater in an urban compared to a rural setting. Differences in socioeconomic status and healthcare utilisation between populations are thought to contribute to this difference.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14056, title = {Health-related quality of life among colorectal cancer patients in Malaysia: a study protocol}, author = {B A Magaji and F M Moy and A C Roslani and I Sagap and J Zakaria and J M Blazeby and C W Law}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3443003/pdf/1471-2407-12-384.pdf}, doi = {10.1186/1471-2407-12-384}, issn = {1471-2407}, year = {2012}, date = {2012-01-01}, journal = {BMC Cancer}, volume = {12}, pages = {384}, abstract = {BACKGROUND: Colorectal cancer is a major public health problem in Malaysia. However, it is also one of the most treatable cancers, resulting in significant numbers of survivors. Therefore, the impact of surviving treatment for colorectal cancer on health related quality of life is important for the patients, clinicians and policy makers, and may differ in different cultures and populations. The aim of this study was to validate the Malaysian versions of the European Organization for Research and Treatment of Cancer quality of life instruments among colorectal cancers patients. METHODS/DESIGN: This is a cross sectional multi centre study. Three hospitals were included, the University of Malaya Medical Centre, the Universiti Kebangsaan Malaysia Medical Centre and Hospital Tuanku Jaafar Seremban. Malaysian citizens and permanent residence were studied and demographic and clinical information obtained from hospital records. The European Organization for Research and Treatment of Cancer Quality of life Core 30, colorectal cancer CR29, and the colorectal cancer liver metastasis LMC 21 were used and an observer assessment of performance obtained with the Karnofsky Performance Scale. Questionnaires were translated into three most commonly spoken languages in Malaysia (Bahasa Malaysia, Chinese and Tamil), then administered, scored and analyzed following the developers' guidelines. Ethical approval was obtained from the participating centres. Tests of reliability and validity were performed to examine the validity of these instruments. CONCLUSION: The result of pilot testing shows that the use of the Malaysian versions of EORTC QLQ C30, CR29 instruments is feasible in our sample of colorectal cancer patients. Instructions for completion as well as questions were well understood except the questions on the overall quality of life, overall health status and sexual activity. Thus we anticipate obtaining good psychometric properties for the instruments at the end of the study.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15978, title = {Barriers to participation in a randomized controlled trial of Qigong exercises amongst cancer survivors: lessons learnt}, author = {S Y Loh and S Y Lee and K F Quek and L Murray}, issn = {1513-7368}, year = {2012}, date = {2012-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {13}, number = {12}, pages = {6337-42}, abstract = {BACKGROUND: Clinical trials on cancer subjects have one of the highest dropout rates. Barriers to recruitment range from patient-related, through institutional-related to staff-related factors. This paper highlights the low response rate and the recruitment barriers faced in our Qigong exercises trial. MATERIALS AND METHOD: The Qigong trial is a three-arm trial with a priori power size of 114 patients for 80% power. The University Malaya Medical Centre database showed a total of 1,933 patients from 2006-2010 and 751 patients met our inclusion criteria. These patients were approached via telephone interview. 131 out of 197 patients attended the trial and the final response rate was 48% (n=95/197). RESULTS: Multiple barriers were identified, and were regrouped as patient- related, clinician-related and/or institutional related. A major consistent barrier was logistic difficulty related to transportation and car parking at the Medical Centre. conclusions: All clinical trials must pay considerable attention to the recruitment process and it should even be piloted to identify potential barriers and facilitators to reduce attrition rate in trials.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15958, title = {Unintentional weight loss is the most important indicator of malnutrition among surgical cancer patients}, author = {K W Loh and M R Vriens and A Gerritsen and I H Borel Rinkes and R Hillegersberg and C Schippers and E Steenhagen and T A Ong and F M Moy and I Q Molenaar}, issn = {0300-2977}, year = {2012}, date = {2012-01-01}, journal = {Neth J Med}, volume = {70}, number = {8}, pages = {365-9}, abstract = {BACKGROUND: Disease-related malnutrition is highly prevalent in hospital patients and varies from 25-40%. Early nutritional screening of patients at admission helps to improve recognition of malnourished patients to allow early interventions and enhance clinical outcomes. METHOD: A total of 104 preoperative surgical patients with oesophageal (34), stomach (17) or pancreatic cancer (53) were recruited in our study. The risk of malnutrition was examined using the quick-and-easy Malnutrition Universal Screening Tool (MUST). Anthropometric data and information on percent weight change over the past six months, unintentional weight loss, dietician referrals, and history of nutritional intervention were collected. RESULTS: A total of 75% of our participants were at high malnutrition risk with a mean (+/-SD) percentage weight loss of 5.18 (+/-6.23)%, despite a mean BMI of 26.09 (+/-5.73) kgm-2. Participants with a significantly higher percent weight loss, unintentional weight loss, dietician referral and nutritional intervention had a higher risk of malnutrition (p\<0.05). Presence of unintentional weight loss was the only significant predictor (OR 3.22; 95%CI 1.23, 8.40) associated with risk of malnutrition after adjusted for all confounders. CONCLUSION: In conclusion, our findings highlight the importance of routine screening of malnutrition in oncology patients. Medical personnel must be aware that unintentional weight loss is an important predictor of malnutrition risks even if the patient's BMI is not suggestive of malnutrition.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15970, title = {Development and validation of a public attitudes toward epilepsy (PATE) scale}, author = {K S Lim and C Wu and W Y Choo and C T Tan}, doi = {10.1016/j.yebeh.2012.03.038}, issn = {1525-5050}, year = {2012}, date = {2012-01-01}, journal = {Epilepsy Behav}, volume = {24}, number = {2}, pages = {207-12}, abstract = {INTRODUCTION: A quantitative scale of public attitudes toward epilepsy is essential to determine the magnitude of social stigma against epilepsy. This study aims to develop and validate a cross-culturally applicable scale of public attitudes toward epilepsy. METHODS: A set of questions was selected from questionnaires identified from a literature review, following which a panel review determined the final version, consisting of 18 items. A 1-5 Likert scale was used for scoring. Additional questions, related to perception of the productivity of people with epilepsy and of a modified epilepsy stigma scale, were added as part of construct validation. One hundred and thirty heterogeneous respondents were collected, consisting of various age groups, ethnicity and occupation status levels. RESULTS: After item and factor analyses, the final version consisted of 14 items. Psychometric properties of the scale were first determined using factor analysis, which revealed a general and a personal domain, with good internal consistency (Cronbach's coefficient 0.868 and 0.633, respectively). Construct validation was demonstrated. The mean score for the personal domain was higher than that for the general domain (2.72+/-0.56 and 2.09+/-0.59, respectively). The mean scores of those with tertiary education were significantly lower for the general domain, but not for the personal domain. Age was positively correlated with the mean scores in the personal domain, but not in the general domain. CONCLUSION: This scale is a reliable and valid scale to assess public attitudes toward epilepsy, in both the general and personal domains.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15966, title = {Ergonomic design and training for preventing work-related musculoskeletal disorders of the upper limb and neck in adults}, author = {V C Hoe and D M Urquhart and H L Kelsall and M R Sim}, url = {http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008570.pub2/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 = {10.1002/14651858.CD008570.pub2}, issn = {1361-6137}, year = {2012}, date = {2012-01-01}, journal = {Cochrane Database Syst Rev}, number = {8}, pages = {Cd008570}, abstract = {BACKGROUND: Work-related upper limb and neck musculoskeletal disorders (MSDs) are one of the most common occupational disorders around the world. Although ergonomic design and training are likely to reduce the risk of workers developing work-related upper limb and neck MSDs, the evidence is unclear. OBJECTIVES: To assess the effects of workplace ergonomic design or training interventions, or both, for the prevention of work-related upper limb and neck MSDs in adults. SEARCH METHODS: We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, AMED, Web of Science (Science Citation Index), SPORTDiscus, Cochrane Occupational Safety and Health Review Group Database and Cochrane Bone, Joint and Muscle Trauma Group Specialised Register to July 2010, and Physiotherapy Evidence Database, US Centers for Disease Control and Prevention, the National Institute for Occupational Safety and Health database, and International Occupational Safety and Health Information Centre database to November 2010. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of ergonomic workplace interventions for preventing work-related upper limb and neck MSDs. We included only studies with a baseline prevalence of MSDs of the upper limb or neck, or both, of less than 25%. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed risk of bias. We included studies with relevant data that we judged to be sufficiently homogeneous regarding the intervention and outcome in the meta-analysis. We assessed the overall quality of the evidence for each comparison using the GRADE approach. MAIN RESULTS: We included 13 RCTs (2397 workers). Eleven studies were conducted in an office environment and two in a healthcare setting. We judged one study to have a low risk of bias. The 13 studies evaluated effectiveness of ergonomic equipment, supplementary breaks or reduced work hours, ergonomic training, a combination of ergonomic training and equipment, and patient lifting interventions for preventing work-related MSDs of the upper limb and neck in adults.Overall, there was moderate-quality evidence that arm support with alternative mouse reduced the incidence of neck/shoulder disorders (risk ratio (RR) 0.52; 95% confidence interval (CI) 0.27 to 0.99) but not the incidence of right upper limb MSDs (RR 0.73; 95% CI 0.32 to 1.66); and low-quality evidence that this intervention reduced neck/shoulder discomfort (standardised mean difference (SMD) -0.41; 95% CI -0.69 to -0.12) and right upper limb discomfort (SMD -0.34; 95% CI -0.63 to -0.06).There was also moderate-quality evidence that the incidence of neck/shoulder and right upper limb disorders were not reduced when comparing alternative mouse and conventional mouse (neck/shoulder RR 0.62; 95% CI 0.19 to 2.00; right upper limb RR 0.91; 95% CI 0.48 to 1.72), arm support and no arm support with conventional mouse (neck/shoulder RR 0.67; 95% CI 0.36 to 1.24; right upper limb RR 1.09; 95% CI 0.51 to 2.29), and alternative mouse with arm support and conventional mouse with arm support (neck/shoulder RR 0.58; 95% CI 0.30 to 1.12; right upper limb RR 0.92; 95% CI 0.36 to 2.36).There was low-quality evidence that using an alternative mouse with arm support compared to conventional mouse with arm support reduced neck/shoulder discomfort (SMD -0.39; 95% CI -0.67 to -0.10). There was low- to very low-quality evidence that other interventions were not effective in reducing work-related upper limb and neck MSDs in adults. AUTHORS' CONCLUSIONS: We found moderate-quality evidence to suggest that the use of arm support with alternative mouse may reduce the incidence of neck/shoulder MSDs, but not right upper limb MSDs. Moreover, we found moderate-quality evidence to suggest that the incidence of neck/shoulder and right upper limb MSDs is not reduced when comparing alternative and conventional mouse with and without arm support. However, given there were multiple comparisons made involving a number of interventions and outcomes, high-quality evidence is needed to determine the effectiveness of these interventions clearly. While we found very-low- to low-quality evidence to suggest that other ergonomic interventions do not prevent work-related MSDs of the upper limb and neck, this was limited by the paucity and heterogeneity of available studies. This review highlights the need for high-quality RCTs examining the prevention of MSDs of the upper limb and neck.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14509, title = {Predictors of breast cancer screening uptake: a pre intervention community survey in Malaysia}, author = {M Dahlui and D E Gan and N A Taib and R Pritam and J Lim}, issn = {1513-7368 (Print) 1513-7368}, year = {2012}, date = {2012-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {13}, number = {7}, pages = {3443-9}, abstract = {INTRODUCTION: Despite health education efforts to educate women on breast cancer and breast cancer screening modalities, the incidence of breast cancer and presentation at an advanced stage are still a problem in Malaysia. OBJECTIVES: To determine factors associated with the uptake of breast cancer screening among women in the general population. METHODS: This pre-intervention survey was conducted in a suburban district. All households were approached and women aged 20 to 60 years old were interviewed with pre-tested guided questionnaires. Variables collected included socio-demographic characteristics, knowledge on breast cancer and screening practice of breast cancer. Univariate and multivariate analysis were performed. RESULTS: 41.5% of a total of 381 respondents scored above average; the mean knowledge score on causes and risks factors of breast cancer was 3.41 out of 5 (SD1.609). 58.5% had ever practiced BSE with 32.5% performing it at regular monthly intervals. Uptake of CBE by nurses and by doctors was 40.7% and 37.3%, respectively. Mammogram uptake was 14.6%. Significant predictors of BSE were good knowledge of breast cancer (OR=2.654, 95% CI: 1.033-6.816), being married (OR=2.213, 95% CI: 1.201-4.076) and attending CBE (OR=1.729, 95% CI: 1.122-2.665). Significant predictors for CBE included being married (OR=2.161, 95% CI: 1.174-3.979), good knowledge of breast cancer (OR=2.286, 95% CI: 1.012-5.161), and social support for breast cancer screening (OR=2.312, 95% CI: 1.245-4.293). Women who had CBE were more likely to undergo mammographic screening of the breast (OR=5.744, 95% CI: 2.112-15.623), p\<0.005. CONCLUSION: CBE attendance is a strong factor in promoting BSE and mammography, educating women on the importance of breast cancer screening and on how to conduct BSE. The currently opportunistic conduct of CBE should be extended to active calling of women for CBE.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14514, title = {Gradually implemented new biomarkers for prognostication of breast cancer: complete case analysis may introduce bias}, author = {N Bhoo Pathy and C S Uiterwaal and N A Taib and H M Verkooijen and C H Yip}, url = {http://ac.els-cdn.com/S0895435611003180/1-s2.0-S0895435611003180-main.pdf?_tid=714c01e4-9e13-11e5-9c21-00000aab0f01\&acdnat=1449624384_425f19ac51bc9ce76789bc3a901841b3}, doi = {10.1016/j.jclinepi.2011.09.013}, issn = {0895-4356}, year = {2012}, date = {2012-01-01}, journal = {J Clin Epidemiol}, volume = {65}, number = {5}, pages = {568-71}, abstract = {OBJECTIVE: Many recent studies investigated the prognostic value of new biomarkers in breast cancer using data from cancer registries. Some of these studies were conducted using only patients for whom biomarker status was available (or tested). Using human epidermal growth factor receptor 2 (HER2) as an example, we determined whether testing for a recently introduced biomarker was associated with the outcome of women with breast cancer. STUDY DESIGN AND SETTING: We included 910 women with newly diagnosed breast cancer in a tertiary academic hospital in Kuala Lumpur, Malaysia, between 2005 and 2007. Individual 2-year absolute mortality risk was estimated using Cox regression analysis. Logistic regression was used to assess the association between the absolute mortality risk and assessment of HER2 status. RESULTS: There was a significant inverted U-shaped association between predicted mortality risk and HER2 status determination. Compared with patients with the lowest predicted mortality risk (quintile 1), patients with highest predicted mortality risk (last quintile) were significantly less likely to be tested for HER2 status, whereas those with intermediate predicted mortality risk (quintile 3) were more likely to be tested. CONCLUSION: Breast cancer prognostication using only patients with available biomarker status may lead to invalid results.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15964, title = {Genetic association of SNPs in the FTO gene and predisposition to obesity in Malaysian Malays}, author = {Y D Apalasamy and M F Ming and S Rampal and A Bulgiba and Z Mohamed}, issn = {0100-879x}, year = {2012}, date = {2012-01-01}, journal = {Braz J Med Biol Res}, volume = {45}, number = {12}, pages = {1119-26}, abstract = {The common variants in the fat mass- and obesity-associated (FTO) gene have been previously found to be associated with obesity in various adult populations. The objective of the present study was to investigate whether the single nucleotide polymorphisms (SNPs) and linkage disequilibrium (LD) blocks in various regions of the FTO gene are associated with predisposition to obesity in Malaysian Malays. Thirty-one FTO SNPs were genotyped in 587 (158 obese and 429 non-obese) Malaysian Malay subjects. Obesity traits and lipid profiles were measured and single-marker association testing, LD testing, and haplotype association analysis were performed. LD analysis of the FTO SNPs revealed the presence of 57 regions with complete LD (D' = 1.0). In addition, we detected the association of rs17817288 with low-density lipoprotein cholesterol. The FTO gene may therefore be involved in lipid metabolism in Malaysian Malays. Two haplotype blocks were present in this region of the FTO gene, but no particular haplotype was found to be significantly associated with an increased risk of obesity in Malaysian Malays.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16014, title = {AMI screening using linguistic fuzzy rules}, author = {R N Ainon and A M Bulgiba and A Lahsasna}, doi = {10.1007/s10916-010-9491-2}, issn = {0148-5598 (Print) 0148-5598}, year = {2012}, date = {2012-01-01}, journal = {J Med Syst}, volume = {36}, number = {2}, pages = {463-73}, abstract = {This paper aims at identifying the factors that would help to diagnose acute myocardial infarction (AMI) using data from an electronic medical record system (EMR) and then generating structure decisions in the form of linguistic fuzzy rules to help predict and understand the outcome of the diagnosis. Since there is a tradeoff in the fuzzy system between the accuracy which measures the capability of the system to predict the diagnosis of AMI and transparency which reflects its ability to describe the symptoms-diagnosis relation in an understandable way, the proposed fuzzy rules are designed in a such a way to find an appropriate balance between these two conflicting modeling objectives using multi-objective genetic algorithms. The main advantage of the generated linguistic fuzzy rules is their ability to describe the relation between the symptoms and the outcome of the diagnosis in an understandable way, close to human thinking and this feature may help doctors to understand the decision process of the fuzzy rules.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @inbook{RN753, title = {Physical Function in Older People}, author = {N N Hairi and A Bulgiba and Guat Hiong Tee and Izzuna Mudla}, editor = {Craig S Atwood}, url = {https://cdn.intechopen.com/pdfs-wm/29294.pdf}, doi = {10.5772/1893}, isbn = {978-953-51-0080-5}, year = {2012}, date = {2012-01-01}, booktitle = {Geriatrics}, pages = {4-28}, publisher = {InTech}, chapter = {1}, keywords = {}, pubstate = {published}, tppubtype = {inbook} } @inbook{RN754, title = {Sarcopenia in Older People}, author = {N N Hairi and A Bulgiba and Guat Hiong Tee and Izzuna Mudla}, editor = {Craig S Atwood}, doi = {10.5772/1893}, isbn = {978-953-51-0080-5}, year = {2012}, date = {2012-01-01}, booktitle = {Geriatrics}, pages = {29-40}, publisher = {InTech}, chapter = {2}, keywords = {}, pubstate = {published}, tppubtype = {inbook} } @book{RN763, title = {Statistical Analysis Using SPSS}, author = {Karuthan Chinna and Krishnakumari Karuthan and Wan Yuen Choo}, year = {2012}, date = {2012-01-01}, publisher = {Pearson Malaysia Sdn Bhd}, address = {Malaysia}, keywords = {}, pubstate = {published}, tppubtype = {book} } @article{RN10519, title = {Boundaries to the articulation of possible selves through social networking sites: the case of Facebook profilers' social connectedness}, author = {Sandra Zwier and Theo Araujo and Mark Boukes and Lotte Willemsen}, url = {http://ovidsp.ovid.com/ovidweb.cgi?T=JS\&CSC=Y\&NEWS=N\&PAGE=fulltext\&D=medl\&AN=21476838 http://ezproxy.lib.monash.edu.au/login?url=http://sfx.monash.edu.au:9003/monash2?sid=OVID:medline\&id=pmid:21476838\&id=doi:\&issn=2152-2723\&isbn=\&volume=14\&issue=10\&spage=571\&pages=571-6\&date=2011\&title=Cyberpsychology%2C+behavior+and+social+networking\&atitle=Boundaries+to+the+articulation+of+possible+selves+through+social+networking+sites%3A+the+case+of+Facebook+profilers%27+social+connectedness.\&aulast=Zwier\&pid=%3Cauthor%3EZwier+S%3BAraujo+T%3BBoukes+M%3BWillemsen+L%3C%2Fauthor%3E%3CAN%3E21476838%3C%2FAN%3E%3CDT%3EJournal+Article%3C%2FDT%3E}, year = {2011}, date = {2011-01-01}, journal = {Cyberpsychology, behavior and social networking}, volume = {14}, number = {10}, pages = {571-6}, abstract = {This study aims to contribute to an emerging literature that seeks to understand how identity markers on social networking sites (SNSs) shape interpersonal impressions, and particularly the boundaries that SNSs present for articulating unconstrained "hoped-for possible selves." An experiment employing mock-up Facebook profiles was conducted, showing that appearing with friends on a Facebook profile picture as well as increasingly higher number of Facebook friends strengthened perceptions of a profiler's hoped-for level of social connectedness. Excessive numbers of friends, however, weakened perceptions of a profiler's real-level social connectedness, particularly among participants with smaller social networks on Facebook themselves. The discussion focuses on when people come to find that reasonable boundaries of self-generated information on an SNS have been exceeded.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN10696, title = {Can Facebook influence funding?}, author = {Paolo Zamboni}, url = {http://ovidsp.ovid.com/ovidweb.cgi?T=JS\&CSC=Y\&NEWS=N\&PAGE=fulltext\&D=medl\&AN=21614061 http://ezproxy.lib.monash.edu.au/login?url=http://sfx.monash.edu.au:9003/monash2?sid=OVID:medline\&id=pmid:21614061\&id=doi:\&issn=0028-0836\&isbn=\&volume=473\&issue=7348\&spage=452\&pages=452\&date=2011\&title=Nature\&atitle=Can+Facebook+influence+funding%3F.\&aulast=Zamboni\&pid=%3Cauthor%3EZamboni+P%3C%2Fauthor%3E%3CAN%3E21614061%3C%2FAN%3E%3CDT%3EComment%3C%2FDT%3E}, year = {2011}, date = {2011-01-01}, journal = {Nature}, volume = {473}, number = {7348}, pages = {452}, abstract = {(Extract) I would like to make it clear that I played no part in instigating a Facebook uprising over my research (Nature 472, 410\textendash411; 2011). I am not an activist but a scientist who has published 27 peer-reviewed studies of chronic cerebrospinal venous insufficiency (CCSVI) and its relationship to multiple sclerosis in 18 interdisciplinary journals. This research was funded by the Italian government and banking foundations, and grants were peer-reviewed by scientific committees under the usual rules.I do not believe that Facebook can influence the diversion of funds to change research priorities or the judgement of the scientific community. CCSVI is a pathological condition first described in the literature two years ago. A Google Scholar search reveals that CCSVI has been cited more than 2,000 times in published scientific papers. Evidently, CCSVI is a hot topic \textemdash it is interesting precisely because it is controversial.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16000, title = {Factors affecting estrogen receptor status in a multiracial Asian country: an analysis of 3557 cases}, author = {C H Yip and N B Pathy and C S Uiterwaal and N A Taib and G H Tan and K S Mun and W Y Choo and A Rhodes}, doi = {10.1016/j.breast.2011.02.004}, issn = {0960-9776}, year = {2011}, date = {2011-01-01}, journal = {Breast}, volume = {20 Suppl 2}, pages = {S60-4}, abstract = {Estrogen receptor (ER) positive rates in breast cancer may be influenced by grade, stage, age and race. This study reviews the ER positive rates over a 15-year period at the University Malaya Medical Centre, Kuala Lumpur, Malaysia. Data on ER status of 3557 patients from 1994 to 2008 was analyzed. ER status was determined by immunohistochemistry with a cut-off point of 10%. ER positivity increased by about 2% for every 5-year cohort, from 54.5% in 1994-1998 to 58.4% in 2004-2008. Ethnicity and grade were significantly associated with ER positivity rates: Malay women were found to have a higher risk of ER negative tumors compared with Chinese women. Grade 1 cancers were nine times more likely to be ER positive compared with grade 3 cancers. In summary, the proportion of ER positive cancers increased with each time period, and ethnicity and grade were independent factors that influenced ER positive rates.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15997, title = {Grandilodines A-C, biologically active indole alkaloids from Kopsia grandifolia}, author = {W S Yap and C Y Gan and Y Y Low and Y M Choo and T Etoh and M Hayashi and K Komiyama and T S Kam}, doi = {10.1021/np200008g}, issn = {0163-3864}, year = {2011}, date = {2011-01-01}, journal = {J Nat Prod}, volume = {74}, number = {5}, pages = {1309-12}, abstract = {Three new indole alkaloids (1-3), named grandilodines A-C, and five known ones were obtained from the Malayan Kopsia grandifolia. The structures were established using NMR and MS analyses and, in the case of 1 and 2, were confirmed by X-ray diffraction analyses. Alkaloids 1, 3, and lapidilectine B (8) were found to reverse multidrug resistance in vincristine-resistant KB cells.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14513, title = {Stigmatization and discrimination towards people living with or affected by HIV/AIDS by the general public in Malaysia}, author = {L P Wong and A R Syuhada}, issn = {0125-1562 (Print) 0125-1562}, year = {2011}, date = {2011-01-01}, journal = {Southeast Asian J Trop Med Public Health}, volume = {42}, number = {5}, pages = {1119-29}, abstract = {Globally, HIV/AIDS-related stigma and discriminatory attitudes deter the effectiveness of HIV prevention and care programs. This study investigated the general public's perceptions about HIV/AIDS-related stigma and discrimination towards people living with or affected by HIV/AIDS in order to understand the root of HIV/AIDS-related stigma and discriminatory attitudes. Study was carried out using qualitative focus group discussions (FGD). An interview guide with semi-structured questions was used. Participants were members of the public in Malaysia. Purposive sampling was adopted for recruitment of participants. A total 14 focus group discussions (n = 74) was carried out between March and July 2008. HIV/AIDS-related stigma and discrimination towards people living with HIV/AIDS (PLWHA) was profound. Key factors affecting discriminatory attitudes included high-risk taking behavior, individuals related to stigmatized identities, sources of HIV infection, stage of the disease, and relationship with an infected person. Other factors that influence attitudes toward PLWHA include ethnicity and urban-rural locality. Malay participants were less likely than other ethnic groups to perceive no stigmatization if their spouses were HIV positive. HIV/AIDS-related stigma and discrimination were stronger among participants in rural settings. The differences indicate attitudes toward PLWHA are influenced by cultural differences.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14530, title = {Public perceptions and attitudes toward thalassaemia: Influencing factors in a multi-racial population}, author = {L P Wong and E George and J A Tan}, doi = {10.1186/1471-2458-11-193}, issn = {1471-2458}, year = {2011}, date = {2011-01-01}, journal = {BMC Public Health}, volume = {11}, pages = {193}, abstract = {BACKGROUND: Thalassaemia is a common public health problem in Malaysia and about 4.5 to 6% of the Malays and Chinese are carriers of this genetic disorder. The major forms of thalassaemia result in death in utero of affected foetuses (alpha-thalassaemia) or life-long blood transfusions for survival in beta-thalassaemia. This study, the first nationwide population based survey of thalassaemia in Malaysia, aimed to determine differences in public awareness, perceptions and attitudes toward thalassaemia in the multi-racial population in Malaysia. METHODS: A cross-sectional computer-assisted telephone interview survey of a representative sample of multi-racial Malaysians aged 18 years and above was conducted between July and December 2009. RESULTS: Of a total of 3723 responding households, 2846 (76.4%) have heard of thalassaemia. Mean knowledge score was 11.85 (SD +/- 4.03), out of a maximum of 21, with higher scores indicating better knowledge. Statistically significant differences (P \< 0.05) in total knowledge score by age groups, education attainment, employment status, and average household income were observed. Although the majority expressed very positive attitudes toward screening for thalassaemia, only 13.6% of married participants interviewed have been screened for thalassaemia. The majority (63.4%) were unsupportive of selective termination of foetuses diagnosed with thalassaemia major. CONCLUSION: Study shows that carrier and premarital screening programs for thalassaemia may be more effective and culturally acceptable in the reduction of pregnancies with thalassaemia major. The findings provide insights into culturally congruent educational interventions to reach out diverse socio-demographic and ethnic communities to increase knowledge and cultivate positive attitudes toward prevention of thalassaemia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14518, title = {A holistic approach to education programs in thalassemia for a multi-ethnic population: consideration of perspectives, attitudes, and perceived needs}, author = {L P Wong and E George and J A Tan}, doi = {10.1007/s12687-011-0039-z}, issn = {1868-310x}, year = {2011}, date = {2011-01-01}, journal = {J Community Genet}, volume = {2}, number = {2}, pages = {71-9}, abstract = {Hemoglobin disorders which include thalassemias are the most common heritable disorders. Effective treatment is available, and these disorders can be avoided as identification of carriers is achievable using simple hematological tests. An in-depth understanding of the awareness, attitudes, perceptions, and screening reservations towards thalassemia is necessary, as Malaysia has a multi-ethnic population with different religious beliefs. A total of 13 focus group discussions (70 participants) with members of the general lay public were conducted between November 2008 and January 2009. Lack of knowledge and understanding about thalassemia leads to general confusions over differences between thalassemia carriers and thalassemia major, inheritance patterns, and the physical and psychologically impact of the disorder in affected individuals and their families. Although most of the participants have not been tested for thalassemia, a large majority expressed willingness to be screened. Views on prenatal diagnosis and termination of fetuses with thalassemia major received mixed opinions from participants with different religions and practices. Perceived stigma and discrimination attached to being a carrier emerged as a vital topic in some group discussions where disparity in the answers exhibited differences in levels of participants' literacy and ethnic origins. The two most common needs identified from the discussion were information and screening facilities. Participants' interest in knowing the severity of the disease and assessing their risk of getting the disorder may imply the health belief model as a possible means of predicting thalassemia public screening services. Findings provide valuable insights for the development of more effective educational, screening, and prenatal diagnostic services in the multi-ethnic Asian society.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14528, title = {Premenstrual syndrome and dysmenorrhea: urban-rural and multiethnic differences in perception, impacts, and treatment seeking}, author = {L P Wong}, doi = {10.1016/j.jpag.2011.03.009}, issn = {1083-3188}, year = {2011}, date = {2011-01-01}, journal = {J Pediatr Adolesc Gynecol}, volume = {24}, number = {5}, pages = {272-7}, abstract = {BACKGROUND: Attitudes toward menarche and menstruation are largely influenced by sociological, cultural, and family environmental factors. Recognizing the influential effects that these factors might have on shaping adolescents' attitudes is crucial in designing a more effective means of transmitting health information. AIMS: This study aimed to gather an in-depth understanding of perceptions, impacts, and treatment seeking on menstruation-related issues from an ethnically mixed group of rural and urban girls. METHODOLOGY: In total, 27 focus group discussions (172 participants) were conducted between November 2008 and April 2009. Participants were adolescent girls aged 13-19 years, recruited from 7 public secondary schools in the Federal Territory of Kuala Lumpur and 4 public secondary schools from the rural districts of Kelantan, in Malaysia. RESULTS: Many participants revealed that they were not given or had not received detailed information about the mechanism or physiology of menstruation prior to its onset. Thus, many described the onset of menarche as shocking, an event for which they were unprepared, and which has had a tremendous impact on their emotions. More positive acceptance of menarche was reported in the urban than with the rural groups. Despite the high prevalence of premenstrual syndrome and dysmenorrhea, participants across urban-rural and ethnic groups perceived the problems as completely normal, hence they relied on self-care methods and did not want to seek professional treatment. More rural girls compared to urban girls were embarrassed to talk to their mothers or consult their physicians regarding menstruation-related problems. CONCLUSION: Menstruation-related education would have a positive impact in improving adolescent girls' knowledge and in nurturing a positive attitude toward menstruation-related matters at home, at school, and in the community.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14527, title = {Socio-demographic and behavioural characteristics of illegal motorcycle street racers in Malaysia}, author = {L P Wong}, doi = {10.1186/1471-2458-11-446}, issn = {1471-2458}, year = {2011}, date = {2011-01-01}, journal = {BMC Public Health}, volume = {11}, pages = {446}, abstract = {BACKGROUND: This study sought to understand the factors associated with street racing among the illegal motorcycle racers in Malaysia or known as the "Mat Rempit". METHODS: Street outreach interviewer-administered surveys were conducted from June 2008 to January 2009 in this multi-state study. RESULTS: A total of 2022 participants were surveyed, the mean +/- SD age of the participants was 20.5 +/- 3.4 years (age range: 12 to 35 years). Mean duration of street racing was 2.65(SD +/- 1.77) years (range: 2 months to 12 years), with 50.1% and 35.8% reporting stunt riding and alcohol drinking while racing, respectively. With regard to risk behaviours, cigarette smoking was highly prevalent among the study participants (78.3%), followed by alcohol drinking (27.8%) and recreational drug use (18.8%). Participants scored high on the masculinity scale (15.7 +/- 4.0 out of 21.0). The results of the logistic regression analysis showed that socio-demographic variables, risk behaviour and masculinity scores were associated with racing frequency. CONCLUSION: Given these associations, tailoring family-centered interventions to the needs of the lower socio-economic groups and interventions recognizing the negative consequences of health risk behaviours related to street racing as an expression of traditional masculinity should be emphasized.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14526, title = {Attitudes toward menstruation, menstrual-related symptoms, and premenstrual syndrome among adolescent girls: a rural school-based survey}, author = {L P Wong}, doi = {10.1080/03630242.2011.574792}, issn = {0363-0242}, year = {2011}, date = {2011-01-01}, journal = {Women Health}, volume = {51}, number = {4}, pages = {340-64}, abstract = {Folk culture surrounding menstrual-related matters has considerable implications for symptom expression and treatment-seeking behavior. A cross-sectional survey of 1,295 rural adolescent girls aged 13 to 19 years was conducted between February 4 and April 16, 2009 to examine these associations. With a higher score indicating a more positive attitude toward menstruation, the mean attitude score was 3.84 (SD +/- 1.62) out of a maximum of six. No significant association was observed between the severity of menstrual symptoms and attitudes. Most (63.1%) of the participants identified themselves as having premenstrual symptoms, and 61.1% viewed premenstrual symptoms as a normal part of menstrual cycle. Participants with a higher severity of symptoms in the premenstrual (OR 1.05, 95% CI 1.01-1.10) and menstrual phase (OR 1.04, 95% CI 1.01-1.07), were more likely to consult a physician for premenstrual symptoms, and having a divorced/separated parents was associated with a reduced odds of consulting a physician compared to those having parents that were married (OR 0.19, 95% CI 0.05-0.83). The findings imply the need for education to help adolescent girls manage menstrual symptoms and increase awareness of the benefit of treating them. Given that menstrual-related information was widely available from mothers, family, and social culture are potentially important in shaping good menstrual attitudes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14525, title = {Attitudes towards dysmenorrhoea, impact and treatment seeking among adolescent girls: a rural school-based survey}, author = {L P Wong}, doi = {10.1111/j.1440-1584.2011.01213.x}, issn = {1038-5282}, year = {2011}, date = {2011-01-01}, journal = {Aust J Rural Health}, volume = {19}, number = {4}, pages = {218-23}, abstract = {OBJECTIVE: Study aimed to determine the prevalence of dysmenorrhoea, its impact, and treatment-seeking behaviour of rural adolescent girls in Malaysia. PARTICIPANTS AND SETTING: Large cross-sectional study on 1295 adolescent girls (aged 13-19 years) from 16 public secondary schools in rural districts of Kelantan, Malaysia conducted between February 2009 and April 2009. RESULTS: Dysmenorrhoea was reported in 76.0% of the participants. Concentration at school (59.9%) and participation in social events (58.6%) have been most affected. Multivariate analysis shows that being in upper secondary level was the strongest predictor for poor concentration, absenteeism, and poor school grade due to dysmenorrhoea. In spite of its high prevalence and enormous impact on their lives, 76.1% believed that dysmenorrhoea is a normal part of the female menstrual cycle and only 14.8% sought medical treatment. The majority of adolescents obtained information from their mothers (62.3%) and peers (52.9%). CONCLUSION: The findings imply the need for educating adolescent girls on effective management of dysmenorrhoea. Education should be extended to parents and school peer leaders to address the reproductive health needs of adolescents.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN1987, title = {Hand-arm vibration syndrome among a group of construction workers in Malaysia}, author = {Ting Anselm Su and Victor Chee Wai Hoe and Retneswari Masilamani and Awang Bulgiba Awang Mahmud}, url = {http://oem.bmj.com/content/68/1/58.abstract}, doi = {10.1136/oem.2009.052373}, year = {2011}, date = {2011-01-01}, journal = {Occupational and Environmental Medicine}, volume = {68}, number = {1}, pages = {58-63}, abstract = {Objectives To determine the extent of hand transmitted vibration exposure problems, particularly hand-arm vibration syndrome (HAVS), among construction workers in Malaysia. Methods A cross-sectional study was conducted on a construction site in Kuala Lumpur, Malaysia. 243 workers were recruited. Questionnaire interviews and hand examinations were administered to 194 respondents. Vibration magnitudes for concrete breakers, drills and grinders were measured using a 3-axis accelerometer. Clinical outcomes were compared and analysed according to vibration exposure status. Results Vibration total values for concrete breakers, impact drills and grinders were 10.02 ms−2, 7.72 ms−2 and 5.29 ms−2, respectively. The mean 8 h time-weighted hand transmitted vibration exposure, A(8), among subjects on current and previous construction sites was 7.52 (SD 2.68) ms−2 and 9.21 (SD 2.48) ms−2, respectively. Finger tingling, finger numbness, musculoskeletal problems of the neck, finger coldness, abnormal Phalen's test and abnormal light touch sensation were significantly more common in the high vibration exposure group (n=139) than the low\textendashmoderate vibration exposure group (n=54). Mean total lifetime vibration dose among exposed subjects was 15.2 (SD 3.2) m2 h3 s−4 (ln scale). HAVS prevalence was 18% and the prevalence ratio of stage 1 and higher disease in the high vibration exposure group versus the low\textendashmoderate vibration exposure group was 4.86 (95% CI 1.19 to 19.80). Conclusions Hand transmitted vibration is a recognisable problem in tropical countries including Malaysia. The current study has identified clinical symptoms and signs suggesting HAVS among construction workers exposed to hand transmitted vibration in a warm environment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16011, title = {Hand-arm vibration syndrome among a group of construction workers in Malaysia}, author = {T A Su and V C Hoe and R Masilamani and A B Awang Mahmud}, doi = {10.1136/oem.2009.052373}, issn = {1351-0711}, year = {2011}, date = {2011-01-01}, journal = {Occup Environ Med}, volume = {68}, number = {1}, pages = {58-63}, abstract = {OBJECTIVES: To determine the extent of hand transmitted vibration exposure problems, particularly hand-arm vibration syndrome (HAVS), among construction workers in Malaysia. METHODS: A cross-sectional study was conducted on a construction site in Kuala Lumpur, Malaysia. 243 workers were recruited. Questionnaire interviews and hand examinations were administered to 194 respondents. Vibration magnitudes for concrete breakers, drills and grinders were measured using a 3-axis accelerometer. Clinical outcomes were compared and analysed according to vibration exposure status. RESULTS: Vibration total values for concrete breakers, impact drills and grinders were 10.02 ms(-2), 7.72 ms(-2) and 5.29ms(-2), respectively. The mean 8 h time-weighted hand transmitted vibration exposure, A(8), among subjects on current and previous construction sites was 7.52 (SD 2.68) ms(-2) and 9.21 (SD 2.48) ms(-2), respectively. Finger tingling, finger numbness, musculoskeletal problems of the neck, finger coldness, abnormal Phalen's test and abnormal light touch sensation were significantly more common in the high vibration exposure group (n=139) than the low-moderate vibration exposure group (n=54). Mean total lifetime vibration dose among exposed subjects was 15.2 (SD 3.2) m(2) h(3) s(-4) (ln scale). HAVS prevalence was 18% and the prevalence ratio of stage 1 and higher disease in the high vibration exposure group versus the low-moderate vibration exposure group was 4.86 (95% CI 1.19 to 19.80). CONCLUSIONS: Hand transmitted vibration is a recognisable problem in tropical countries including Malaysia. The current study has identified clinical symptoms and signs suggesting HAVS among construction workers exposed to hand transmitted vibration in a warm environment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14639, title = {Prevalence and risk factors of latent tuberculosis infection among health care workers in Malaysia}, author = {S Rafiza and K G Rampal and A Tahir}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3033828/pdf/1471-2334-11-19.pdf}, doi = {10.1186/1471-2334-11-19}, issn = {1471-2334}, year = {2011}, date = {2011-01-01}, journal = {BMC Infect Dis}, volume = {11}, pages = {19}, abstract = {BACKGROUND: Health care workers are exposed to patients with tuberculosis and are at risk of nosocomial infection. The aim of this study was to determine the prevalence and factors associated with latent tuberculosis infection among health care workers in Malaysia and also to evaluate the agreement between Quantiferon TB Gold in tube test with Tuberculin Skin Test. METHODS: A cross sectional study was conducted at four randomly selected hospitals in the Klang Valley from December 2008 to May 2009. Self administered questionnaire was used to obtain information on health care workers and possible risk factors. The response rate for this study was 90.8% with 954 respondents completed the questionnaire and were tested with Quantiferon TB Gold in tube for latent tuberculosis infection. Agreement between Quantiferon TB Gold in tube and Tuberculin Skin Test was assessed among 95 health care workers who consented to undergo both tests. RESULTS: The overall prevalence of latent tuberculosis infection among health care workers was 10.6% (CI: 8.6%; 12.6%). Factors significantly associated with latent tuberculosis infection were aged 35 years and older [9.49 (CI: 2.22; 40.50)], history of living in the same house with close family members or friends who had active tuberculosis [8.69 (CI: 3.00; 25.18)], worked as a nurse [4.65 (CI: 1.10; 19.65)] and being male [3.70 (CI: 1.36; 10.02)]. Agreement between Quantiferon TB Gold in tube test and tuberculin skin test at cut-off points of 10 mm and 15 mm was 50.5% and 82.1% respectively. However, Kappa-agreement was poor for both cut-off points. CONCLUSION: The prevalence of latent tuberculosis infection in Malaysia was relatively low for an intermediate TB burden country. We could not comment on the occupational risk of latent tuberculosis infection among health care worker compared to the general population as there were no prevalence data available for latent tuberculosis infection in the general population. Kappa agreement between Quantiferon TB gold in-tube and tuberculin skin test was poor.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14531, title = {Breast cancer in a multi-ethnic Asian setting: results from the Singapore-Malaysia hospital-based breast cancer registry}, author = {N B Pathy and C H Yip and N A Taib and M Hartman and N Saxena and P Iau and A M Bulgiba and S C Lee and S E Lim and J E Wong and H M Verkooijen}, doi = {10.1016/j.breast.2011.01.015}, issn = {0960-9776}, year = {2011}, date = {2011-01-01}, journal = {Breast}, volume = {20 Suppl 2}, pages = {S75-80}, abstract = {Two hospital-based breast cancer databases (University Malaya Medical Center, Malaysia [n = 1513] and National University Hospital, Singapore [n = 2545]) were merged into a regional registry of breast cancer patients diagnosed between 1990 and 2007. A review of the data found 51% of patients diagnosed before the age of 50 years. and 72% percent of the women were Chinese followed by Malays (16%), Indians (8%), and other races (4%). Median tumor size at presentation was 26 mm and about 25% of patients presented with TNM stage III or IV disease. Most tumors were of ductal histology (87%). Fifty-seven percent of tumors were estrogen receptor positive and 40% were poorly differentiated. Of those patients who had surgery, 70% had mastectomy while 30% had breast conserving surgery. Overall, chemotherapy was administered to 56% of patients and hormonal treatment to 60%. Five-year overall survival was 82.5% in patients with TNM stage 0 to stage II cancer, and 30.2% in those with later stages.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14636, title = {Impact of breast surgery on survival in women presenting with metastatic breast cancer}, author = {N B Pathy and H M Verkooijen and N A Taib and M Hartman and C H Yip}, url = {http://onlinelibrary.wiley.com/doi/10.1002/bjs.7650/abstract}, doi = {10.1002/bjs.7650}, issn = {0007-1323}, year = {2011}, date = {2011-01-01}, journal = {Br J Surg}, volume = {98}, number = {11}, pages = {1566-72}, abstract = {BACKGROUND: Advanced breast cancer is common in less affluent parts of Asia. The impact of breast surgery on survival of women presenting with metastatic breast cancer in this setting was investigated. METHODS: Women presenting with metastatic breast cancer at the initial diagnosis at the University Malaya Medical Centre (Malaysia) between 1993 and 2008 were included in the study. Mortality of patients who had primary breast surgery was compared with that of those without surgery, and adjusted for possible confounders by means of a propensity score. RESULTS: Of 3689 patients, 375 (10.2 per cent) presented with metastatic disease. One hundred and thirty-nine patients (37.1 per cent) underwent surgery. A total of 330 deaths occurred during 6814 person-months of follow-up. The 2-year survival rate was 21.2 (95 per cent confidence interval (c.i.) 15.9 to 26.5) per cent in women who did not have surgery and 46.3 (37.7 to 54.9) per cent in those who had breast surgery. Breast surgery was associated with a 28 per cent lower risk of death (hazard ratio 0.72, 95 per cent c.i. 0.56 to 0.94), after adjustment for patient and tumour characteristics, metastatic profile and treatment. CONCLUSION: Surgical resection of the primary breast tumour was independently associated with a survival advantage in patients presenting with metastatic breast cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14522, title = {High prevalence of vitamin D insufficiency and its association with obesity and metabolic syndrome among Malay adults in Kuala Lumpur, Malaysia}, author = {F M Moy and A Bulgiba}, doi = {10.1186/1471-2458-11-735}, issn = {1471-2458}, year = {2011}, date = {2011-01-01}, journal = {BMC Public Health}, volume = {11}, pages = {735}, abstract = {BACKGROUND: Vitamin D status, as indicated by 25-hydroxyvitamin D is inversely associated with adiposity, glucose homeostasis, lipid profiles, and blood pressure along with its classic role in calcium homeostasis and bone metabolism. It is also shown to be inversely associated with metabolic syndrome and cardiovascular diseases in western populations. However, evidence from the Asian population is limited. Therefore, we aim to study the prevalence of vitamin D insufficiency (\< 50 nmol/L) and the association of 25-hydroxyvitamin D with metabolic risk factors among an existing Malay cohort in Kuala Lumpur. METHODS: This is an analytical cross sectional study. A total of 380 subjects were sampled and their vitamins D status (25-hydroxyvitamin D), fasting blood glucose, full lipid profile were assessed using venous blood. Systolic and diastolic blood pressure, weight, height and waist circumference were measured following standard protocols. Socio-demographic data such as sex, age, smoking status etc were also collected. Data was analysed using t-test, chi-square test, General Linear Model and multiple logistic regression. RESULTS: Females made up 58% of the sample. The mean age of respondents was 48.5 (SD 5.2) years. Females had significantly lower mean Vitamin D levels (36.2; 95% CI: 34.5, 38.0 nmol/L) compared to males (56.2; 95% CI: 53.2, 59.2 nmol/L). Approximately 41% and 87% of males and females respectively had insufficient (\< 50 nmol/L) levels of 25-hydroxyvitamin D (p \< 0.001). The prevalence of Metabolic Syndrome for the whole sample was 38.4 (95% CI: 33.5, 43.3)%. In the multivariate model (adjusted for age, sex, abdominal obesity, HDL-cholesterol, diastolic blood pressure), insufficient Vitamin D status was significantly associated with 1-year age increments (OR: 0.93; 95% CI: 0.88, 0.98), being female (OR: 8.68; 95% CI: 5.08, 14.83) and abdominal obesity (OR: 2.57; 95% CI: 1.51, 4.39). Respondents with insufficient vitamin D were found to have higher odds of having Metabolic Syndrome (OR: 1.73; 95% CI: 1.02, 2.92) after adjusting for age and sex. CONCLUSIONS: Our results highlight the high prevalence of vitamin D insufficiency among Malay adults in Kuala Lumpur. Vitamin D insufficiency is independently associated with younger age, female sex and greater abdominal obesity. Vitamin D insufficiency is also associated with Metabolic Syndrome.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14637, title = {Vitamin D status and its associated factors of free living Malay adults in a tropical country, Malaysia}, author = {F M Moy}, url = {http://ac.els-cdn.com/S1011134411001266/1-s2.0-S1011134411001266-main.pdf?_tid=fb9146c0-673b-11e5-b8c3-00000aab0f02\&acdnat=1443594482_54974591166038b4647734e95262eca9}, doi = {10.1016/j.jphotobiol.2011.05.002}, issn = {1011-1344}, year = {2011}, date = {2011-01-01}, journal = {J Photochem Photobiol B}, volume = {104}, number = {3}, pages = {444-8}, abstract = {Vitamin D status is influenced by sun exposure, geographic latitude, daily outdoor activities, body surface exposed to sunlight and dietary intakes. Malaysia, is sunny all year round. However, the vitamin D status of this population especially among the healthy and free living adults is not known. Therefore a study of vitamin D status and associated factors was initiated among an existing Malay cohort in Kuala Lumpur. A total of 380 subjects were sampled to have their vitamin D status assessed using 25-hydroxyvitamin D (25(OH)D). A short questionnaire enquiring socio-demographic characteristics, exposure to sunlight and clothing style was administered. Their mean age was 48.5+/-5.2years and the mean 25(OH)D for males and females were 56.2+/-18.9nmol/L and 36.2+/-13.4nmol/L respectively. There were significant positive correlation for sun exposure score (r=0.27, p\<0.001) and negative correlation for sun protection score (r=-0.41, p\<0.001) with 25(OH)D levels. In the logistic regression model, females (OR=2.93; 95% CI: 1.17, 7.31), BMI (1.1; 1.03, 1.20) and sun exposure score (0.998; 0.996, 0.999) were significantly associated with vitamin D status as represented by 25(OH)D levels. Our findings show that obesity, lifestyle behaviours and clothing style are directly associated with our participants especially females' low vitamin D status.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN11819, title = {Predictors of Handgrip Strength among the Free Living Elderly in Rural Pahang, Malaysia}, author = {F Moy and E Chang and K Kee}, issn = {2251-6085 (Print) 2251-6085 (Linking)}, year = {2011}, date = {2011-01-01}, journal = {Iran J Public Health}, volume = {40}, number = {4}, pages = {44-53}, abstract = {BACKGROUND: Reduced handgrip strength is an aging process that significantly influences the living activities of elderly. It is linked to premature mortality, disability and other health complications among elderly. Therefore, we aim to determine the associated predictors with handgrip strength among the free living elderly in Malaysia. METHODS: This was a cross sectional study conducted in a rural state in Malaysia. A total of 434 elderly individuals performed handgrip assessment. Socio-demographic characteristics, medical conditions, occupational history, functional ability (ADL) and depression (GDS) were enquired. Anthropometric measurements (weight and height) were also obtained. RESULTS: Majority of the respondents were Malays with mean age of 67.9 +/- 6.3 years. Maximum handgrip strength of males and females were 28.8+/-9.2 kg and 18.9+/-6.9 kg respectively (P\<0.05). The aborigines had significantly lower handgrip strength (P\<0.05) compared to Malays, Chinese and Indians. Handgrip strength was positively correlated (P\<0.05) with weight, height and ADL, while negatively associated (P\<0.05) with GDS for both gender. In the multivariate linear regression analysis; weight, height and race significantly predicted handgrip strength among both male and female elderly after adjustment for all potential confounders. However, GDS and ADL were only found to significantly predict handgrip strength among the male elderly; while age was only significant among the females. CONCLUSION: Our sample population has significantly lower handgrip strength than the Western counterpart. Weight, height and race significantly predict handgrip strength among both male and female elderly. GDS, ADL are only found to be significant in males while age was only significant among the females.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15999, title = {Occupational pressure-targeting organisational factors to ameliorate occupational dysfunction}, author = {S Y Loh and W Than and K F Quek}, doi = {10.1007/s10926-011-9287-3}, issn = {1053-0487}, year = {2011}, date = {2011-01-01}, journal = {J Occup Rehabil}, volume = {21}, number = {4}, pages = {493-500}, abstract = {INTRODUCTION: Chronic pressure at work has debilitating impact on healthcare employers (e.g. reduced productivity, high costs, poor patient care) and on female healthcare employees (e.g. sickness, dysfunction). This paper highlights relationship at work as the key occupational source of work-stress which is organisational in nature. METHODS: A cross-sectional study (n = 230) was conducted using the Pressure Management Inventory on several female dominated health professions within a large public hospital. Analysis of variance was used to show relationship between sources and outcome of pressure. Linear regressions were used to predict which sources of pressure (IV) was linked to the outcomes of occupational pressure (DV). RESULTS: The number one source of occupational pressure is relationships at work (i.e. with supervisors), and not workload. 'Relationship' is also the key predictor of several negative outcomes of pressure at work. Analysis of variance showed significant differences in two sources of pressures, i.e. Workload (P = 0.04) and Home-work balance (P = 0.03). CONCLUSION: This paper provides insights into the occupational pressure of women health professionals by highlighting the organisational sources of pressure and the implications for preventing occupational dysfunction secondary to stress at work.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15990, title = {Cancer-behavior-coping in women with breast cancer: Effect of a cancer self-management program}, author = {S Y Loh and K Quek}, doi = {10.4103/2229-516x.91150}, issn = {2229-516X (Print) 2229-516x}, year = {2011}, date = {2011-01-01}, journal = {Int J Appl Basic Med Res}, volume = {1}, number = {2}, pages = {84-8}, abstract = {OBJECTIVE: The Cancer Behavior Inventory (CBI), a measure of self-efficacy for coping with cancer, was used to examine the feasibility and impact of a self-management program for women with breast cancer. This controlled clinical trial was conducted on newly diagnosed breast cancer patients, using a time series, block design. Sixty-nine patients were allocated to receive four weekly sessions of the self-management training program, while 78 patients were allocated to the control (usual-care) group. RESULTS: A significant difference was found between the means of the experimental and the control group at post-test (T2; P=.01) and at follow-up (T3; P=.02). The multivariate analyses of the three repeated measures showed significant differences (P=.001; partial eta-squared = 0.092). Pair-wise comparison shows that the differences were significant between baseline (T1) measure and follow-up (T3) measure (P=.01), and between post-test (T2) and follow-up (T3) (P=.03). CONCLUSION: For women undergoing intervention, the cancer-specific self-efficacy as measured by the cancer-behavior-coping inventory showed improvement over time. The result demonstrated that the self-management program to improve self-care correlates significantly with coping behavior in cancer. A larger and longer study of this efficacy-enhancing intervention is warranted.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15982, title = {Quality of life in breast cancer survivors: 2 years post self-management intervention}, author = {S Y Loh and S L Chew and S Y Lee and K F Quek}, issn = {1513-7368}, year = {2011}, date = {2011-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {12}, number = {6}, pages = {1497-501}, abstract = {INTRODUCTION: Today, cancer survivors have an added new role to self manage living with the medical, emotional and role tasks that can affect their quality of life (QOL). The purpose of the study was to evaluate the QOL of women two years after participating in a self-management intervention program. METHOD: The clinical trial was conducted at University Malaya Medical Centre between 2006 and 2008. The experimental group underwent a 4-week self management program, and the control group underwent usual care. Two years after the intervention, questionnaires were randomly posted out to the participants. RESULTS: A total of 51 questionnaires returned. There were statistically differences between groups in psychological, self-care, mobility and participation aspects in PIPP (p\<0.05). The experimental group reported having higher confidence to live with breast cancer compared to control group (p\<0.05). There were significant between-group changes in anxiety scores at T2 (immediately after intervention) to T4 (two years later), and the differences in anxiety scores within groups between time point T2 and T4 were significantly different (p\<0.05). CONCLUSION: The SAMA program is potentially capable to serve as a model intervention for successful transition to survivorship following breast cancer treatment. The program needs to be further tested for efficacy in a larger trial involving more diverse populations of women completing breast cancer treatment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14524, title = {Chronic diseases, depressive symptoms and functional limitation amongst older people in rural Malaysia, a middle income developing country}, author = {N N Hairi and A Bulgiba and I Mudla and M A Said}, url = {http://ac.els-cdn.com/S009174351100288X/1-s2.0-S009174351100288X-main.pdf?_tid=ef1297d2-e139-11e5-bcd7-00000aab0f27\&acdnat=1457007644_c88a125b6ff8e21786b116d224a45355}, doi = {10.1016/j.ypmed.2011.07.020}, issn = {0091-7435}, year = {2011}, date = {2011-01-01}, journal = {Prev Med}, volume = {53}, number = {4-5}, pages = {343-6}, abstract = {OBJECTIVES: To determine prevalence and prevalence ratio of functional limitation amongst older people with combined chronic diseases and co-morbid depressive symptoms compared with older people with either chronic disease or depressive symptoms alone. METHODS: Data were analysed from a cross-sectional study of 765 people aged 60 years and over, conducted from 2007 to 2008 in Malaysia. Chronic diseases were self-reported, depressive symptoms were measured using the Geriatric Depression Scale and functional limitation was assessed using the Tinetti Performance Oriented Mobility Assessment Tool. RESULTS: A higher proportion of older people with combined chronic diseases and depressive symptoms reported having functional limitation (44.7%) compared with older people with chronic diseases alone (12.5%) and depressive symptoms alone (18.1%). Adjusting for socio-demographic characteristics, cognitive status and living arrangements, chronic diseases were associated with functional limitation (PR 2.21, 95% CI 1.31, 3.72). Depressive symptoms were also associated with functional limitation (PR 2.07, 95% CI 1.56, 2.76). The prevalence ratio for functional limitation was much greater for combined chronic diseases and depressive symptoms (PR 4.09, 95% CI 2.23, 7.51). CONCLUSIONS: Older people with combined chronic diseases and depressive symptoms are more likely to have functional limitation than those with chronic disease or depressive symptoms alone.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16010, title = {Survival and prognostic factors of motor neuron disease in a multi-ethnic Asian population}, author = {K J Goh and S Tian and N Shahrizaila and C W Ng and C T Tan}, doi = {10.3109/17482968.2010.527986}, issn = {1471-180x}, year = {2011}, date = {2011-01-01}, journal = {Amyotroph Lateral Scler}, volume = {12}, number = {2}, pages = {124-9}, abstract = {Our objective was to determine the survival and prognostic factors of motor neuron disease (MND) in a multi-ethnic cohort of Malaysian patients. All patients seen at a university medical centre between January 2000 and December 2009 had their case records reviewed for demographic, clinical and follow-up data. Mortality data, if unavailable from records, were obtained by telephone interview of relatives or from the national mortality registry. Of the 73 patients, 64.4% were Chinese, 19.2% Malays and 16.4% Indians. Male: female ratio was 1.43: 1. Mean age at onset was 51.5 + 11.3 years. Onset was spinal in 75.3% and bulbar in 24.7% of the patients; 94.5% were ALS and 5.5% were progressive muscular atrophy (PMA). Overall median survival was 44.9 + 5.8 months. Ethnic Indians had shorter interval from symptom onset to diagnosis and shorter median survival compared to non-Indians. On Cox proportional hazards analysis, poor prognostic factors were bulbar onset, shorter interval from symptom onset to diagnosis and worse functional score at presentation. In conclusion, age of onset and median survival duration are similar to previous reports in Asians. Clinical features and prognostic factors are similar to other populations. In our cohort, ethnic Indians had more rapid disease course accounting for their shorter survival.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14119, title = {Validation of a food frequency questionnaire to assess dietary cholesterol, total fat and different types of fat intakes among Malay adults}, author = {J Y Eng and F M Moy}, issn = {0964-7058 (Print) 0964-7058}, year = {2011}, date = {2011-01-01}, journal = {Asia Pac J Clin Nutr}, volume = {20}, number = {4}, pages = {639-45}, abstract = {BACKGROUND: Cardiovascular diseases are the major cause of death in Malaysia. Evidence shows that dietary fat intake is one of the important risk factors for cardiovascular disease. However, studies assessing the association of fatty acids and risk of cardiovascular diseases in Malaysia are scarce. Therefore, this study aimed to develop and validate a food frequency questionnaire (FFQ) assessing total fat and different types of fat among Malay adults in Malaysia. METHODS: A 100 food item FFQ focused on dietary cholesterol, total fat, saturated fat, monounsaturated fat and polyunsaturated fat intake for the past one month was developed and validated against 3-day dietary record (DR) among 151 Malay participants. Validity was assessed through the reliability and agreement of two methods. Intra-class correlation (ICC) coefficients were used to assess reliability; while regression analysis and classification into categories were used to assess agreement of the two methods. RESULTS: The mean nutrient intakes tended to be higher in FFQ compared to DR. The developed FFQ showed excellent reliability with ICC coefficients ranging from 0.92-0.98. Regression analysis demonstrated an acceptable agreement between FFQ and DR for total fat and different types of fat intakes. There were a relatively high proportion of subjects being correctly classified (into same or adjacent category) and only a small number of grossly misclassification for total energy, fat, dietary cholesterol, saturated fat and unsaturated fat occurred. CONCLUSION: This FFQ is valid in assessing absolute total energy, total fat and types of fat intakes among Malay adults.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14517, title = {Breast cancer prevention and control programs in Malaysia}, author = {M Dahlui and S Ramli and A M Bulgiba}, issn = {1513-7368 (Print) 1513-7368}, year = {2011}, date = {2011-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {12}, number = {6}, pages = {1631-4}, abstract = {Breast cancer is the most common cancer in Malaysian females. The National Cancer Registry in 2003 and 2006 reported that the age standardized incidence of breast cancer was 46.2 and 39.3 per 100,000 populations, respectively. With the cumulative risk at 5.0; a woman in Malaysia had a 1 in 20 chance of developing breast cancer in her lifetime. The incidence of cancer in general, and for breast cancer specifically was highest in the Chinese, followed by Indians and Malays. Most of the patients with breast cancers presented at late stages (stage I: 15.45%, stage II: 46.9%, stage III: 22.2% and stage IV: 15.5%). The Healthy Lifestyles Campaign which started in the early nineties had created awareness on breast cancer and after a decade the effort was enhanced with the Breast Health Awareness program to promote breast self examination (BSE) to all women, to perform annual clinical breast examination (CBE) on women above 40 and mammogram on women above 50. The National Health Morbidity Survey in 2006 showed that the prevalence rate of 70.35% by any of three methods of breast screening; 57.1% by BSE, 51.8% by CBE and 7.6% by mammogram. The current screening policy for breast cancer focuses on CBE whereby all women at the age of 20 years and above must undergo breast examination by trained health care providers every 3 years for age between 20-39 years, and annually for age 40 and above. Several breast cancer preventive programs had been developed by various ministries in Malaysia; among which are the RM50 subsidy for mammogram by the Ministry of Women, Family and Community Development and the SIPPS program (a call-recall system for women to do PAP smear and CBE) by the Ministry of Health. Measures to increase uptake of breast cancer screening and factors as to why women with breast cancer present late should be studied to assist in more development of policy on the prevention of breast cancer in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14529, title = {Is breast self examination (BSE) still relevant? A study on BSE performance among female staff of University of Malaya}, author = {M Dahlui and C Ng and N Al-Sadat and S Ismail and A Bulgiba}, issn = {1513-7368 (Print) 1513-7368}, year = {2011}, date = {2011-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {12}, number = {2}, pages = {369-72}, abstract = {OBJECTIVES: This study aimed to determine the rate of breast self examination (BSE) among the female staff of University of Malaya and to determine the role of BSE in detecting breast abnormalities. METHODS: A total of 1598 questionnaires were posted to all female staff, aged 35 years and above. Their knowledge on breast cancer, practice of BSE and detection rate of breast abnormality as confirmed by CBE was determined. RESULTS: The response rate for this study was 45 percent (714 respondents). The rate of respondents having awareness on breast cancer was 98.7 percent. Eighty four percent (598) of the respondents had performed BSE in their lifetime. However, in only 41% was it regular at the recommended time. Forty seven percent (334) had undergone CBE at least once in a lifetime but only 26% (185) had CBE at least once in the past 3 years, while 23% (165) had had a mammogram. There was a significant relationship between CBE and BSE whereby those who had CBE were twice more likely to do BSE. Nineteen percent (84 respondents) of those who did BSE claimed they had detected a breast lump. Of these, 87% (73) had gone for CBE and all were confirmed as such. CONCLUSION: BSE is still relevant as a screening tool of breast cancer since those who detect breast lump by BSE will most probably go for further check up. CBE should be done to all women, especially those at highest risk of breast cancer, to encourage and train for BSE.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14519, title = {Victimization experiences of adolescents in Malaysia}, author = {W Y Choo and M P Dunne and M J Marret and M Fleming and Y L Wong}, url = {http://ac.els-cdn.com/S1054139X11001534/1-s2.0-S1054139X11001534-main.pdf?_tid=8e574c68-e12e-11e5-a293-00000aab0f6c\&acdnat=1457002757_0e48183729dba7bacd67d0a22af8377c}, doi = {10.1016/j.jadohealth.2011.04.020}, issn = {1054-139x}, year = {2011}, date = {2011-01-01}, journal = {J Adolesc Health}, volume = {49}, number = {6}, pages = {627-34}, abstract = {PURPOSE: There has been little community-based research regarding multiple-type victimization experiences of young people in Asia, and none in Malaysia. This study aimed to estimate prevalence, explore gender differences, as well as describe typical perpetrators and family and social risk factors among Malaysian adolescents. METHODS: A cross-sectional survey of 1,870 students was conducted in 20 randomly selected secondary schools in Selangor state (mean age: 16 years; 58.8% female). The questionnaire included items on individual, family, and social background and different types of victimization experiences in childhood. RESULTS: Emotional and physical types of victimization were most common. A significant proportion of adolescents (22.1%) were exposed to more than one type, with 3% reporting all four types. Compared with females, males reported more physical, emotional, and sexual victimization. The excess of sexual victimization among boys was due to higher exposure to noncontact events, whereas prevalence of forced intercourse was equal for both genders (3.0%). Although adult male perpetrators predominate, female adults and peers of both genders also contribute substantially. Low quality of parent-child relationships and poor school and neighborhood environments had the strongest associations with victimization. Family structure (parental divorce, presence of step-parent or single parent, or household size), parental drug use, and rural/urban location were not influential in this sample. CONCLUSION: This study extends the analysis of multiple-type victimization to a Malaysian population. Although some personal, familial, and social factors correlate with those found in western nations, there are cross-cultural differences, especially with regard to the nature of sexual violence based on gender and the influence of family structure.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14523, title = {Factors related to poor practice of Pap smear screening among secondary school teachers in Malaysia}, author = {F Abdullah and N A Aziz and T T Su}, issn = {1513-7368 (Print) 1513-7368}, year = {2011}, date = {2011-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {12}, number = {5}, pages = {1347-52}, abstract = {INTRODUCTION: The Pap smear test has been regarded as a promising cervical screening tool since 1940s. Yet its importance has been overlooked by beneficiaries in Malaysia. This underlines the need to identify the prevalence of Pap smear practice and influencing factors towards the practice among educated working women. METHODS: A survey was conducted with 403 female teachers from 40 public secondary schools in Malaysia selected by cluster random sampling. Data were collected from January to March 2010 using a self-administered questionnaire. Multivariate logistic regression was performed to identify the factors related to the Pap smear practice. RESULTS: The rate for participants who ever had Pap test was only 38% and poor practice of was significantly higher among: those with aged less than 35 years; those practicing hormonal contraceptive method; and individuals perceiving barriers to the Pap smear screening test. In contrast, the findings were significantly lower in women with longer duration of teaching service; higher income groups; ever pregnant; having chronic diseases; health insurance coverage; and who had perceived benefit of Pap smear screening. CONCLUSION: Barriers towards practicing Pap smear exist even among educated career women. Tailor-made health promotion and education on cervical cancer and the benefit of Pap smear screening are essential to change the behavior of the study population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14533, title = {Information needs, preferred educational messages and channel of delivery, and opinion on strategies to promote organ donation: a multicultural perspective}, author = {L P Wong}, issn = {0037-5675 (Print) 0037-5675}, year = {2010}, date = {2010-01-01}, journal = {Singapore Med J}, volume = {51}, number = {10}, pages = {790-5}, abstract = {INTRODUCTION: This study assessed the information needs, preferred educational messages and channels of delivery, as well as opinions on strategies to promote organ donation. It aimed to provide insight into a culturally sensitive public education campaign to encourage organ donation in diverse ethnic communities in Asia, namely the Malays, Chinese and Indians. METHODS: A total of 17 focus group discussions with 105 participants were conducted between September and December 2008. The participants were members of the general public aged 18 to 60 years, who were recruited through convenient sampling in the Klang Valley area of Malaysia. RESULTS: Across ethnic groups, there was a general concern about the mistreatment of the deceased's body in the organ procurement process. The Chinese and Indian participants wanted assurance that the body would be treated with respect and care. The Muslims wanted assurance that the handling of a Muslim's body would follow the rules and regulations of the Islamic faith. The most important information requested by the Muslim participants was whether cadaveric donation is permissible in Islam. A lack of national public education and promotion of organ donation was noted. All the three ethnic groups, especially the Malays, required community and religious leaders for support, encouragement and involvement, as sociocultural influences play a significant role in the willingness to donate organs. CONCLUSION: The pronounced ethnic differences in information needs suggest that culturally sensitive public educational messages are required. Organ donation and transplantation organisations should work closely with community and religious organisations to address the sociocultural barriers identified.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16018, title = {Anthropometric, biochemical and clinical assessment of malnutrition in Malaysian patients with advanced cirrhosis}, author = {M L Tai and K L Goh and S H Mohd-Taib and S Rampal and S Mahadeva}, doi = {10.1186/1475-2891-9-27}, issn = {1475-2891}, year = {2010}, date = {2010-01-01}, journal = {Nutr J}, volume = {9}, pages = {27}, abstract = {BACKGROUND: There is limited data on the nutritional status of Asian patients with various aetiologies of cirrhosis. This study aimed to determine the prevalence of malnutrition and to compare nutritional differences between various aetiologies. METHODOLOGY: A cross-sectional study of adult patients with decompensated cirrhosis was conducted. Nutritional status was assessed using standard anthropometry, serum visceral proteins and subjective global assessment (SGA). RESULTS: Thirty six patients (mean age 59.8 +/- 12.8 years; 66.7% males; 41.6% viral hepatitis; Child-Pugh C 55.6%) with decompensated cirrhosis were recruited. Malnutrition was prevalent in 18 (50%) patients and the mean caloric intake was low at 15.2 kcal/kg/day. SGA grade C, as compared to SGA grade B, demonstrated significantly lower anthropometric values in males (BMI 18.1 +/- 1.6 vs 26.3 +/- 3.5 kg/m2, p \< 0.0001; MAMC 19.4 +/- 1.5 vs 24.5 +/- 3.6 cm}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16012, title = {The Bahasa Melayu version of the Nursing Stress Scale among nurses: a reliability study in Malaysia}, author = {M R Rosnawati and H Moe and R Masilamani and A Darus}, doi = {10.1177/1010539510380560}, issn = {1010-5395}, year = {2010}, date = {2010-01-01}, journal = {Asia Pac J Public Health}, volume = {22}, number = {4}, pages = {501-6}, abstract = {The Nursing Stress Scale (NSS) has been shown to be a valid and reliable instrument to assess occupational stressors among nurses. The NSS, which was previously used in the English version, was translated and back-translated into Bahasa Melayu. This study was conducted to assess the reliability of the Bahasa Melayu version of the NSS among nurses for future studies in this country. The reliability of the NSS was assessed after its readministration to 30 nurses with a 2-week interval. The Spearman coefficient was calculated to assess its stability. The internal consistency was measured through 4 measures: Cronbach's alpha, Spearman-Brown, Guttman split-half, and standardized item alpha coefficients. The total response rate was 70%. Test-retest reliability showed remarkable stability (Spearman's rho exceeded .70). All 4 measures of internal consistency among items indicated a satisfactory level (coefficients in the range of .68 to .87). In conclusion, the Bahasa Melayu version of the NSS is a reliable and useful instrument for measuring the possible stressors at the workplace among nurses.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16033, title = {Variation in the prevalence, awareness, and control of diabetes in a multiethnic population: a nationwide population study in Malaysia}, author = {S Rampal and L Rampal and R Rahmat and A M Zain and Y G Yap and M Mohamed and M Taha}, doi = {10.1177/1010539509334816}, issn = {1010-5395}, year = {2010}, date = {2010-01-01}, journal = {Asia Pac J Public Health}, volume = {22}, number = {2}, pages = {194-202}, abstract = {The purpose of this study was to determine the association between different ethnic groups and the prevalence, awareness, and control of diabetes in Malaysia. A population-based cross-sectional study using multistage sampling was conducted in Malaysia. Diabetes is defined as having a fasting blood glucose \> or =7 mmol/L or a self-reported diabetic on treatment. Among the 7683 respondents aged \> or =30 years, the prevalence of diabetes mellitus was 15.2% (95% CI = 14.1, 16.4). Multivariate analysis showed that compared with Malays, Chinese had lower odds (adjusted odds ratio [aOR] 0.71; 95% CI = 0.56, 0.91) and Indians had higher odds of having diabetes (aOR 1.54; 95% CI = 1.20, 1.98). The odds of diabetes increased with age, family history of diabetes, body mass index, and lower education levels. Among those with diabetes mellitus, 45.0% were aware and 42.7% were under treatment. Among treated diabetics, 25.1% had their fasting blood sugar under control. There is a significant association between prevalence of diabetes and different ethnic groups.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14534, title = {The modified NCEP ATP III criteria maybe better than the IDF criteria in diagnosing Metabolic Syndrome among Malays in Kuala Lumpur}, author = {F M Moy and A Bulgiba}, doi = {10.1186/1471-2458-10-678}, issn = {1471-2458}, year = {2010}, date = {2010-01-01}, journal = {BMC Public Health}, volume = {10}, pages = {678}, abstract = {BACKGROUND: Metabolic Syndrome is associated with increased risk for type 2 diabetes and cardiovascular diseases. However, different diagnostic criteria have been recommended by different expert groups. In Malaysia, there is a lack of research comparing these different diagnostic criteria. Therefore, it is our aim to study the concordance between the IDF and the modified NCEP ATP III definitions of Metabolic Syndrome among a Malay cohort in Kuala Lumpur; and to demonstrate if all participants have the same cardiometabolic risks. METHODS: This was an analytical cross sectional study. Ethics approval was obtained and informed consent was given by all participants. Anthropometric measurements, blood pressure, fasting blood glucose and lipid profile were taken following standard protocols. RESULTS: Metabolic Syndrome was diagnosed in 41.4% and 38.2% participants using the modified NCEP and IDF criteria respectively. Among those diagnosed with Metabolic Syndrome by modified NCEP, 7.6% were missed by the IDF criteria. Participants diagnosed by the modified NCEP criteria had lower BMI and waist circumference but had higher cardiometabolic risks than those diagnosed with both criteria. Their blood pressure, glucose, total cholesterol and triglyceride were more adverse than the IDF group. This demonstrated that central obesity may not be a prerequisite for the development of increased cardiometabolic risks within this Malay cohort. CONCLUSION: Metabolic syndrome is common in this Malay cohort regardless of the criterion used. The modified NCEP ATP III criteria may be more suitable in diagnosis of metabolic syndrome for this Malay cohort.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16013, title = {Brain-drain and health care delivery in developing countries}, author = {Y A Misau and N Al-Sadat and A B Gerei}, doi = {10.4081/jphia.2010.e6}, issn = {2038-9922 (Print) 2038-9922}, year = {2010}, date = {2010-01-01}, journal = {J Public Health Afr}, volume = {1}, number = {1}, pages = {e6}, abstract = {Migration of health workers 'Brain drain' is defined as the movement of health personnel in search of a better standard of living and life quality, higher salaries, access to advanced technology and more stable political conditions in different places worldwide. The debate about migration of health workers from the developing to the developed world has remained pertinent for decades now. Regardless of the push and pull factors, migration of health care workers from developing countries to developed ones, have done more harm than good on the health care deliveries in the developing countries. This article reviews the literature on the effects of cross-border migration of health care professionals.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16023, title = {Risk factors associated with dyspepsia in a rural Asian population and its impact on quality of life}, author = {S Mahadeva and H Yadav and S Rampal and K L Goh}, doi = {10.1038/ajg.2010.26}, issn = {0002-9270}, year = {2010}, date = {2010-01-01}, journal = {Am J Gastroenterol}, volume = {105}, number = {4}, pages = {904-12}, abstract = {OBJECTIVES: The epidemiology and impact of dyspepsia in rural Asia remains uncertain. We aimed to determine the prevalence epidemiology and impact of dyspepsia in a rural Malaysian community. METHODS: A door-to-door survey was conducted in a representative rural population in Malaysia. Dyspepsia was defined according to the Rome II criteria, and health-related quality of life (HRQOL) was assessed using the Euroqol (EQ-5D) instrument. RESULTS: Of 2,260 adults, 2,000 (88.5%) completed the survey. The mean age of respondents was 40.4+/-15.3 years, 62.7% were women, 79.0% were ethnic Malays, 8.4% had been educated up to the tertiary level, 49.7% were unemployed, and 63.4% resided in village-type housing with 49.1% having \>8 residents per household. Dyspepsia was prevalent in 292 (14.6%) adults, and they had lower mean EQ-5D utility scores compared with healthy controls (0.91+/-0.17 vs. 0.97+/-0.08, P\<0.0001). Dyspepsia was found to be associated with female gender (15.8 vs. 12.7% males}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16024, title = {Ethnic variation, epidemiological factors and quality of life impairment associated with dyspepsia in urban Malaysia}, author = {S Mahadeva and H Yadav and S Rampal and S M Everett and K L Goh}, doi = {10.1111/j.1365-2036.2010.04270.x}, issn = {0269-2813}, year = {2010}, date = {2010-01-01}, journal = {Aliment Pharmacol Ther}, volume = {31}, number = {10}, pages = {1141-51}, abstract = {BACKGROUND: The role of ethnicity in the development of dyspepsia remains uncertain. AIMS: To examine the epidemiology of dyspepsia in a multi-ethnic Asian population and its impact on health-related quality of life (HRQOL). METHODS: A cross-sectional survey was conducted in a representative urban population in Kuala Lumpur, Malaysia. RESULTS: A total of 2039 adults (mean +/- s.d. age: 40.5 +/- 11.8 years, males 44.2%, ethnicity: Malays 45.3%, Chinese 38.0% and Indians 13.1%, tertiary education level 62%, professional employment 47.7% and median monthly income USD 850.00) were interviewed. Dyspepsia was prevalent in 496 (24.3%) adults. Independent predictors for dyspepsia, explored by logistic regression, were identified as: Malay (OR 2.17, 95% CI = 1.57-2.99) and Indian (OR 1.59, 95% CI = 1.03-2.45) ethnicity, heavy chilli intake (OR 2.35, 95% CI = 1.15-4.80), use of regular analgesia (OR 3.51, 95% CI = 2.54-4.87) and chronic illness (OR 1.67, 95% CI = 1.22-2.28). HRQOL was assessed with the EQ-5D and significantly lower scores were noted in dyspeptics compared with healthy controls (0.85 +/- 0.17 vs. 0.95 +/- 0.12, P \< 0.0001). CONCLUSION: Ethnicity, in addition to recognized epidemiological factors, is a risk factor for dyspepsia in an urban multi-racial Asian population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16004, title = {Self management pilot study on women with breast cancer: lessons learnt in Malaysia}, author = {S Y Loh and C H Yip and T Packer and K F Quek}, issn = {1513-7368}, year = {2010}, date = {2010-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {11}, number = {5}, pages = {1293-9}, abstract = {OBJECTIVE: With increasing survival rates, breast cancer is now considered a chronic condition necessitating innovative care to meet the long-term needs of survivors. This paper presents the findings of a pilot study on self-management for women diagnosed with breast cancer and their implications for Asian health care providers. METHODS: A pre-test/ post-test pilot study was conducted to gain preliminary insights into program feasibility and barriers to participation, and to provide justification for a larger trial. RESULTS: The study found the 4 week self-management program feasible and acceptable, with a favourable trend in quality of life. The recruitment barriers ranged from competing medical appointments, uncollaborative health providers, linguistic barriers and social-household concerns. Supporting facilitators identified were family, health professionals and fellow participants ("buddies"). Lessons from the study are discussed with regard to Asian health providers. CONCLUSION: There is preliminary evidence that self management is a workable and potentially useful model even in an Asians entrenched-hierarchical medical model of care. The initial challenge was breaking down barriers in acceptancee of a collaborative stance. A clinical trial is now warranted to gather more evidence.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16015, title = {The efficacy of periprostatic local anaesthetic infiltration in transrectal ultrasound biopsy of prostate: a prospective randomised control study}, author = {S Kuppusamy and N Faizal and K F Quek and A H Razack and N Dublin}, doi = {10.1007/s00345-010-0578-7}, issn = {0724-4983}, year = {2010}, date = {2010-01-01}, journal = {World J Urol}, volume = {28}, number = {6}, pages = {673-6}, abstract = {OBJECTIVE: It is still uncertain as to which form of anaesthesia is the optimum. We conducted a study to identify the best location and optimum volume of anaesthetic agent in order to achieve best pain relief and cooperation from our patients. We also assessed the need for local anaesthetic gel for probe lubrication and if the number of cores during biopsy makes a difference in the pain score. MATERIALS AND METHOD: A total of 386 patients were randomised into 4 groups i.e. no anaesthesia (Group A), 10 cc 1% Lignocaine at apical region of prostate (Group B), 5 cc 1% Lignocaine each at both bases (Group C) and lastly, 4 cc at apex and 3 cc each at both bases (Group D). Pain assessment was performed using the 10-point Visual Analog Scale after the procedure with regard to probe insertion and during the biopsy. RESULTS: The groups were comparable in number and mean age. Group B recorded the lowest mean pain score of 2.59. Comparative analysis showed significant pain relief when comparing Group B vs. Group A (P = 0.001). The other groups were not as effective. The overall mean pain score for the probe insertion and the number of cores during biopsy was also not significant. CONCLUSIONS: We suggest that a 10 cc 1% Lignocaine infiltration at the apical region of the prostate be used to obtain best pain relief during this procedure. Plain lubricant jelly is sufficient for probe insertion. There is no need to alter the anaesthetic requirement if number of cores is increased.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN11836, title = {Trends in overweight and obese adults in Malaysia (1996-2009): a systematic review}, author = {A Z Khambalia and L S Seen}, url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1467-789X.2010.00728.x/abstract}, doi = {10.1111/j.1467-789X.2010.00728.x}, issn = {1467-789X (Electronic) 1467-7881 (Linking)}, year = {2010}, date = {2010-01-01}, journal = {Obes Rev}, volume = {11}, number = {6}, pages = {403-12}, abstract = {Like other nations experiencing rapid industrialization, urbanization and a nutrition transition, there is concern in Malaysia of a possible escalation in the prevalence of overweight and obesity. In 1996, the National Health and Morbidity Survey reported a 16.6% and 4.4% prevalence of overweight and obesity, respectively. In the following decade, there have been several national and community surveys on overweight and obesity in Malaysia. The objective of this systematic review is to describe the trend from 1996 to 2009 in the prevalence of overweight and obesity in adults in Malaysia nationally and by gender, age and race. Results indicate that there has been a small rise in overweight adults in the years 1996, 2003 and 2006 (20.7%, 26.7% and 29.1%) and a much more dramatic increase in obesity in 1996, 2003, 2004 and 2006 (5.5%, 12.2%, 12.3% and 14.0%). Evidence showed a greater risk for overweight and obesity among women compared with men. Based on the highest-quality studies, overweight and obesity levels were highest among adults 40-59 years old. Overweight levels were highest among Indians, followed by Malays, Chinese and Aboriginals, with less consistency across studies on the order of risk or obesity by ethnicity.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14535, title = {Loss of muscle strength, mass (sarcopenia), and quality (specific force) and its relationship with functional limitation and physical disability: the Concord Health and Ageing in Men Project}, author = {N N Hairi and R G Cumming and V Naganathan and D J Handelsman and D G Le Couteur and H Creasey and L M Waite and M J Seibel and P N Sambrook}, url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1532-5415.2010.03145.x/abstract}, doi = {10.1111/j.1532-5415.2010.03145.x}, issn = {0002-8614}, year = {2010}, date = {2010-01-01}, journal = {J Am Geriatr Soc}, volume = {58}, number = {11}, pages = {2055-62}, abstract = {OBJECTIVES: To determine the association between loss of muscle strength, mass, and quality and functional limitation and physical disability in older men. DESIGN: Cross-sectional study of older men participating in the Concord Health and Ageing in Men Project (CHAMP). SETTING: Elderly men living in a defined geographical region in Sydney, Australia. PARTICIPANTS: One thousand seven hundred five community-dwelling men aged 70 and older who participated in the baseline assessments of CHAMP. MEASUREMENTS: Upper and lower extremity strength were measured using dynamometers for grip and quadriceps strength. Appendicular skeletal lean mass was assessed using dual X-ray absorptiometry. Muscle quality was defined as the ratio of strength to mass in upper and lower extremities. For each parameter, subjects in the lowest 20% of the distribution were defined as below normal. Functional limitation was assessed according to self-report and objective lower extremity performance measures. Physical disability was measured according to self-report questionnaire. RESULTS: After adjusting for important confounders, the prevalence ratio (PR) for poor quadriceps strength and self-reported functional limitation was 1.91 (95% confidence interval (CI) = 1.10-2.40); for performance-based functional limitation the PR was 1.81 (95% CI = 1.45-2.24). The adjusted PR for poor grip strength and physical disability in instrumental activities of daily living (IADLs) was 1.37 (95% CI = 1.20-1.56). The adjusted PR for low skeletal lean mass (adjusted for fat mass) and physical disability in basic activities of daily living was 2.08 (95% CI = 1.37-3.15). For muscle quality, the PR for lower extremity specific force and functional limitation and physical disability was stronger than upper extremity specific force. CONCLUSION: Muscle strength is the single best measure of age-related muscle change and is associated with physical disability in IADLs and functional limitation.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14537, title = {Prevalence and correlates of physical disability and functional limitation among community dwelling older people in rural Malaysia, a middle income country}, author = {N N Hairi and A Bulgiba and R G Cumming and V Naganathan and I Mudla}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933720/pdf/1471-2458-10-492.pdf}, doi = {10.1186/1471-2458-10-492}, issn = {1471-2458}, year = {2010}, date = {2010-01-01}, journal = {BMC Public Health}, volume = {10}, pages = {492}, abstract = {BACKGROUND: The prevalence and correlates of physical disability and functional limitation among older people have been studied in many developed countries but not in a middle income country such as Malaysia. The present study investigated the epidemiology of physical disability and functional limitation among older people in Malaysia and compares findings to other countries. METHODS: A population-based cross sectional study was conducted in Alor Gajah, Malacca. Seven hundred and sixty five older people aged 60 years and above underwent tests of functional limitation (Tinetti Performance Oriented Mobility Assessment Tool). Data were also collected for self reported activities of daily living (ADL) using the Barthel Index (ten items). To compare prevalence with other studies, ADL disability was also defined using six basic ADL's (eating, bathing, dressing, transferring, toileting and walking) and five basic ADL's (eating, bathing, dressing, transferring and toileting). RESULTS: Ten, six and five basic ADL disability was reported by 24.7% (95% CI 21.6-27.9), 14.4% (95% CI 11.9-17.2) and 10.6% (95% CI 8.5-13.1), respectively. Functional limitation was found in 19.5% (95% CI 16.8-22.5) of participants. Variables independently associated with 10 item ADL disability physical disability, were advanced age (\> or = 75 years: prevalence ratio (PR) 7.9; 95% CI 4.8-12.9), presence of diabetes (PR 1.8; 95% CI 1.4-2.3), stroke (PR 1.5; 95% CI 1.1-2.2), depressive symptomology (PR 1.3; 95% CI 1.1-1.8) and visual impairment (blind: PR 2.0; 95% CI 1.1-3.6). Advancing age (\> or = 75 years: PR 3.0; 95% CI 1.7-5.2) being female (PR 2.7; 95% CI 1.2-6.1), presence of arthritis (PR 1.6; 95% CI 1.2-2.1) and depressive symptomology (PR 2.0; 95% CI 1.5-2.7) were significantly associated with functional limitation. CONCLUSIONS: The prevalence of physical disability and functional limitation among older Malaysians appears to be much higher than in developed countries but is comparable to developing countries. Associations with socio-demographic and other health related variables were consistent with other studies.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16020, title = {Aspidospermatan-aspidospermatan and eburnane-sarpagine bisindole alkaloids from Leuconotis}, author = {C Y Gan and Y Y Low and W T Robinson and K Komiyama and T S Kam}, doi = {10.1016/j.phytochem.2010.05.015}, issn = {0031-9422}, year = {2010}, date = {2010-01-01}, journal = {Phytochemistry}, volume = {71}, number = {11-12}, pages = {1365-70}, abstract = {Leucofoline and leuconoline, representing the first members of the aspidospermatan-aspidospermatan and eburnane-sarpagine subclasses of the bisindole alkaloids, respectively, were isolated from the Malayan Leuconotis griffithii. The structures of these bisindole alkaloids were established using NMR and MS analysis, and in the case of leuconoline, confirmed by X-ray diffraction analysis. Both alkaloids showed weak cytotoxicity towards human KB cells.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16021, title = {Leucoridines A-D, cytotoxic Strychnos-Strychnos bisindole alkaloids from Leuconotis}, author = {C Y Gan and T Etoh and M Hayashi and K Komiyama and T S Kam}, doi = {10.1021/np1001187}, issn = {0163-3864}, year = {2010}, date = {2010-01-01}, journal = {J Nat Prod}, volume = {73}, number = {6}, pages = {1107-11}, abstract = {Four new bisindole alkaloids of the Strychnos-Strychnos type, leucoridines A-D (1-4), were isolated from the stem-bark extract of Leuconotis griffithii. Alkaloids 1-4 showed moderate cytotoxicity against drug-sensitive and vincristine-resistant human KB cells.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16002, title = {High tumour stage and margin clearance are still important prognostic factors for post-mastectomy locoregional recurrence in Malaysia}, author = {L P Choong and N A Taib and S Rampal and M Saad and A Z Bustam and C H Yip}, issn = {1513-7368}, year = {2010}, date = {2010-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {11}, number = {5}, pages = {1409-16}, abstract = {BACKGROUND: Locoregional recurrence after mastectomy for breast cancer may predict distant recurrence and mortality. This study examined the pattern and rates of post-mastectomy locoregional recurrence (PMLRR), survival outcome and prognostic factors for isolated PMLRR (ILR) in a breast cancer cohort in University of Malaya Medical Center (UMMC). METHODS: We studied 522 patients who underwent mastectomy between 1998 and 2002 and followed them up until 2008. We defined PMLRR as recurrence to the axilla, supraclavicular nodes and or chest wall. ILR was defined as PMLRR occurring as an isolated event. Prognostic factors for locoregional recurrence were determined using the Cox proportional hazards regression model. RESULTS: The overall PMLRR rate was 16.4%. ILR developed in 42 of 522 patients (8.0%). Within this subgroup, 25 (59.5%) remained disease free after treatment while 17 (40.5%) suffered disease progression. Univariate analyses identified race, age, size, stage, margin involvement, lymph node involvement, grade, lymphovascular invasion and ER status as probable prognostic factors for ILR. Cox regression resulted in only stage III disease and margin involvement as independent prognostic factors. The hazard of ILR was 2.5 times higher when the margins were involved compared to when they were clear (aHRR 2.5; 95% CI 1.3 to 5.0). Similarly, compared with stage I those with Stage II (aHRR 2.1; 95%CI 0.6 to 6.8) and stage III (aHRR 4.6; 95%CI 1.4 to 15.9) had worse prognosis for ILR. CONCLUSION: Margin involvement and stage III disease were identified to be independent prognostic factors for ILR. Close follow-up of high risk patients and prompt treatment of locoregional recurrence were recommended.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16005, title = {Treatment options for locally advanced breast cancer--experience in an Asian tertiary hospital}, author = {H Y Chong and N A Taib and S Rampal and M Saad and A Z Bustam and C H Yip}, issn = {1513-7368}, year = {2010}, date = {2010-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {11}, number = {4}, pages = {913-7}, abstract = {BACKGROUND: Locally advanced breast cancer (LABC) is characterized by the presence of a large primary tumour (\>5 cm) associated with or without skin or chest-wall involvement (T4) or with fixed (matted) axillary lymph nodes in the absence of any evidence of distant metastases. These cancers are classified as stage IIIA and IIIB according to the AJCC Staging System. Treatment of choice involves combinations of surgery, chemotherapy, radiotherapy and/or hormonal therapy. Current guidelines recommend primary surgery or neoadjuvant therapy followed by surgery. The primary objective of this study was to compare the outcome of LABC patients subjected to neoadjuvant chemotherapy before surgery and those who underwent surgery as the primary treatment and to determine prognostic predictors. Secondary objectives were to evaluate the response after neoadjuvant therapy and to determine the treatment compliance rate. METHODS: This retrospective study of Stage III breast cancer patients was conducted over a 5 year period from 1998 to 2002. The survival data were obtained from the National Registry of Births and Deaths with the end-point of the study in April 2006. The Kaplan Meier method was applied for survival analysis. Cox regression analysis by stepwise selection was performed to identify important prognostic factors. RESULTS: Out of a 155 evaluable patients, 74 (47.7%) had primary surgery, 62 (40%) had neoadjuvant chemotherapy, 10 patients (6.5%) were given Tamoxifen as the primary treatment, while 9 patients (5.8%) defaulted any form of treatment. After neoadjuvant chemotherapy, 9 patients defaulted further treatment, leaving 53 evaluable patients. Out of these 53 evaluable patients, 5 patients (9.4%) had complete pathological response, 5 (9.4%) a complete clinical response, and 26 (49.1%) had partial response after neoadjuvant chemotherapy. The 5-year survival in the primary surgery group was 56.7 % compared to 44.7% in the neoadjuvant chemotherapy group (p\<0.01). The important prognostic factors were race, size of tumour, nodal status, estrogen receptor status and response to neoadjuvant chemotherapy. CONCLUSION: Patients who had primary surgery had better survival than those who underwent neoadjuvant chemotherapy, which may be due to bias in the selection of patients for neoadjuvant chemotherapy. Out of a total of 155 patients, 25.1% defaulted part of the treatment, or did not receive optimal treatment, emphasizing the importance of psychosocial support and counselling for this group of patients.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14642, title = {Developing global public health links in southeast Asia}, author = {A M Bulgiba and M Dahlui}, url = {https://www.ncbi.nlm.nih.gov/pubmed/20566528}, doi = {10.1177/1010539510372831}, issn = {1941-2479 (Electronic) 1010-5395 (Linking)}, year = {2010}, date = {2010-01-01}, journal = {Asia Pac J Public Health}, volume = {22}, number = {3 Suppl}, pages = {14S-18S}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN804, title = {Recent development in occupational health services in Malaysia}, author = {R Masilamani}, year = {2010}, date = {2010-01-01}, journal = {Malaysian Journal of Public Health Medicine}, volume = {10}, number = {2}, pages = {1-5}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14532, title = {Seroprevalence survey of Chikungunya virus in Bagan Panchor, Malaysia}, author = {S M Ayu and L R Lai and Y F Chan and A Hatim and N N Hairi and A Ayob and I C Sam}, url = {http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990039/pdf/tropmed-83-1245.pdf}, doi = {10.4269/ajtmh.2010.10-0279}, issn = {0002-9637}, year = {2010}, date = {2010-01-01}, journal = {Am J Trop Med Hyg}, volume = {83}, number = {6}, pages = {1245-8}, abstract = {In 2006, an outbreak of Chikungunya virus (CHIKV) of the Asian genotype affected over 200 people in Bagan Panchor village in Malaysia. One year later, a post-outbreak survey was performed to determine attack rate, asymptomatic rate, and post-infection sequelae. Findings were compared with recent CHIKV outbreaks of the Central/East African genotype. A total of 180 residents were interviewed for acute symptoms and post-infection physical quality of life and depressive symptoms. Sera from 72 residents were tested for CHIKV neutralizing antibodies. The estimated attack rate was 55.6%, and 17.5% of infected residents were asymptomatic. Arthralgia was reported up to 3 months after infection, but there were no reports of long-term functional dependence or depression. Symptomatic and seropositive residents were significantly more likely to live in the area with the most dense housing and commercial activities. CHIKV had a high attack rate and considerable clinical impact during the Bagan Panchor outbreak.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN13779, title = {Patient satisfaction and loyalty to the private hospitals in Sana'a, Yemen}, author = {A Anbori and S N Ghani and H Yadav and A M Daher and T T Su}, url = {http://intqhc.oxfordjournals.org/content/intqhc/22/4/310.full.pdf}, doi = {10.1093/intqhc/mzq029}, issn = {1353-4505}, year = {2010}, date = {2010-01-01}, journal = {Int J Qual Health Care}, volume = {22}, number = {4}, pages = {310-5}, abstract = {OBJECTIVE: To evaluate patients' satisfaction and loyalty to private hospitals and to identify factors influencing patient loyalty. DESIGN: A cross-sectional, population-based study was conducted between May and September of 2005. SETTING: Sana'a, the capital city of the Republic of Yemen. PARTICIPANTS: Eight hundred and nineteen respondents who were admitted for at least 1 day in a private hospital within last 6 months from the date of interview. MAIN OUTCOME MEASURES: The scores on the modified SERVQUAL market research instrument including six domains (tangibility, reliability, responsiveness, assurance, empathy and cost) that identify perceptions of service quality. In addition, the respondents were asked whether or not they would return to the same facility when they need future medical care (loyalty). RESULTS: Loyalty was higher among females [odds ratio (OR) = 1.44; P \< 0.05], among those reporting higher reliability scores (OR = 1.24; P \< 0.01), higher assurance scores (OR = 1.2; P \< 0.01) and higher empathy scores (OR = 1.13; P \< 0.05) and also among those reporting higher cost (OR = 1.15; P\<0.05). No significant association was found between patient loyalty and, tangibility and responsiveness score. CONCLUSIONS: Improvements are required to achieve high-quality healthcare services in the private hospitals in Yemen and increase loyalty among patients. Findings from this study could inform private sector healthcare development in low- and middle-income countries.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16007, title = {Gender and risk of depression in Saudi Arabia, a systematic review and meta-analysis}, author = {O A Alibrahim and N Al-Sadat and N A Elawad}, doi = {10.4081/jphia.2010.e7}, issn = {2038-9922 (Print) 2038-9922}, year = {2010}, date = {2010-01-01}, journal = {J Public Health Afr}, volume = {1}, number = {1}, pages = {e7}, abstract = {Depression is one of the leading causes of mortality and morbidity worldwide. In the year 2000 depression accounted for 4.4% of the global disability adjusted life years (DALYs). The Kingdom of Saudi Arabia (KSA) has a population of 28 million people and is one of the countries experiencing demographic transition in its population structure. Improvements in socioeconomic status have been shown to be associated with increased chronic diseases including chronic mental diseases like depression, but still there is no comprehensive review summarizing the various reports currently existing in the literature. Although individual studies within Saudi Arabia have reported prevalence rates and risks, the quality of such studies need to be subjected to rigorous assessment and their findings pooled to give combined weighted evidence that will provide basis for targeted intervention. Pooled risks have the advantage of adjusting inherent variations within sampled populations and therefore providing more reliable estimates even though there are concerns about possible magnification of smaller individual risks.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14538, title = {Adolescent tobacco use and health in Southeast Asia}, author = {N Al-Sadat and A Y Misau and Z Zarihah and D Maznah and Su Tin Tin}, url = {http://aph.sagepub.com/content/22/3_suppl/175S.full.pdf}, doi = {10.1177/1010539510372835}, issn = {1010-5395}, year = {2010}, date = {2010-01-01}, journal = {Asia Pac J Public Health}, volume = {22}, number = {3 Suppl}, pages = {175s-180s}, abstract = {The use of tobacco by adolescents is a major public health concern worldwide. There are 1.2 billion smokers globally, of which more than 50% are young people. The Southeast Asian countries have about 600 million tobacco smokers within the global burden of tobacco users. Most smokers begin at early stage of life and persist through adulthood. Malaysia alone has about 5 million smokers, 20% of whom are younger than 18 years old. Many factors are implicated in the continuous rising trend of tobacco use among adolescents in Southeast Asia. A triad of family, environmental, and individual factors synergistically acts to motivate adolescents toward smoking. This article discusses the current trends of tobacco use and implications of increasing rise in adolescent smoking in the Southeast Asia region.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14640, title = {Enhancement of the cervical cancer screening program in Malaysia: a qualitative study}, author = {F Abdullah and T T Su}, issn = {1513-7368 (Print) 1513-7368}, year = {2010}, date = {2010-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {11}, number = {5}, pages = {1359-66}, abstract = {INTRODUCTION: Cervical cancer has long been known as a preventable disease. Yet it still is a prime women's health issue globally. In Malaysia, the current cervical cancer screening program, introduced in the 1960s, has been found to be unsuccessful in terms of Pap smear coverage. The aim of this study is to determine providers perceptives on the program and the feasibility of practicing an organized cervical screening program in Malaysia. METHODS: 11 key informant interviews were conducted with policy makers and health care providers from the Ministry of Health in Malaysia from October 2009 to May 2010. Interviewees' perceptions were explored on current and organized cervical screening program based on their expertise and experience. RESULTS: The results highlighted that the existing cervical screening program in Malaysia faced flaws at all levels that failed to reduce cervical cancer morbidity and mortality. The identified weaknesses were poor acceptance by women, lack of commitment by health care providers, nature of the program, an improper follow-up system, limited resources and other competing needs. Complementarily, all interviewees perceived an organized cervical screening program as an alternative approach both feasible and acceptable by women and government to practice in Malaysia. CONCLUSION: Better screening coverage depends on an effective screening program that incorporates a behaviour-based strategy. A new program should be focused in the policy-making context to improve screening coverage and to effectively combat cervical cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN774, title = {CARDIOVASCULAR RISKS AMONG SHIFT AND NON-SHIFT WORKERS IN A PUBLIC MEDICAL CENTRE IN KUALA LUMPUR}, author = {FM Moy and VCW Hoe and CPL Tan and M Rosmawati}, url = {https://ejournal.um.edu.my/index.php/jummec/article/view/4634}, issn = {2289-392X}, year = {2010}, date = {2010-01-01}, journal = {JUMMEC: Journal of Health and Translational Medicine (Formerly known as Journal of the University of Malaya Medical Centre)}, volume = {13}, number = {1}, pages = {45-49}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN772, title = {SOCIODEMOGRAPHIC AND LIFESTYLE FACTORS AS THE RISK OF DIABETIC FOOT ULCER IN THE UNIVERSITY OF MALAYA MEDICAL CENTRE}, author = {A Misliza and S Mas Ayu}, url = {https://ejournal.um.edu.my/index.php/jummec/article/view/4613}, issn = {2289-392X}, year = {2009}, date = {2009-01-01}, journal = {JUMMEC: Journal of Health and Translational Medicine (Formerly known as Journal of the University of Malaya Medical Centre)}, number = {1}, pages = {15-21%V 12}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16035, title = {Transvaginal sonography of cervical length and Bishop score as predictors of successful induction of term labor: the effect of parity}, author = {P C Tan and N Vallikkannu and S Suguna and K F Quek and J Hassan}, issn = {0390-6663 (Print) 0390-6663}, year = {2009}, date = {2009-01-01}, journal = {Clin Exp Obstet Gynecol}, volume = {36}, number = {1}, pages = {35-9}, abstract = {OBJECTIVE: To evaluate the predictive value for successful labor induction of transvaginal ultrasound (TVS) of cervical length according to parity. METHOD: TVS of the cervix was performed before term labor induction. Induction was considered successful if vaginal delivery was achieved within 24 hours; 231 women were available for final analysis. RESULTS: Analysis of the receiver operator characteristics curve showed an optimal cut-off for cervical length of \< or = 20 mm for successful induction. Following multivariate logistic regression analysis, a sonographic short cervix (AOR 5.6; p \< 0.001) was an independent predictor of successful induction but not a favorable Bishop score (p = 0.47). Among multiparas with a short cervix, positive and negative predictive values for successful induction were 98% (95% CI 90-100%) and 21% (95% CI 13%-32%) and among nulliparas, predictive values were 69% (95% CI 53%-82%) and 77% (95% CI 64%-87%) respectively. CONCLUSION: In nulliparas, cervical length can usefully predict labor induction outcome.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16031, title = {Clinical characteristics of triple-negative breast cancer: experience in an Asian developing country}, author = {G H Tan and N A Taib and W Y Choo and S H Teo and C H Yip}, issn = {1513-7368}, year = {2009}, date = {2009-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {10}, number = {3}, pages = {395-8}, abstract = {INTRODUCTION: Triple negative (TN) breast cancers are defined by a lack of expression of oestrogen, progesterone, and HER2 receptors. They tend to have a higher grade, with a poorer outcome compared to non-TN breast cancers. OBJECTIVE: The aim of this study is to determine the incidence of TN breast cancer in an Asian country consisting of Malays, Chinese and Indians, and to determine the factors associated with this type of breast cancer. RESULTS: The incidence of TN breast cancer in the University Malaya Medical Center is 17.6%. There is no significant difference amongst the Malays, Chinese and Indians. In bivariate analysis, TN breast cancer was significantly associated with younger age and Grade 3. However, in multivariate analysis using logistic regression, TN breast cancer was only associated with Grade 3. CONCLUSION: The incidence of TN breast cancer in our study is similar to other studies, and associated with a higher grade.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16025, title = {Factors associated with HER2 overexpression in breast cancer: Experience in an Asian developing country}, author = {G H Tan and W Y Choo and N A Taib and C H Yip}, issn = {1513-7368}, year = {2009}, date = {2009-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {10}, number = {5}, pages = {837-40}, abstract = {INTRODUCTION: The HER2 gene is amplified in up to 30% of human breast cancers, leading to overexpression of the HER2 protein on the cell surface. Overexpression of HER2 is associated with a more aggressive cancer and hence a poorer overall survival. OBJECTIVE: To evaluate the association between clinico-pathological features and HER2 overexpression in breast cancer. METHODS: This is a retrospective study conducted in the Department of Surgery, University Malaya Medical Centre. The association between HER2 overexpression, determined by immunohistochemistry, and other clinicopathological factors was evaluated in 996 patients with newly diagnosed breast cancer treated from 2005 to 2007 using univariate and multivariate logistic regression. RESULTS: HER2 overexpression occurred in 30.3% of patients. On bivariate analysis, HER2 overexpression was inversely related to ER expression (p\<0.01) and PR expression (p\<0.01). This overexpression was associated with a higher tumour grade, lymphovascular positivity and infiltrating ductal carcinoma subtype. On multivariate analysis, HER2 overexpression was significantly associated with higher tumour grade (p= 0.018, CI 1.25-11.04), PR negativity (p= 0.002, CI 0.30-0.77) and lymphovascular positivity (p= 0.042, CI 1.01-2.12). CONCLUSIONS: HER2 overexpression was observed in 30.3% of Malaysian female breast cancer patients. This group of patients represents a more aggressive subtype of breast cancer with higher tumour grade, PR negativity and lymphovascular positivity. No significant relationship was established between HER2 overexpression and age, race, lymph node, ER, pathology subtype and stage of disease from this study.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14543, title = {Key quality aspect: a fundamental step for quality improvement in a resource-poor setting}, author = {T T Su and S Sax}, doi = {10.1177/1010539509342433}, issn = {1010-5395}, year = {2009}, date = {2009-01-01}, journal = {Asia Pac J Public Health}, volume = {21}, number = {4}, pages = {477-86}, abstract = {The objective of the study is to identify user's perception of key quality aspects of the hospital and its influence on willingness to pay. The study was conducted in 2001 in Dhading District Hospital, Nepal. This was a descriptive, cross-sectional study design using quantitative and qualitative methods: questionnaire exit interview and focus group discussions with inpatients and outpatients, focus group discussion with service providers, and key informant interviews. The research identified attitude, technical and interpersonal skills of health personnel, availability of drugs and services as important quality aspects to be improved. Users were motivated to use this hospital and were ready to pay if they received proper treatment from skilled and communicative staff. This study highlights the importance of identifying the quality factors important to service users as a first step in improving quality. For the users within this study, this meant improving attitude, interpersonal skills, and technical skills of service personnel.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16034, title = {Are our new medical graduates ready to prescribe?}, author = {S M Sim and W Y Choo and C J Ng}, doi = {10.1111/j.1365-2923.2009.03352.x}, issn = {0308-0110}, year = {2009}, date = {2009-01-01}, journal = {Med Educ}, volume = {43}, number = {5}, pages = {492}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN13320, title = {Severity of visual impairment and depression among elderly Malaysians}, author = {N H Noran and M G Izzuna and A M Bulgiba and Z Mimiwati and S M Ayu}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19124335}, doi = {10.1177/1010539508327353}, issn = {1010-5395 (Print) 1010-5395 (Linking)}, year = {2009}, date = {2009-01-01}, journal = {Asia Pac J Public Health}, volume = {21}, number = {1}, pages = {43-50}, abstract = {OBJECTIVE: This study aimed at evaluating the relationship between severity of visual impairment and depression among elderly Malaysians attending an eye clinic. METHODS: This was a cross-sectional study. The study population included patients, aged\>or=60 years who attended the Eye Clinic in University Malaya Medical Centre. Exposure measurement was based on ophthalmologic examinations by an ophthalmologist. Data on outcome were measured using the Geriatric Depression Scale. RESULTS: After adjusting for important confounders, severity of visual impairment either having low vision or blind were independent risk factors of depression. The odds of developing depression among elderly with low vision were 2 times more than those with normal vision, and elderly who were blind had almost 5 times the odds to be depressed compared with those having normal vision. CONCLUSION: Findings from this study suggest a positive relationship between the severity of visual impairment and depression among elderly Malaysians.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14649, title = {Counting Ethnicity in Malaysia: the Complexity of Measuring Diversity*}, author = {Shyamala Nagaraj and Kiong-Hock Lee and Nai-Peng Tey and Chiu-Wan Ng and Jean Pala}, url = {http://ezproxy.um.edu.my/docview/312320179?accountid=28930}, issn = {15114554}, year = {2009}, date = {2009-01-01}, journal = {Malaysian Journal of Economic Studies}, volume = {46}, number = {1}, pages = {5-32}, abstract = {Malaysia has long been concerned with the ethnic dimensions in society. A driver of government policy since the early 1970s, it is factored into the production of official statistics. Data on ethnicity is therefore very important for monitoring and strengthening public policies that seek to address ethnic imbalances. This paper examines the complexity of defining and measuring ethnicity across time and across different official documents. The paper highlights the difficulties in collecting ethnic data and shows how creative the data collection agencies have been over the years in defining and redefining ethnicity as Malaysian society and needs evolve. The experience of Malaysia indicates that not only does measurement of ethnic data support policy but that policy can also drive ethnic measurement in data. The discussion raises important questions on how ethnic groups have been defined, the purpose for which such data is gathered and how the data is gathered. The problem is not the data themselves but how they are used to formulate, implement and monitor policies. [PUBLICATION ABSTRACT]}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14541, title = {Breakfast Skipping and Its Associated Factors among Undergraduates in a Public University in Kuala Lumpur}, author = {F M Moy and S Johari and Y Ismail and R Mahad and F H Tie and W A Wan Ismail}, issn = {1394-035X (Print) 1394-035x}, year = {2009}, date = {2009-01-01}, journal = {Malays J Nutr}, volume = {15}, number = {2}, pages = {165-74}, abstract = {An analytical cross-sectional study was conducted in a public university in Kuala Lumpur among a random sample of 2665 undergraduates. The objective was to study the prevalence of breakfast skipping and its associated factors. Data collection was conducted via a self-administered pre-tested questionnaire. There were 43.5% male respondents, with Malays being the majority (58.3%). The prevalence of breakfast skipping was 29.2 (95% CI: 27.3 - 30.3)%. The factors significantly associated with breakfast skipping (p\<0.05) were age, race, accommodation, faculty and skipping dinner. As the respondents' age increased, their risk of breakfast skipping was lower (OR: 0.95; 0.89 - 0.99). Malays (OR: 1.94; 1.48 - 2.54), Indians (OR: 1.70; 1.08 - 2.66), and students from the Sabah and Sarawak indigenous communities (OR: 2.13; 1.37 - 3.33) were more likely to skip breakfast compared to their Chinese counterparts. Respondents who stayed in their own houses were also less likely to skip breakfast compared to those staying in hostel with meals catered (OR: 2.32; 1.39 - 3.84), hostel with cafeteria (OR: 2.92; 1.74 - 4.91) or in rented houses (OR: 2.08; 1.25 - 3.46). Respondents majoring in Arts and Economics had 1.40 (1.07 - 1.82) times risk of breakfast skipping compared to those majoring in Life Sciences. Those who skipped dinner too had twice the odds (1.47 - 2.77) of breakfast skipping. In conclusion the prevalence of breakfast skipping among the undergraduates of this university was moderately high. Health awareness campaigns or introduction of healthy eating guidelines should be initiated for the undergraduates as well as food caterers in campus. The policy and pricing of catered food in campus should also be reviewed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16029, title = {Leucophyllidine, a cytotoxic bisindole alkaloid constituted from the union of an eburnan and a new vinylquinoline alkaloid}, author = {C Y Gan and W T Robinson and T Etoh and M Hayashi and K Komiyama and T S Kam}, doi = {10.1021/ol9016172}, issn = {1523-7052}, year = {2009}, date = {2009-01-01}, journal = {Org Lett}, volume = {11}, number = {17}, pages = {3962-5}, abstract = {A cytotoxic bisindole alkaloid possessing an unprecedented structure constituted from the union of an eburnan half and a novel vinylquinoline alkaloid has been isolated from Leuconotis griffithii. The structure was established by analysis of the spectroscopic data and confirmed by X-ray diffraction analysis. A possible biogenetic pathway to the novel quinolinic coupling partner is presented from an Aspidosperma precursor.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16026, title = {Leuconicines A-G and (-)-eburnamaline, biologically active strychnan and eburnan alkaloids from Leuconotis}, author = {C Y Gan and Y Y Low and T Etoh and M Hayashi and K Komiyama and T S Kam}, doi = {10.1021/np900576b}, issn = {0163-3864}, year = {2009}, date = {2009-01-01}, journal = {J Nat Prod}, volume = {72}, number = {12}, pages = {2098-103}, abstract = {Seven new indole alkaloids of the Strychnos type, leuconicines A-G (1-7), and a new eburnan alkaloid, (-)-eburnamaline (8), were isolated from the stem-bark extract of two Malayan Leuconotis species. The structures of these alkaloids were established using NMR and MS analysis and in the case of 8 also by partial synthesis. Alkaloids 1-5 reversed multidrug resistance in vincristine-resistant KB cells.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN13810, title = {Quality of life in transfusion-dependent thalassaemia patients on desferrioxamine treatment}, author = {M Dahlui and M I Hishamshah and A J Rahman and S M Aljunid}, issn = {0037-5675 (Print) 0037-5675}, year = {2009}, date = {2009-01-01}, journal = {Singapore Med J}, volume = {50}, number = {8}, pages = {794-9}, abstract = {INTRODUCTION: The quality of life of transfusion-dependent thalassaemia patients is affected by the disease itself and iron overload complications from repeated blood transfusion. Desferrioxamine has been used to remove the excess iron, resulting in decreased mortality and morbidity. In Malaysia, a significant proportion of the transfusion-dependent thalassaemia patients are not prescribed desferrioxamine, due to its high cost, especially as it is not subsidized by the government. The aim of this study was to measure the quality of life of thalassaemia patients on desferrioxamine treatment. METHODS: A cross-sectional study was performed on all transfusion-dependent thalassaemia patients on follow-up at two tertiary hospitals in Kuala Lumpur, Malaysia, in 2005. Quality-of-life scores were measured by using the translated MOS SF-36 questionnaires, while diseases related to iron overload complications were obtained from the medical records. Use of desferrioxamine was elicited through interviews and validated by drug records. Quality-adjusted life-years (QALYs) presented were formulated from residual life-years and quality-of-life scores. RESULTS: A total of 112 transfusion-dependent thalassaemia patients were recruited, with 54 (48 percent) and 58 (52 percent) patients on sub-optimum and optimum desferrioxamine treatments, respectively. QALYs were higher in patients on optimum desferrioxamine (9.04, standard deviation [SD] 2.46) than patients on sub-optimum desferrioxamine (5.12, SD 2.51). QALYs were associated with the level of serum ferritin, iron overload complications and total family income. CONCLUSION: Optimum desferrioxamine usage reduces iron overload complications and provides a better quality of life.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN820, title = {Predictors of axillary lymph node metastases in breast cancer: is there a role for minimal axillary surgery?}, author = {C H Yip and N A Taib and G H Tan and K L Ng and B K Yoong and W Y Choo}, doi = {10.1007/s00268-008-9782-7}, issn = {0364-2313 (Print) 0364-2313}, year = {2009}, date = {2009-01-01}, journal = {World J Surg}, volume = {33}, number = {1}, pages = {54-7}, keywords = {}, pubstate = {published}, tppubtype = {article} } @book{RN755, title = {Health Care in Malaysia}, author = {S Noor Ghani and H Yadav}, isbn = {978-983-100-444-9}, year = {2008}, date = {2008-01-01}, publisher = {University of Malaya Press}, address = {Kuala Lumpur, Malaysia}, keywords = {}, pubstate = {published}, tppubtype = {book} } @book{RN761, title = {Occupational Health For Health Care Professionals \textendash Caring For The Carers}, author = {R Masilamani and J Gurusamy}, isbn = {978-983-99128-3-8}, year = {2008}, date = {2008-01-01}, publisher = {Malaysian Medical Association}, address = {Kuala Lumpur, Malaysia}, keywords = {}, pubstate = {published}, tppubtype = {book} } @article{RN809, title = {TOOTH MORTALITY IN A SELECTED POPULATION IN SANAA}, author = {Fouad Hussain and Fouad Al-Bayaty and Nidhai Au and Awang Bulgiba and Adnan Muther}, year = {2008}, date = {2008-01-01}, journal = {dentika Dental Journal}, volume = {11}, number = {2}, pages = {144-150}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN773, title = {Road Traffic Injuries among patients who attended the Accident and Emergency Unit of the University of Malaya Medical Centre, Kuala Lumpur}, author = {Htay Moe}, url = {https://jummec.um.edu.my/index.php/jummec/article/view/4572}, issn = {2289-392X}, year = {2008}, date = {2008-01-01}, journal = {JUMMEC: Journal of Health and Translational Medicine (Formerly known as Journal of the University of Malaya Medical Centre)}, number = {1}, pages = {22-26}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN814, title = {Perceived risks, barriers and stages of change on smoking cessation among The Malay security guards in a public university in Kuala Lumpur}, author = {FM Moy and AS Atiya and ML Wong}, url = {http://journals.iium.edu.my/imjm/index.php/eimj/article/view/2}, issn = {18234631}, year = {2008}, date = {2008-01-01}, journal = {The International Medical Journal of Malaysia}, volume = {7}, number = {2}, pages = {9-13}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16045, title = {The prevalence of enamel opacities in permanent teeth of 11-12 year-old school children in Kuala Lumpur, Malaysia}, author = {N Yusoff and N Jaafar and I A Razak and Y Y Chew and N Ismail and A M Bulgiba}, issn = {0265-539X (Print) 0265-539x}, year = {2008}, date = {2008-01-01}, journal = {Community Dent Health}, volume = {25}, number = {1}, pages = {55-8}, abstract = {OBJECTIVE: To determine the prevalence, distribution, severity and treatment need of enamel opacities among 11-12 year-old school children in a fluoridated urban community. DESIGN: A cross-sectional descriptive survey of enamel opacities in 11-12 year-old schoolchildren. CLINICAL SETTING: A questionnaire survey and a clinical examination of erupted teeth using the Modified DDE Index was conducted on schoolchildren in randomly selected schools. PARTICIPANTS: 957 schoolchildren from government schools in Kuala Lumpur comprising the three major ethnic groups of Malay, Chinese and Indian children. MAIN OUTCOME MEASURES: The severity of enamel opacities was assessed by the extent of buccal surface involvement. Normative treatment need was based on severity of opacities. RESULTS: Enamel opacities were found in 90.7% of subjects and 47.2% of teeth. Malays have the highest prevalence with Chinese the least. Although ethnic differences is statistically significant (p \< 0.01), the differences in prevalence between ethnicity is small. The most common type of defect was "diffuse opacities" (88.6% of subjects). Most subjects (70%) showed bilateral distribution of diffuse opacities indicating a systemic disturbance. Posterior teeth were twice more commonly affected (p \< 0.05). The majority of opacities in anterior teeth (66.7%) were minor, involving less than 1/3 of the labial surface. Only 0.6% of the whole sample required some form of aesthetic intervention. CONCLUSION: Despite the high prevalence of enamel opacities, the degree of severity is very mild with only minimal aesthetic and public health concern.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14548, title = {Reassessment on the development of children with disability in Malaysia}, author = {K L Tan and H Yadav}, issn = {0300-5283 (Print) 0300-5283}, year = {2008}, date = {2008-01-01}, journal = {Med J Malaysia}, volume = {63}, number = {1}, pages = {17-20}, abstract = {This is a cohort study investigating the profile of children with disability registered with the primary health care clinics in Malaysia. The purpose of the study was to determine whether reassessment on the development of children with disability under rehabilitation should be done at three months interval or six months interval. Secondary data from the pilot project conducted by the Family Health Development Division, Ministry of Health Malaysia was used in this study. The study was carried out for seven months from 1st August 2004 until 28th February 2005. A total of 168 disabled children followed up for six months were selected in this study. Schedule of Growing Scale (SGS) II was the tool used for analysis. Results showed a statistically significant difference in the mean total SGS score at six months interval but not at three months interval. The result suggests that reassessment on children with Down Syndrome, Autism, Cerebral Palsy, mental retardation and delayed speech under rehabilitation should be carried out every six months while children with gross developmental delay and slow learner might need a longer interval for reassessment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN819, title = {PREVALENCE OF SLEEP DISTURBANCE AMONG NURSES IN A MALAYSIAN GOVERNMENT HOSPITAL AND ITS ASSOCIATIONWITH WORK CHARACTERISTICS}, author = {S M Nazatul and I Saimy and F M Moy and A S Nabila}, url = {https://ejournal.um.edu.my/index.php/jummec/article/view/4581}, issn = {2289-392X}, year = {2008}, date = {2008-01-01}, journal = {JUMMEC: Journal of Health and Translational Medicine (Formerly known as Journal of the University of Malaya Medical Centre)}, number = {2}, pages = {66-71%V 11}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16036, title = {Awareness on ex-gratia compensation scheme among medical department staff in a tertiary government hospital in Kuala Lumpur}, author = {T Su and V C Hoe}, issn = {0300-5283 (Print) 0300-5283}, year = {2008}, date = {2008-01-01}, journal = {Med J Malaysia}, volume = {63}, number = {4}, pages = {302-5}, abstract = {The Ex-Gratia Compensation Scheme was introduced by the Government of Malaysia in 1994 to provide compensation, which is not covered by any prior legislation, for all its workers suffering from injuries and illnesses due to work. Despite more than ten years of implementation, the submission for claims is still minimal and there is an impression that awareness on the provision of Ex-Gratia benefit among government employees, especially health care staff, is poor. A cross sectional survey was conducted at a medical department of a government hospital in Kuala Lumpur to assess the knowledge and awareness level on Ex-Gratia among a representative group of front line health care workers. The results show that the respondents' knowledge on Ex-Gratia is generally poor as compared to knowledge on the Social Security (SOCSO) Schemes. Majority of the respondents are unsure whether they will be compensated in case of occupational illness and injuries. They also do not know what kind of compensation scheme they are currently eligible. There is an urgent need for the Treasury and health care managers to expand the knowledge and awareness on Ex-Gratia among health care workers.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14650, title = {Prevalence, awareness, treatment and control of hypertension in Malaysia: a national study of 16,440 subjects}, author = {L Rampal and S Rampal and M Z Azhar and A R Rahman}, url = {http://ac.els-cdn.com/S0033350607001709/1-s2.0-S0033350607001709-main.pdf?_tid=ac51b476-9e0b-11e5-9750-00000aab0f26\&acdnat=1449621047_f0018edc1cdfb3783d32f33c2f119f2d}, doi = {10.1016/j.puhe.2007.05.008}, issn = {0033-3506 (Print) 0033-3506}, year = {2008}, date = {2008-01-01}, journal = {Public Health}, volume = {122}, number = {1}, pages = {11-8}, abstract = {STUDY DESIGN: A cross-sectional study was conducted in all states of Malaysia to determine the prevalence, awareness, treatment and control of hypertension. A stratified two-stage cluster sampling design with proportional allocation was used. METHODS: Trained nurses obtained two blood pressure measurements from each subject. Hypertension was defined as mean systolic blood pressure \>140 mmHg, diastolic blood pressure \>90 mmHg, or a self-reported diagnosis of hypertension and taking antihypertensive medication. All data were analysed using Stata 9.2 software and took the complex survey design into account. A two-sided P-value of \<0.05 was considered to be statistically significant. RESULTS: The overall prevalence of hypertension for subjects aged 15 years was 27.8% (95% confidence interval (CI) 26.9-28.8). The prevalence of hypertension was significantly higher in males (29.6%, 95% CI 28.3-31.0) compared with females (26.0%, 95% CI 25.0-27.1). Multivariate logistic regression showed that the odds of having hypertension increased with increasing age, in males, in subjects with a family history of hypertension, with increasing body mass index, in non-smokers and with decreasing levels of education. Only 34.6% of the subjects with hypertension were aware of their hypertensive status, and 32.4 were taking antihypertensive medication. Amongst the latter group, only 26.8% had their blood pressure under control. The prevalence of hypertension amongst those aged 30 years has increased from 32.9% in 1996 to 40.5% in 2004. CONCLUSION: In Malaysia, the prevalence of hypertension is high, but levels of awareness, treatment and control are low. There is an urgent need for a comprehensive integrated population-based intervention programme to ameliorate the growing problem of hypertension in Malaysians.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14648, title = {Ethnic dimensions of gender differentials in mortality in Malaysia}, author = {Shyamala Nagaraj and Nai-Peng Tey and Chiu-Wan Ng and Balambigai Balakrishnan}, url = {http://dx.doi.org/10.1007/BF03031948 http://download.springer.com/static/pdf/540/art%253A10.1007%252FBF03031948.pdf?originUrl=http%3A%2F%2Flink.springer.com%2Farticle%2F10.1007%2FBF03031948\&token2=exp=1449622146~acl=%2Fstatic%2Fpdf%2F540%2Fart%25253A10.1007%25252FBF03031948.pdf%3ForiginUrl%3Dhttp%253A%252F%252Flink.springer.com%252Farticle%252F10.1007%252FBF03031948*~hmac=48512f2336d106c46979f455602879239588ad663f3ad817fe31e2ade49740f2}, doi = {10.1007/BF03031948}, issn = {1443-2447}, year = {2008}, date = {2008-01-01}, journal = {Journal of Population Research}, volume = {25}, number = {2}, pages = {183-205}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14550, title = {Framingham Risk Scores and Anthropometric Measurements in Predicting Cardiovascular Risks among Malay Men}, author = {F M Moy and A S Atiya and M L Wong}, issn = {1394-035X (Print) 1394-035x}, year = {2008}, date = {2008-01-01}, journal = {Malays J Nutr}, volume = {14}, number = {1}, pages = {57-63}, abstract = {Framingham Risk Scores is an established method to predict an individual's 10-year risk for coronary heart disease (CHD). It provides a more precise delineation of risk which might lead to appropriate selection of therapy and opportunities for patient education and motivation. A Healthy Lifestyle Project was initiated to decrease the modifiable risk factors for CHD in a worksite in Kuala Lumpur. The participants were Malay men (n=186) working as security guards in a public university. Their mean age was 46.6 + 6.6 years. The majority had secondary education and were married. The participants' 10-year risks based on the Framingham Risk Scores were 55.4%, 39.8% and 4.8% respectively for categories of low (\< 10%), intermediate (10 to 20%) and high (\>20%) risk. Their Framingham Risk Scores were then correlated with anthropometric measurements such as the Body Mass Index (BMI), waist circumference and waist-hip-ratio (WHR). All the anthropometric measurements had weak but significant correlation with the Framingham Risk Scores (WHR: r=0.26; waist circumference: r=0.23; BMI: r=0.16). In conclusion, 44.6% of our participants had more than 10% risk in developing CHD in the coming ten years. Hence, they are suitable target candidates for the promotion of a healthy lifestyle such as smoking cessation, weight control, healthy dietary patterns and increased physical activities. Indicators of abdominal obesity like WHR or waist circumference may be used to complement the Framingham Risk Scores for the prediction of CHD risk in this population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN816, title = {A national study on the prevalence and factors associated with smoking amongst Malaysians aged 18 years and above}, author = {Lekhraj Rampal and Sanjay Rampal and M Z Azhar and Sherina Mohd Sidik and T Mohamad and R Ramlee and J Ahmad}, year = {2008}, date = {2008-01-01}, journal = {Malaysian Journal of Medicine and Health Sciences}, volume = {4}, number = {2}, pages = {41-53}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14544, title = {Dietary modification in a workplace health promotion program in Kuala Lumpur, Malaysia}, author = {F M Moy and A Ab Sallam and M L Wong}, issn = {1010-5395 (Print) 1010-5395}, year = {2008}, date = {2008-01-01}, journal = {Asia Pac J Public Health}, volume = {20 Suppl}, pages = {166-72}, abstract = {Lifestyle modification is effective in the prevention of cardiovascular diseases. This study aimed to promote healthy lifestyle behaviours to prevent cardiovascular disease. This study was a quasi-experimental trial with a follow up of two years. The intervention group (n = 102) received intensive individual and group counselling on diet and physical activity. The comparison group (n = 84) was given minimal education through mail and group counselling. Following the intervention, both groups reduced their total fat intake through a replacement in carbohydrate intake. The saturated fat and cholesterol intake was also reduced with a larger magnitude in the intervention group. Fruits and vegetables consumption was increased within the intervention group. The intervention group showed a statistically significant reduction in their mean total cholesterol levels with an intervention effect of -0.38 (95% C.I. = -0.63, -0.14) mmol/l. This study has achieved moderate improvement in dietary intakes as well as the total cholesterol of the participants.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN771, title = {Editorial: The menace of vector-borne diseases}, author = {M Retneswari}, url = {https://jummec.um.edu.my/index.php/jummec/article/view/4576}, year = {2008}, date = {2008-01-01}, journal = {Journal of the University of Malaya Medical Centre}, volume = {11}, number = {2}, pages = {37-38}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16044, title = {Translating the Research Diagnostic Criteria for Temporomandibular Disorders into Malay: evaluation of content and process}, author = {S P Khoo and A U Yap and Y H Chan and A M Bulgiba}, issn = {1064-6655 (Print) 1064-6655}, year = {2008}, date = {2008-01-01}, journal = {J Orofac Pain}, volume = {22}, number = {2}, pages = {131-8}, abstract = {AIMS: To develop a Malay-language version of the Axis II Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) through a formal translation/back-translation process and to summarize available data about the psychometric properties of the translated scales. METHODS: To cross-culturally adapt the instrument, the RDC/TMD underwent translation using a forward-backward method. Subjects were recruited to test the congruency between translated and original versions of the RDC/TMD. The psychometric properties of 3 domains (Graded Chronic Pain Scale, Nonspecific Physical Symptoms, and Depression) of the RDC/TMD were examined, and the literature on this topic was reviewed. RESULTS: All the items scored 93% to 100% congruency. Cronbach's alphas for Graded Chronic Pain Scale, Nonspecific Physical Symptoms, and Depression were 0.77, 0.71, and 0.88, respectively (n = 40). The test-retest reliability of scores (intraclass correlation coefficient [ICC]) and levels (Spearman's rho) for these domains showed ICCs of 0.97, 0.94, and 0.95, respectively, with a lowest ICC value of 0.84 (n = 40); the Spearman's rho values were 0.93, 0.74, and 0.74, respectively. The discriminant validity between patients with pain symptoms (n = 40) and normal pain-free controls (n = 40) were statistically significant (P \< .001). These correlations provide support for the internal consistency and validity of the Graded Chronic Pain Scale, Nonspecific Physical Symptoms, and Depression domains of the translated version of the RDC/TMD, which were found to be comparable to the psychometric properties of the original and other international translated versions. CONCLUSION: The cross-cultural adaptation of the RDC/TMD into the Malay language is suitable for use in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16043, title = {Pattern and predictors of soil-transmitted helminth reinfection among aboriginal schoolchildren in rural Peninsular Malaysia}, author = {M Hesham Al-Mekhlafi and J Surin and A S Atiya and W A Ariffin and A K Mohammed Mahdy and H Che Abdullah}, doi = {10.1016/j.actatropica.2008.05.022}, issn = {0001-706X (Print) 0001-706x}, year = {2008}, date = {2008-01-01}, journal = {Acta Trop}, volume = {107}, number = {2}, pages = {200-4}, abstract = {Data on soil-transmitted helminth (STH) infections and reinfection among Orang Asli (aborigine) schoolchildren and their nutritional and socioeconomic status were analyzed to investigate the pattern and the possible predictors of STH reinfection. In this longitudinal study, 120 (60 males and 60 females) Orang Asli primary schoolchildren aged 7-12 years and living in remote areas in Pos Betau, Kuala Lipis, Pahang were screened for the presence of STH using modified cellophane thick smear and Harada Mori techniques. The overall prevalence of ascariasis, trichuriasis and hookworm infections were 65.8, 97.5 and 10.8%, respectively. After complete deworming with a 3-day course of 400mg/daily of albendazole tablets, children were re-examined at 3 and 6 months from baseline. The reinfection rate, by one or more of STH species, at 3 months after deworming was high (49.5%) while 79.6% of the children were reinfected at 6 months after deworming. Logistic regression analyses showed that females, stunted children and those living in houses without toilets had significantly higher reinfection rates than others at 3 months (P\<0.05). At 6 months, maternal employment status emerged as another predictor where children of working mothers had significantly higher reinfection rates (P=0.026). In conclusion, reinfection rate of STH is high and thus necessitates frequent and periodic deworming among children. Public health personnel need to re-look at the current control measures and identify innovative and integrated ways in order to reduce STH significantly in the rural communities.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14646, title = {The evolving evidence base for child protection in Chinese societies}, author = {M P Dunne and J Q Chen and Choo Wan Yuen}, url = {http://aph.sagepub.com/content/20/4/267.full.pdf}, doi = {10.1177/1010539508325047}, issn = {1010-5395}, year = {2008}, date = {2008-01-01}, journal = {Asia Pac J Public Health}, volume = {20}, number = {4}, pages = {267-76}, abstract = {Child maltreatment is a substantial public health problem worldwide. Although extensively studied in Western countries, until recently little systematic research had been published about the situation in the world's most populous nation and ethnic diaspora. In this review, we examine trends from community-based research with Chinese young people and parents in mainland China, Hong Kong SAR, Taiwan, Singapore, and Malaysia. It is clear that many Chinese adolescents experience a substantial burden from various forms of maltreatment and the psychological and behavioral correlates are similar to those found in other cultures. However, the research reveals a large gap between this reality and Chinese adults' perceptions about emotional, physical, and sexual abuse. Comprehensive awareness programs are needed to close this information gap and thereby mobilize support for prevention and care initiatives.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @book{RN818, title = {Use of Radiographic Densitometry to Predict the Bone Healing Index in Distraction Osteogenesis}, author = {Aik Saw and S Manimaran and S Faizal and A M Bulgiba}, doi = {10.5704/MOJ.0804.008}, year = {2008}, date = {2008-01-01}, volume = {2}, pages = {44-48}, keywords = {}, pubstate = {published}, tppubtype = {book} } @article{RN14545, title = {Exploring why girls smoke in Malaysia--a qualitative approach}, author = {N Al-Sadat and C W Binns}, issn = {1010-5395 (Print) 1010-5395}, year = {2008}, date = {2008-01-01}, journal = {Asia Pac J Public Health}, volume = {20 Suppl}, pages = {6-14}, abstract = {The fast increase in the rate of uptake of smoking amongst adolescent girls in Malaysia is a public health concern. The objective of this study was to investigate factors that influenced the initiation of smoking and the effects of advertisement on consolidating the smoking habit among teenage girls in the urban city of Kuala Lumpur. Qualitative research was conducted using both interviews and focus group discussions with groups of adolescent girls. Data collected was analysed using grounded thematic theory methodology and validated using methodological triangulation. The reasons for initiating smoking elicited from the study can be grouped into 4 general themes; influence by peers, influence of seeing parents smoking, misguided belief that it could alleviate stress and finally that it would impress others. Smoking imageries in media and advertisements were not primary influencing factors in the initiation of smoking but it encouraged them to progress to become regulars. Ways should be sought to empower girls to feel more confident about resisting pressures to initiate smoking. This could be done through activities such as positive peer sports, education on how to alleviate stress and curbing of smoking imageries in the media.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16038, title = {Current prevalence and predictors of protein-energy malnutrition among schoolchildren in rural Peninsular Malaysia}, author = {M S Al-Mekhlafi and J Surin and A S Atiya and W A Ariffin and A K Mahdy and H C Abdullah}, issn = {0125-1562 (Print) 0125-1562}, year = {2008}, date = {2008-01-01}, journal = {Southeast Asian J Trop Med Public Health}, volume = {39}, number = {5}, pages = {922-31}, abstract = {A cross-sectional study was carried out to determine the current prevalence of protein-energy malnutrition (PEM) among Orang Asli schoolchildren and to investigate the potential predictors of malnutrition. A total of 241 (120 males and 121 females) Orang Asli schoolchildren age 7-12 years living in remote areas of Pos Betau, Pahang participated voluntarily in this study. Anthropometric and socioeconomic data were collected and the children were screened for intestinal parasitic infections. The overall prevalences of mild and significant underweight conditions were 52.3% and 37.3%, respectively, and the prevalences of mild stunting and wasting were 43.6% and 43.1%, respectively, while the prevalences of significant stunting and wasting were 43.6% and 5.6%, respectively. There was a significant association between gender (male) and malnutrition (p = 0.029). The results also showed a higher prevalence of stunting among children age \< or = 10 years than in older children (p = 0.001). Other independent variables, including socioeconomic status and intestinal parasitic infections, had no significant associations with malnutrition indices. PEM is prevalent among schoolchildren in rural Malaysia and therefore of public health concern since PEM diminishes immune function and impairs cognitive function and educational performance. School-based programs of prevention through health education and interventions should be considered as an essential part of measures to improve the quality of life of schoolchildren in rural Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16041, title = {Anaemia and iron deficiency anaemia among aboriginal schoolchildren in rural Peninsular Malaysia: an update on a continuing problem}, author = {M H Al-Mekhlafi and J Surin and A S Atiya and W A Ariffin and A K Mahdy and H C Abdullah}, doi = {10.1016/j.trstmh.2008.05.012}, issn = {0035-9203}, year = {2008}, date = {2008-01-01}, journal = {Trans R Soc Trop Med Hyg}, volume = {102}, number = {10}, pages = {1046-52}, abstract = {A cross-sectional study to determine the current prevalence of anaemia and iron deficiency anaemia (IDA) and to investigate the possible risk factors for IDA was carried out on 241 aboriginal schoolchildren (120 boys, 121 girls) aged 7-12 years and living in remote areas in Pos Betau, Pahang, Malaysia. Haemoglobin (Hb) level was measured and serum iron status was assessed by serum ferritin (SF), serum iron (SI) and total iron binding capacity measurements. Socioeconomic data were collected using pre-tested questionnaires. All children were screened for intestinal parasitic infections. Overall, 48.5% (95% CI 42.3-54.8) of children were anaemic (Hb\<12 g/dl). The prevalence of IDA was 34% (95% CI 28.3-40.2), which accounted for 70.1% of the anaemia cases. The prevalence of IDA was significantly higher in females than males. Low levels of mothers' education and low household income were identified as risk factors for IDA. Severe trichuriasis also found to be associated with low SF and SI. Logistic regression confirmed low levels of mothers' education and gender as significant risk factors for IDA. Improvement of socioeconomic status and health education together with periodic mass deworming should be included in public health strategies for the control and prevention of anaemia and IDA in this population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16047, title = {Tooth mortality in smokers and nonsmokers in a selected population in Sana'a, Yemen}, author = {F H Al-Bayaty and N A Wahid and A M Bulgiba}, doi = {10.1111/j.1600-0765.2007.00988.x}, issn = {0022-3484}, year = {2008}, date = {2008-01-01}, journal = {J Periodontal Res}, volume = {43}, number = {1}, pages = {9-13}, abstract = {BACKGROUND AND OBJECTIVE: Tobacco smoking has been shown to be a major risk factor for tooth loss. The present study was designed to examine tooth mortality and the patterns of tooth loss in smokers and nonsmokers over a wide age range in a selected population from Sana'a, Yemen. MATERIAL AND METHODS: A total of 2506 persons between the ages of 15 and 64 years were examined, and every permanent tooth was assessed. Missing teeth included both extracted and missing teeth. Individuals currently smoking one or more boxes of cigarettes (20 cigarettes) a day for 5 years were considered as smokers, whereas individuals with no smoking history were considered as nonsmokers. RESULTS: Smokers had a higher mean tooth loss than nonsmokers. The difference was statistically significant at p \< 0.001. Mean tooth loss was significantly higher in smokers across all age groups, except for those in the 45-54 years age group. Smokers had a significantly higher mean upper tooth loss than nonsmokers. Tooth loss decreased from the incisors to the canines and then increased, with peak loss in the first molars. CONCLUSION: Tooth loss among smokers is significantly higher than among nonsmokers. The central incisors, lateral incisors and first molars were the most commonly missing teeth in smokers, compared with nonsmokers.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN792, title = {The prevalence of enamel opacities in permanent teeth of 11-12 year-old school children in Kuala Lumpur, Malaysia}, author = {Noriah Yusoff and Nasruddin Jaafar and I A Razak and Y Y Chew and N Ismail and Awang Bulgiba}, doi = {10.1922/CDH_2114Yusoff04}, year = {2008}, date = {2008-01-01}, journal = {Community Dent Health}, volume = {25}, number = {1}, pages = {55-8}, keywords = {}, pubstate = {published}, tppubtype = {article} } @proceedings{spm-2007-a, title = {Does Severity of Visual Impairment Predict Depression in Elderly Malaysians?}, author = {AM Bulgiba MMG. Izunna NH Noran}, year = {2007}, date = {2007-07-28}, publisher = {University of Malaya}, abstract = {Does Severity of Visual Impairment Predict Depression in Elderly Malaysians? Author: NH Noran (1), MMG. Izunna (2), AM Bulgiba (1), Z. Mimiwati (3) Mas Ayu Said (1) (1) Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, (2) Ministry of Health, Malaysia, (3) University Malaya Medical Centre Objective: To evaluate the relationship between severity of visual impairment and depression among elderly Malaysians attending an eye clinic. Results: After adjusting for important confounders, the severity of visual impairment either having a low vision or blind were independent risk factors of depression. The odds of developing depression among elderly with low vision were two times more than those with normal vision (adjusted OR 2.64: 95 % CI: 1.27, 5.50), and elderly who were blind had almost five times the odds to be depressed (adjusted OR 4.99: 95 % CI: 1.90, 12.95).}, keywords = {}, pubstate = {published}, tppubtype = {proceedings} } @article{RN813, title = {Desferrioxamine treatment in thalassaemia: A cost utility analysis}, author = {Maznah Dahlui and Hishamshah Ibrahim and A J A Rahman and Khadijah Shamsuddin and Syed Aljunid}, year = {2007}, date = {2007-01-01}, journal = {Malaysian Journal of Public Health Medicine}, volume = {7}, number = {2}, pages = {4-9}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN785, title = {The Incidence of Public Spending on Healthcare: Comparative Evidence from Asia}, author = {Eddy Doorslaer and Owen O'Donnell and Ravi P. Rannan-Eliya and Aparnaa Somanathan and Shiva Adhikari and Deni Harbianto and Charu Garg and Piya Hanvoravongchai and Mohammed N. Huq and Anup Karan and Gabriel M. Leung and Chiu Wan Ng and Badri Raj Pande and Keith Tin and Kanjana Tisayatikom and Laksono Trisnantoro and Yuhui Zhang and Yuxin Zhao}, doi = {10.1093/wber/lhl009}, year = {2007}, date = {2007-01-01}, journal = {The World Bank Economic Review}, volume = {21}, number = {1}, pages = {93-123}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN782, title = {Anemia in pregnancy in Malaysia: a cross-sectional survey}, author = {J Haniff and A Das and L T Onn and C W Sun and N M Nordin and S Rampal and S Bahrin and M Ganeslingam and K I Kularatnam and Z M Zaher}, issn = {0964-7058 (Print) 0964-7058}, year = {2007}, date = {2007-01-01}, journal = {Asia Pac J Clin Nutr}, volume = {16}, number = {3}, pages = {527-36}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN786, title = {Prevalence of Overweight among Secondary School Students in Klang District, Selangor}, author = {G R Lekhraj Rampal and S Mohd Sidik and S Rampal and Y J Daniel Wong and P L Chow and J S Liew and Y S Shum}, issn = {1394-035X (Print) 1394-035x}, year = {2007}, date = {2007-01-01}, journal = {Malays J Nutr}, volume = {13}, number = {1}, pages = {1-8}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN781, title = {A case control study on risk factors associated with drug addiction amongst Malaysian males}, author = {Azhar Md Zain and Sanjay Rampal and Lekhraj Rampal}, year = {2007}, date = {2007-01-01}, journal = {Malaysian Journal of Medicine and Health Sciences}, volume = {3}, number = {2}, pages = {17-27}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN815, title = {Factors influencing the uptake of pap smear screening among malay women in a public university in Kuala Lumpur - a pilot study}, author = {F M Moy and C H Lim and C J A Tan and S Y Tay}, url = {http://www.myjurnal.my/public/article-view.php?id=62282}, year = {2007}, date = {2007-01-01}, journal = {Malaysian Journal of Public Health Medicine}, volume = {7}, number = {2}, pages = {23-28}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN783, title = {The association between body mass index and age related cataract}, author = {N H Noran and S Nooriah and Z Mimiwati}, issn = {0300-5283 (Print) 0300-5283}, year = {2007}, date = {2007-01-01}, journal = {Med J Malaysia}, volume = {62}, number = {1}, pages = {49-52}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN784, title = {Relationship between reproductive exposures and age-related cataract in women}, author = {N H Noran and N Salleh and M Zahari}, doi = {10.1177/10105395070190020501}, issn = {1010-5395 (Print) 1010-5395}, year = {2007}, date = {2007-01-01}, journal = {Asia Pac J Public Health}, volume = {19}, number = {2}, pages = {23-8}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN787, title = {Demand analysis of tobacco consumption in Malaysia}, author = {H Ross and N A Al-Sadat}, doi = {10.1080/14622200701648433}, issn = {1462-2203 (Print) 1462-2203}, year = {2007}, date = {2007-01-01}, journal = {Nicotine Tob Res}, volume = {9}, number = {11}, pages = {1163-9}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN788, title = {Effectiveness of 18-hour lactation management course organised by District Health Office for Health staff}, author = {Kok Leong Tan and S N Ghani}, year = {2007}, date = {2007-01-01}, journal = {JUMMEC: Journal of Health and Translational Medicine (Formerly known as Journal of the University of Malaya Medical Centre)}, volume = {10}, number = {1}, pages = {21-24}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN789, title = {Changing habits and attitudes towards smoking among future physicians}, author = {G H Tee and N H Noran and H Farizah and N H Azhana}, issn = {0300-5283 (Print) 0300-5283}, year = {2007}, date = {2007-01-01}, journal = {Med J Malaysia}, volume = {62}, number = {5}, pages = {383-7}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN790, title = {Catastrophic payments for health care in Asia}, author = {E Doorslaer and O O'Donnell and R P Rannan-Eliya and A Somanathan and S R Adhikari and C C Garg and D Harbianto and A N Herrin and M N Huq and S Ibragimova and A Karan and T J Lee and G M Leung and J F Lu and C W Ng and B R Pande and R Racelis and S Tao and K Tin and K Tisayaticom and L Trisnantoro and C Vasavid and Y Zhao}, url = {http://onlinelibrary.wiley.com/store/10.1002/hec.1209/asset/1209_ftp.pdf?v=1\&t=jdjyc576\&s=49759bf2817b25302d926b7f9ce89f87b10f0ae6}, doi = {10.1002/hec.1209}, issn = {1057-9230 (Print) 1057-9230}, year = {2007}, date = {2007-01-01}, journal = {Health Econ}, volume = {16}, number = {11}, pages = {1159-84}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16052, title = {Effects of temperature changes on nasal patency}, author = {R Yogeetha and R Raman and K F Quek}, issn = {0037-5675 (Print) 0037-5675}, year = {2007}, date = {2007-01-01}, journal = {Singapore Med J}, volume = {48}, number = {4}, pages = {304-6}, abstract = {INTRODUCTION: This study aims to assess the difference in nasal patency and resistance to temperature changes objectively and subjectively. METHODS: This cross-sectional study involved 50 subjects without nasal obstruction. All these subjects were given a questionnaire to determine nasal obstruction subjectively on a visual analogue scale. Acoustic rhinometry was performed in all these subjects for objective measurement of nasal obstruction. The study was conducted in two separate rooms in the departmental laboratory where the temperatures were maintained at 30-33 degrees Celsius and an air-conditioned room at 18-22 degrees Celsius, respectively. RESULTS: The objective measurement to two different temperature exposures showed differences in nasal patency and resistance. There was an increase in nasal resistance and a decrease in nasal patency to air-conditioned air compared to room temperature air. Subjective assessment also showed significant correlation to the two temperature exposures. However, independent sample test only showed significant difference in the subjective questionnaire (p-value equals 0.001). Objective acoustic rhinometry did not show significant difference. CONCLUSION: There is no significant difference in objective acoustic rhinometry with regard to nasal resistance and patency with environmental temperature changes in the tropics.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16051, title = {Transvaginal sonographic measurement of cervical length vs. Bishop score in labor induction at term: tolerability and prediction of Cesarean delivery}, author = {P C Tan and N Vallikkannu and S Suguna and K F Quek and J Hassan}, doi = {10.1002/uog.4018}, issn = {0960-7692 (Print) 0960-7692}, year = {2007}, date = {2007-01-01}, journal = {Ultrasound Obstet Gynecol}, volume = {29}, number = {5}, pages = {568-73}, abstract = {OBJECTIVES: To compare transvaginal sonography for cervical length measurement and digital examination for Bishop score assessment in women undergoing labor induction at term, to assess their tolerability (in terms of pain) and ability to predict need for Cesarean delivery. METHODS: A prospective study was performed on 249 women admitted for labor induction. Cervical length was measured using transvaginal ultrasound examination. A 10-point visual analog scale (VAS) for procedure-related pain was obtained. Bishop score was determined just before labor induction and another pain score was obtained. Delivery outcome was recorded. Analyses were by t-test, Fisher's exact test, receiver-operating characteristics (ROC) curves and multivariate logistic regression. RESULTS: Transvaginal sonography was significantly less painful than digital examination for Bishop score assessment (mean difference in VAS score 3.46; P\<0.001). Analyses of the ROC curves for cervical length and Bishop score indicated that both were predictors of Cesarean delivery (area under the curve 0.611 vs. 0.607; P=0.012 vs. P=0.015, respectively) with optimal cut-offs for predicting Cesarean delivery of \>20 mm for cervical length and Bishop score\<or=5. Cervical length had superior sensitivity (80% vs. 64%) and marginally better positive (30% vs. 27%) and negative (89% vs. 83%) predictive values. Multivariate logistic regression analysis revealed that only nulliparity (adjusted odds ratio (AOR) 4.1; 95% CI, 2.1-8.1; P\<0.001) and transvaginal sonographic cervical length\>20 mm (AOR 3.4; 95% CI, 1.4-8.1; P=0.006) were independent predictors of Cesarean delivery. CONCLUSIONS: Transvaginal sonography for cervical length measurement is better tolerated than digital examination for Bishop score assessment. Both cervical length and Bishop score are useful predictors of the need for Cesarean delivery following labor induction. A cervical length\>20 mm at labor induction at term is an independent predictor of Cesarean delivery.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16049, title = {Pregnancy outcome in hyperemesis gravidarum and the effect of laboratory clinical indicators of hyperemesis severity}, author = {P C Tan and R Jacob and K F Quek and S Z Omar}, doi = {10.1111/j.1447-0756.2007.00552.x}, issn = {1341-8076 (Print) 1341-8076}, year = {2007}, date = {2007-01-01}, journal = {J Obstet Gynaecol Res}, volume = {33}, number = {4}, pages = {457-64}, abstract = {OBJECTIVE: To determine pregnancy outcome in hyperemesis gravidarum and the effect of metabolic, biochemical, hematological and clinical indicators of disease severity on outcome. STUDY DESIGN: A retrospective study based on 166 women hospitalized for confirmed hyperemesis gravidarum from January 2004 to January 2005. For each woman, three controls matched for age, parity and ethnicity were obtained from our 2004 birth register. The effects of laboratory indicators of hyperemesis severity were separately analyzed within the hyperemesis gravidarum study group. Outcome measures include stillbirths, Apgar score, mode of delivery, low birthweight, preterm delivery, labor induction, pregnancy induced hypertension and gestational diabetes. Analysis was by t-test, Fisher's exact test and multivariable logistic regression analysis. RESULTS: Women with hyperemesis had similar pregnancy outcome compared to controls. In the analysis of laboratory indicators of hyperemesis severity and pregnancy outcomes, hypokalemia (adjusted odds ratio [AOR] 2.7: 95% confidence interval [CI] 1.0-6.8) was associated with emergency operative delivery, high creatinine (odds ratio 4.4: 95% CI 1.3-15) with labor induction and raised gamma glutamyltransferase (AOR 7.5: 95% CI 1.2-46) with the development of gestational diabetes. CONCLUSIONS: Hyperemesis gravidarum per se was not associated adverse pregnancy outcome. Hypokalemia, high creatinine and raised gamma glutamyltransferase in women with hyperemesis gravidarum were associated with adverse pregnancy outcome.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14651, title = {A national study on the prevalence of obesity among 16,127 Malaysians}, author = {L Rampal and S Rampal and G L Khor and A M Zain and S B Ooyub and R B Rahmat and S N Ghani and J Krishnan}, issn = {0964-7058 (Print) 0964-7058}, year = {2007}, date = {2007-01-01}, journal = {Asia Pac J Clin Nutr}, volume = {16}, number = {3}, pages = {561-6}, abstract = {A population-based cross-sectional study was conducted in all states of Malaysia with the aim to determine the prevalence of obesity among Malaysians aged fifteen years and above and factors associated. A stratified two-stage cluster sampling design with proportional allocation was used. Trained interviewers using a standardized protocol obtained the weight and height measurements and other relevant information. Subjects with a body mass index \>= 30 kg/m2 were labelled as obese. The results show that the overall national prevalence of obesity among Malaysians aged 15 years old and above was 11.7% (95% CI = 11.1 - 12.4%). The prevalence of obesity was significantly higher in females (13.8%) as compared to 9.6% in males (p\< 0.0001). Prevalence of obesity was highest amongst the Malays (13.6%) and Indians (13.5%) followed by the indigenous group of "Sarawak Bumiputra" (10.8%) and the Chinese (8.5%). The indigenous group of "Sabah Bumiputra" had the lowest prevalence of 7.3%. These differences are statistically significant (p\< 0.0001). Logistic regression analysis results show that there was a significant association between obesity and age, gender, ethnicity urban/rural status and smoking status. The prevalence of obesity amongst those aged \>= 18 years old has markedly increased by 280% since the last National Health and Morbidity Survey in 1996. CONCLUSION: The overall prevalence of obesity in Malaysia is very high as compared to 1996. There is an urgent need for a comprehensive integrated population-based intervention program to ameliorate the growing problem of obesity in Malaysians.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14551, title = {The association between body mass index and age related cataract}, author = {N H Noran and S Nooriah and Z Mimiwati}, issn = {0300-5283 (Print) 0300-5283}, year = {2007}, date = {2007-01-01}, journal = {Med J Malaysia}, volume = {62}, number = {1}, pages = {49-52}, abstract = {This study was carried out to determine the association between body mass index and age related cataract among patients attending eye clinic. We conducted a case control study. The outcome of clinical eye assessment determined the patient's status. Mean body mass index among the cases was shown to be higher (25.4 +/- 4.5) than the control group (24.4 +/- 3.9) (p \< 0.01). Crude analysis showed that only obese respondents were 2.4 times more likely to develop age related cataract, however this association was not seen in the multivariate analysis after adjusting for other determinants (aOR 1.81; 95% CI 0.91 - 3.62). We conclude that there is no association between body mass index and age related cataract.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN791, title = {Bone Overgrowth after Fracture of the Femoral Shaft in Children}, author = {S M Yong and A Saw and S Sengupta and A M Bulgiba}, url = {http://morthoj.org/2007v1n1/bone_overgrowth.pdf}, year = {2007}, date = {2007-01-01}, journal = {Malaysian Orthopaedic Journal}, volume = {1}, number = {1}, pages = {8-11}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16048, title = {Evaluation of the routine use of the anaerobic bottle when using the BACTEC blood culture system}, author = {R Karunakaran and N S Raja and K F Quek and V C Hoe and P Navaratnam}, issn = {1684-1182 (Print) 1684-1182}, year = {2007}, date = {2007-01-01}, journal = {J Microbiol Immunol Infect}, volume = {40}, number = {5}, pages = {445-9}, abstract = {The established practice of sending blood cultures in an aerobic-anaerobic pair of bottles has been questioned in recent years, and this study was conducted to evaluate the routine use of an anaerobic bottle in the BACTEC blood culture set at the University of Malaya Medical Centre, Kuala Lumpur, from January to December 2004. A total of 11,663 paired blood culture sets were received, of which 3326 were from pediatric patients and 8337 were from adult patients. The overall positive isolation rate was 15%; the positive isolation rate on excluding the anaerobic bottles was 13%. Overall, there were significantly more organisms isolated from the aerobic bottle (p\<0.05); however, the best yield was obtained on using the paired aerobic-anaerobic bottles. Among the positive blood culture sets, organisms were isolated from the anaerobic bottle alone in 15.2% of the pediatric sets and in 18.1% of the adult sets. Organisms that grew more frequently in the anaerobic bottle were anaerobes and some facultative anaerobes; however, the difference was not statistically significant except for anaerobes in the adult sets. We recommend that when culturing blood, an aerobic-anaerobic pair of bottles be used rather than an aerobic-aerobic pair, to optimize the recovery of a wider spectrum of organisms, including obligatory anaerobes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16053, title = {Ethnicity and H. pylori as risk factors for gastric cancer in Malaysia: A prospective case control study}, author = {K L Goh and P L Cheah and N Md and K F Quek and N Parasakthi}, doi = {10.1111/j.1572-0241.2006.00885.x}, issn = {0002-9270 (Print) 0002-9270}, year = {2007}, date = {2007-01-01}, journal = {Am J Gastroenterol}, volume = {102}, number = {1}, pages = {40-5}, abstract = {OBJECTIVE: To determine the risk factors for gastric cancer (GCA), with particular emphasis on ethnicity in our multiracial population. METHODS: A prospective case control study with ratio of cancer:controls of 1:2. Diagnosis of H. pylori was made by serology using the ELISA technique. Dietary intake was assessed by dietary recall over the preceding 6 months. RESULTS: Eighty-seven cases of GCA were enrolled. The cancers were predominantly distal in location and of the intestinal type. Risk factors identified following multiple logistic regression analysis were: Chinese race (OR 10.23 [2.87-36.47]), H. pylori (OR 2.54 [1.16-5.58]), low level of education (OR 9.81 [2.03-47.46]), smoking (OR 2.52 [1.23-5.15]), and high intake of salted fish and vegetables (OR 5.18 [1.35-20.00]) were identified as significant independent risk factors for GCA, while high intake of fresh fruits and vegetables was protective for GCA (OR 0.15 [0.04-0.64]). Chili intake was not a significant protective factor following multivariate analysis. CONCLUSIONS: Chinese race was a strong independent predictor of GCA. H. pylori was an important predictor of GCA with a 2.5-fold greater risk in our patients. Despite a high prevalence of H. pylori, the prevalence of GCA among Indians was low and this paradox can be appropriately called the "Indian enigma."}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16042, title = {An unceasing problem: soil-transmitted helminthiases in rural Malaysian communities}, author = {M S Al-Mekhlafi and A S Atiya and Y A Lim and A K Mahdy and W A Ariffin and H C Abdullah and J Surin}, issn = {0125-1562 (Print) 0125-1562}, year = {2007}, date = {2007-01-01}, journal = {Southeast Asian J Trop Med Public Health}, volume = {38}, number = {6}, pages = {998-1007}, abstract = {Despite great development in socioeconomic status throughout 50 years of independence, Malaysia is still plagued with soil-transmitted helminthiases (STH). STH continue to have a significant impact on public health particularly in rural communities. In order to determine the prevalence of STH among rural Orang Asli children and to investigate the possible risk factors affecting the pattern of this prevalence, fecal samples were collected from 292 Orang Asli primary schoolchildren (145 males and 147 females) age 7-12 years, from Pos Betau, Kuala Lipis, Pahang. The samples were examined by Kato-Katz and Harada Mori techniques. Socioeconomic data were collected using pre-tested questionnaires. The overall prevalence of ascariasis, trichuriasis, and hookworm infections were 67.8, 95.5 and 13.4%, respectively. Twenty-nine point eight percent of the children had heavy trichuriasis, while 22.3% had heavy ascariasis. Sixty-seven point seven percent of the children had mixed infections. Age \> 10 years (p = 0.016), no toilet in the house (p = 0.012), working mother (p = 0.040), low household income (p = 0.033), and large family size (p = 0.028) were identified as risk factors for ascariasis. Logistic regression confirmed low income, no toilet in the house and working mother as significant risk factors for ascariasis. The prevalence of STH is still very high in rural Malaysian communities. STH may also contribute to other health problems such as micronutrient deficiencies, protein-energy malnutrition and poor educational achievement. Public health personnel need to reassess current control measures and identify innovative and integrated ways in order to reduce STH significantly in rural communities.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @book{RN757, title = {Hospital Management}, author = {H Yadav}, isbn = {983-100-314-4}, year = {2006}, date = {2006-01-01}, keywords = {}, pubstate = {published}, tppubtype = {book} } @article{RN810, title = {DIAGNOSING ANGINA USING A SIMPLE NEURAL NETWORK ARCHITECTURE}, author = {A M Bulgiba}, url = {https://ejournal.um.edu.my/index.php/jummec/article/view/4540}, issn = {2289-392X}, year = {2006}, date = {2006-01-01}, journal = {JUMMEC: Journal of Health and Translational Medicine (Formerly known as Journal of the University of Malaya Medical Centre)}, volume = {9}, number = {1}, pages = {39-43}, keywords = {}, pubstate = {published}, tppubtype = {article} } @book{RN812, title = {Eating Patterns of School Children and Adolescents in Kuala Lumpur}, author = {Foong-Ming Moy and Chong Ying Gan and Siti Zaleha Mohd Kassin}, year = {2006}, date = {2006-01-01}, volume = {12}, keywords = {}, pubstate = {published}, tppubtype = {book} } @article{RN811, title = {Effect of payments for health care on poverty estimates in 11 countries in Asia: an analysis of household survey data}, author = {Eddy Doorslaer and Owen O'Donnell and Ravi P Rannan-Eliya and Aparnaa Somanathan and Shiva Raj Adhikari and Charu C Garg and Deni Harbianto and Alejandro N Herrin and Mohammed Nazmul Huq and Shamsia Ibragimova and Anup Karan and Chiu Wan Ng and Badri Raj Pande and Rachel Racelis and Sihai Tao and Keith Tin and Kanjana Tisayaticom and Laksono Trisnantoro and Chitpranee Vasavid and Yuxin Zhao}, url = {http://dx.doi.org/10.1016/S0140-6736(06)69560-3}, doi = {10.1016/S0140-6736(06)69560-3}, issn = {0140-6736}, year = {2006}, date = {2006-01-01}, journal = {The Lancet}, volume = {368}, number = {9544}, pages = {1357-1364}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN801, title = {The Prevalence of Visual Defect among Commercial Vehicle Drivers in Selangor, Malaysia.}, author = {C W Victor Hoe}, url = {http://myais.fsktm.um.edu.my/6373/1/Victor_Hoe.pdf}, year = {2006}, date = {2006-01-01}, journal = {Journal of the University of Malaya Medical Centre}, volume = {9}, number = {1}, pages = {35-38}, abstract = {A cross-sectional survey of commercial vehicle drivers who were renewing their own licences was conducted at the Selangor Road Transport Department office in Padang Jawa between 1 February 2002 and 28 February 2002, using questionnaire and medical examination. The objective was to determine the prevalence of myopia, colour vision deficiency and visual field defect among the commercial vehicle drivers. The respondents that reported visual defect at the time of interview was compared with those detected by the author through medical examination. Out of the 223 respondents, 21 (9.4%) reported to have myopia by the questionnaire survey. Through the visual examination there were 63 (28.3%) with myopia (visual acuity worse than 6/12), six (2.6%) had a visual field defect and 14 (6.3%) had red-green colour deficiency. The visual defect detected during the study among the commercial vehicle drivers, which were missed at the time of the routine medical examination were significant. The process of the statutory medical examination should be reviewed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16058, title = {Indicators of prolonged hospital stay in hyperemesis gravidarum}, author = {P C Tan and R Jacob and K F Quek and S Z Omar}, doi = {10.1016/j.ijgo.2006.03.012}, issn = {0020-7292 (Print) 0020-7292}, year = {2006}, date = {2006-01-01}, journal = {Int J Gynaecol Obstet}, volume = {93}, number = {3}, pages = {246-7}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16057, title = {The fetal sex ratio and metabolic, biochemical, haematological and clinical indicators of severity of hyperemesis gravidarum}, author = {P C Tan and R Jacob and K F Quek and S Z Omar}, doi = {10.1111/j.1471-0528.2006.00947.x}, issn = {1470-0328 (Print) 1470-0328}, year = {2006}, date = {2006-01-01}, journal = {Bjog}, volume = {113}, number = {6}, pages = {733-7}, abstract = {The association between female fetal sex and hyperemesis gravidarum is well established in European and North American populations. The association between female fetuses and severity of hyperemesis remains uncertain. A retrospective study based on case notes review of 166 Asian women hospitalised for hyperemesis was performed. Female fetuses were significantly associated with hyperemesis in our population (P= 0.004, OR 1.6, 95% CI 1.2-2.2) as well as associated with severe ketonuria and high urea. When both severe ketonuria and high urea were present at initial hospital admission for hyperemesis, 83% (95% CI 66-93) of the fetuses were female.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16056, title = {Readmission risk and metabolic, biochemical, haematological and clinical indicators of severity in hyperemesis gravidarum}, author = {P C Tan and R Jacob and K F Quek and S Z Omar}, doi = {10.1111/j.1479-828X.2006.00632.x}, issn = {0004-8666 (Print) 0004-8666}, year = {2006}, date = {2006-01-01}, journal = {Aust N Z J Obstet Gynaecol}, volume = {46}, number = {5}, pages = {446-50}, abstract = {In a retrospective analysis of 192 cases of presumed hyperemesis gravidarum, there were no biochemical markers that predicted hospital readmission. There was, however, statistically significant negative predictive value in abnormal liver function tests. This could represent acute self-limited illness with a component of hepatitis as the cause for the clinical presentation, rather than hyperemesis.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14554, title = {Screening results of anaemia among infants in a village in Okinawa, Japan: a cross-sectional study}, author = {K F Quek and T Hokama and C Yogi}, issn = {1010-5395 (Print) 1010-5395}, year = {2006}, date = {2006-01-01}, journal = {Asia Pac J Public Health}, volume = {18}, number = {1}, pages = {24-8}, abstract = {The aim of this study is to highlight the baseline characteristics of the results of a screening test for anaemia among infants in a village in Okinawa, Japan. The groups were classified into two; infants with and without anaemia. A total of 201 infants were screened at 3-4 months, 9-10 months and 18 months. The study showed that gestational age and BMI were predictive of anaemia at 3-4 months of age. At 9-10 months, types of feeding and weight ratio were the only factors that were found to be significantly predictive of anaemia. However, no factor was found to be predictive of anaemia at 18 months. Anaemia cases were found to occur at 3-4 months and 9-10 months. Most of the anaemia cases have successfully undergone treatment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14553, title = {The results of a worksite health promotion programme in Kuala Lumpur, Malaysia}, author = {F Moy and A A Sallam and M Wong}, doi = {10.1093/heapro/dal031}, issn = {0957-4824 (Print) 0957-4824}, year = {2006}, date = {2006-01-01}, journal = {Health Promot Int}, volume = {21}, number = {4}, pages = {301-10}, abstract = {The worksite is one of the key channels for the delivery of interventions to reduce chronic diseases among adult populations. It provides easy and regular access to a relatively stable population and it encourages sustained peer support. This paper reports a 2-year follow-up of the impact of a worksite health promotion programme on serum cholesterol and dietary changes among employees in a city in Malaysia. A quasi-experimental study was conducted among Malay-Muslim male security guards, with those working in a public university in Kuala Lumpur comprising the intervention group, and those working in the teaching hospital of the same university as the comparison group. They were comparable in socio-demographic characteristics. The intervention group received intensive individual and group counselling on diet, physical activity and quitting smoking. The comparison group was given minimal education on the same lifestyle changes through mail and group counselling. The intervention group showed a statistically significant reduction in their mean total cholesterol levels as compared with the comparison group, with an intervention effect of -0.38 (95% CI = -0.63, -0.14) mmol/l. The intervention group also reported a reduction in the amount of cigarettes smoked. The worksite was shown to be an effective channel for health promotion. The adoption of the new lifestyle behaviours should be supported and sustained through modification of work policies.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16054, title = {How do men perceive erectile dysfunction and its treatment? A qualitative study on opinions of men}, author = {W Y Low and C J Ng and W Y Choo and H M Tan}, doi = {10.1080/13685530600914601}, issn = {1368-5538 (Print) 1368-5538}, year = {2006}, date = {2006-01-01}, journal = {Aging Male}, volume = {9}, number = {3}, pages = {175-80}, abstract = {INTRODUCTION: Erectile dysfunction (ED) is a common medical disorder affecting the aging male. A man's perception of a disease affects his health seeking behaviour. This study aimed to explore perceptions of ED among men with ED and how these perceptions came about. METHODS: This qualitative study utilized in-depth interviews involving 17 urban men aged between 40 and 75 years old. RESULTS: Misconceptions existed regarding the definitions of ED. Most men perceived impotence to be more serious than ED. Although most were aware of the medical causes of ED, 'overuse of penis' and black magic were mentioned as culturally-related causes. ED was perceived as a serious problem associated with loss of manhood and it had a significant impact on relationships with their partners. However, some adopted an 'accepting' view and attributed it to aging and fate. Most men were only familiar with PDE-5 inhibitors and traditional therapies. PDE-5 inhibitors were perceived to be effective but they were concerned about side effects and costs. CONCLUSIONS: Identifying men's perceptions of ED and its treatment would help doctors in their consultation, and inform health policy makers in planning appropriate public education and services.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14594, title = {Reliability of reasons for early termination of breastfeeding: application of a bivariate probability model with sample selection to data from surveys in Malaysia in 1976-77 and 1988-89}, author = {B Kuate-Defo and J DaVanzo}, doi = {10.1080/00324720500462223}, issn = {0032-4728 (Print) 0032-4728}, year = {2006}, date = {2006-01-01}, journal = {Popul Stud (Camb)}, volume = {60}, number = {1}, pages = {83-98}, abstract = {Although extensively collected, data on people's reasons for their behaviour provided retrospectively have been met with some scepticism on the grounds that they may be subject to biases and errors that jeopardize their usefulness. This study investigates, for a sample of 1,327 births, the reliability with which women in Peninsular Malaysia recalled, at intervals 12 years apart, reasons for not initiating or for stopping breastfeeding less than 3 months after a birth. Overall, we find low to moderate reliability of recall. Levels of reliability are relatively high for some reasons (the child died and no or insufficient milk) but low for some others (child ill, breastfeeding inconvenient). Results from selection models show that reliability does not vary with the length of time since the child's birth but is inversely related to socio-economic status (proxied by education and employment). Social status, social norms, and health-related factors appear to be significant influences on women's consistency of reporting.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14552, title = {Using neural networks and just nine patient-reportable factors of screen for AMI}, author = {A M Bulgiba and M H Fisher}, url = {http://jhi.sagepub.com/content/12/3/213.full.pdf}, doi = {10.1177/1460458206066665}, issn = {1460-4582 (Print) 1460-4582}, year = {2006}, date = {2006-01-01}, journal = {Health Informatics J}, volume = {12}, number = {3}, pages = {213-25}, abstract = {The study investigated the effect of different input selections on the performance of artificial neural networks in screening for acute myocardial infarction (AMI) in Malaysian patients complaining of chest pain. We used hospital data to create neural networks with four input selections and used these to diagnose AMI. A 10-fold cross-validation and committee approach was used. All the neural networks using various input selections outperformed a multiple logistic regression model, although the difference was not statistically significant. The neural networks achieved an area under the ROC curve of 0.792 using nine inputs, whereas multiple logistic regression achieved 0.739 using 64 inputs. Sensitivity levels of over 90 per cent were achieved using low output threshold levels. Specificity levels of over 90 per cent were achieved using threshold levels of 0.4-0.5. Thus neural networks can perform as well as multiple logistic regression models even when using far fewer inputs.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN806, title = {An evaluation of information dissemination during the severe acute respiratory syndrome (SARS) outbreak among selected rural communities in Kuala Kangsar}, author = {A M Hazreen and S Myint Myint and H Farizah and M Abd Rashid and C C Chai and V K Dymna and W Gilbert and S Sri Rahayu and M A Seri Diana and H Noor Huzaimnah}, issn = {0300-5283 (Print) 0300-5283}, year = {2005}, date = {2005-01-01}, journal = {Med J Malaysia}, volume = {60}, number = {2}, pages = {180-7}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN807, title = {A Study on the Profile of 1016 Drug Addicts in Malaysia}, author = {G R Lekhraj Rampal and M Z Azhar and S Rampal}, year = {2005}, date = {2005-01-01}, journal = {Malaysian Journal of Medicine and Health Sciences}, volume = {1}, number = {2}, pages = {1-12}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN808, title = {LIFESTYLE PRACTICES AND PREVALENCE OF OBESITY IN A COMMUNITY WITHIN A UNIVERSITY CAMPUS}, author = {F M Moy and A S Atiya}, url = {https://jice.um.edu.my/index.php/jummec/article/view/4526}, issn = {2289-392X}, year = {2005}, date = {2005-01-01}, journal = {JUMMEC: Journal of Health and Translational Medicine (Formerly known as Journal of the University of Malaya Medical Centre)}, volume = {8}, number = {1}, pages = {33-38}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14555, title = {Awareness of prostatism among male patients in Teluk Intan Hospital}, author = {S B Zainal and K F Quek and C Biswajit}, issn = {0300-5283 (Print) 0300-5283}, year = {2005}, date = {2005-01-01}, journal = {Med J Malaysia}, volume = {60}, number = {5}, pages = {540-7}, abstract = {To determine the relationship between socio-demography, knowledge and attitude regarding prostatism among male in-patients in Teluk Intan Hospital. Two hundred respondents were recruited. Questionnaires that consist of demographic data such as age, ethnicity and religion and some question that pertaining knowledge and awareness were used. The questions eliciting symptoms of prostatism were based on the International Prostate Symptom Score (IPSS). 76.0% of the respondents were symptomatic as they presented with prostatic symptoms. The prevalence of asymptomatic cases is higher (6.7%) among the adults whereas the percentage in elderly respondents is higher than the adults in moderate to severe cases (p \< 0.001). Only 10% of respondents have heard about prostatism and mass media is ranked highest as the most preferred source of information regarding this matter with 66.7% preference. About 85.70% of respondents who had a severe score and 18.5% who had a moderate score were dissatisfied with their quality of life due to prostatic symptoms. This study provides a deeper understanding on the prevalence and severity of the prostatic symptoms and its association with the quality of life. It also illustrates low awareness, poor health seeking behaviour and poor knowledge pertaining to prostatism among the study population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN13915, title = {Construction of the Mandarin version of the International Prostate Symptom Score inventory in assessing lower urinary tract symptoms in a Malaysian population}, author = {K F Quek and C B Chua and A H Razack and W Y Low and C S Loh}, url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1442-2042.2004.00988.x/abstract}, doi = {10.1111/j.1442-2042.2004.00988.x}, issn = {0919-8172 (Print) 0919-8172}, year = {2005}, date = {2005-01-01}, journal = {Int J Urol}, volume = {12}, number = {1}, pages = {39-45}, abstract = {BACKGROUND: The purpose of the present study was to validate the Mandarin version of the International Prostate Symptom Score (Mand-IPSS) in a Malaysian population. METHODS: The validity and reliability were studied in patients with lower urinary tract symptoms (LUTS; benign prostatic hyperplasia [BPH] group) and without LUTS (control group). Test-retest methodology was used to assess the reliability while Cronbach alpha was used to assess the internal consistency. Sensitivity to change was used to express the effect size index in the preintervention versus post-intervention score in patients with LUTS who underwent transurethral resection of the prostate. RESULTS: For the control group and BPH group, the internal consistency was excellent and a high degree of internal consistency was observed for all seven items (Cronbach alpha = 0.86-0.98 and 0.90-0.98, respectively). Test-retest correlation coefficients for all items were highly significant. Intraclass correlation coefficient (ICC) was high for the control (ICC = 0.93-0.99) and BPH group (ICC = 0.91-0.99). The sensitivity and specificity showed a high degree of sensitivity and specificity to the effects of treatment. A high degree of significance between baseline and post-treatment scores was observed across all seven items in the BPH group but not in the control group. CONCLUSIONS: The Mand-IPSS is a suitable, reliable, valid and sensitive instrument to measure clinical change in the Malaysian population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14556, title = {Factors affecting health-related quality of life among patients with lower urinary tract symptoms}, author = {K F Quek}, doi = {10.1111/j.1442-2042.2005.01198.x}, issn = {0919-8172 (Print) 0919-8172}, year = {2005}, date = {2005-01-01}, journal = {Int J Urol}, volume = {12}, number = {12}, pages = {1032-6}, abstract = {BACKGROUND: This study aimed to evaluate the association of factors such as pain, lower urinary tract symptoms (LUTS), anxiety, depression and psychiatric morbidity on health-related quality of life (HRQoL) of patients with LUTS. METHODS: A total of 227 patients with LUTS were recruited into the study. The patients were assessed on pain, LUTS, anxiety, depression, psychiatric morbidity and health-related quality of life (HRQoL) using standardized questionnaires. RESULTS: The study showed that after adjustment, age, pain, anxiety, depression, psychiatric morbidity and LUTS contributed 31%, 13%, 45%, 16% and 48% respectively to the variability of the physical, mental, social, global and overall HRQoL. CONCLUSION: Age, pain, psychiatric morbidity, anxiety and depression are associated with HRQoL among patients with LUTS.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16061, title = {Management studies in medical education}, author = {S Noor Ghani and I Saimy}, issn = {0300-5283 (Print) 0300-5283}, year = {2005}, date = {2005-01-01}, journal = {Med J Malaysia}, volume = {60 Suppl D}, pages = {66-8}, abstract = {In 1977, the World Health Assembly (WHA) set the social target--the "Health For All" goal and in 1995, urged member states to "re-orientate medical education and medical practice for "Health For All" (resolution WHA 48.8). This led to World Health Organisation to enunciate the "5-star doctor" needing skills in healthcare management, quality assurance and health economics. The Faculty of Medicine, University of Malaya introduced the New Integrated Curriculum (NIC) in 1995. The objective was aimed at producing a competent doctor with a holistic approach to the practice of medicine. This was to be achieved by having 3 strands of studies i.e. The Scientific Basis of Medicine (SBM), the Doctor, Patient, Health and Society (DPHS), and Personal and Professional Development (PPD) over the 5-year programme, split into 3 phases. Elements of the "5-star doctor" were introduced in strand 2--DPHS and strand 3--PPD. Management studies were introduced in the Personal and Professional Development (PPD) strand. This led to an instructional module--"Principles of Management in Health Care Services (PMGT)" comprising of the Management of Self, Resources and People and incorporating a three week field programme. Evaluation is undertaken at the end of the phase IIIA of the studies. This NIC approach will be able to produce a "5-star doctor", a team player, leader, communicator and an effective manager.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16062, title = {Tuberculosis in HIV/AIDS patients: a Malaysian experience}, author = {V Nissapatorn and I Kuppusamy and B L Sim and K F Quek and A Khairul Anuar}, issn = {0125-1562 (Print) 0125-1562}, year = {2005}, date = {2005-01-01}, journal = {Southeast Asian J Trop Med Public Health}, volume = {36}, number = {4}, pages = {946-53}, abstract = {This retrospective study was conducted at the National Tuberculosis Center (NTBC) where 252 HIV-positive patients coexisting with tuberculosis (TB/HIV) were examined. We found that patients with pulmonary (PTB) and extrapulmonary tuberculosis (EPT) had similar mean age. A higher sex ratio between male to female (10.7:1) was observed in patients with PTB. The other characteristics of patients with pulmonary and extrapulmonary tuberculosis were not statistically different from each other. Cough (88%) and hemoptysis were the most common presenting symptoms, significantly related to patients with PTB. Lymphadenopathy (33.5%) was the most common sign in patients with EPT. The majority of patients with pulmonary and extrapulmonary tuberculosis had CD4 cell counts of less than 200 cells/mm3 (range 0-1,179 with a median of 57 cells/mm3). Lung (89%) and miliary (55.6%) forms were the most frequent disease locations in patients with PTB and EPT, respectively. A higher percentage of patients with PTB (42%) were treated successfully with short-course (6 months) therapy, whereas in patients with EPT (43%) needed a longer period (9 months) for successful treatment. Of the patients who defaulted treatment, a higher proportion (87%) had PTB. No MDR-TB or relapse cases were found in this study.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14557, title = {An evaluation of information dissemination during the severe acute respiratory syndrome (SARS) outbreak among selected rural communities in Kuala Kangsar}, author = {A M Hazreen and S Myint Myint and H Farizah and M Abd Rashid and C C Chai and V K Dymna and W Gilbert and S Sri Rahayu and M A Seri Diana and H Noor Huzaimnah}, issn = {0300-5283 (Print) 0300-5283}, year = {2005}, date = {2005-01-01}, journal = {Med J Malaysia}, volume = {60}, number = {2}, pages = {180-7}, abstract = {To assess the level of knowledge, attitude and practice (KAP) on SARS and its preventive measures among the rural population of Kuala Kangsar district. This KAP study was also done to identify the expectation and preference of rural population upon obtaining health information. This is a cross-sectional study of 201 households from four villages in Kuala Kangsar. Face-to-face interview was done regarding knowledge, attitude and practice on SARS and its preventive measures. Statistical analyses were performed with SPSS (Version 10.0). A scoring system was used to assess the level of knowledge, attitude and practice towards SARS. Ninety one percent of the study population was aware of SARS. Majority of them have good attitude towards SARS based on the formulated scoring system. Television was found to be the first hand information about SARS and most preferred source of information by the rural population. Knowledge and attitude of respondents concerning SARS were good. Television was found to be the preference among the rural population in obtaining health information.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16063, title = {Colorectal cancer in Asians: a demographic and anatomic survey in Malaysian patients undergoing colonoscopy}, author = {K L Goh and K F Quek and G T Yeo and I N Hilmi and C K Lee and N Hasnida and M Aznan and K L Kwan and K T Ong}, doi = {10.1111/j.1365-2036.2005.02646.x}, issn = {0269-2813 (Print) 0269-2813}, year = {2005}, date = {2005-01-01}, journal = {Aliment Pharmacol Ther}, volume = {22}, number = {9}, pages = {859-64}, abstract = {BACKGROUND: Colorectal cancer is one of the most common forms of gastrointestinal cancer in the world today. In the Asia-Pacific area, it is the fastest emerging gastrointestinal cancer. AIM: To determine the basic demographic features of patients with colorectal cancer and the anatomic distribution and characteristics of the tumour in a local Asian population. METHODS: We conducted a review of consecutive patients who had undergone colonoscopy from 1999 to 2003 at the University of Malaya Medical Center, Kuala Lumpur, Malaysia. RESULTS: Analysis was carried out on 3404 patients who underwent colonoscopy. A total of 228 patients (7%) were diagnosed with carcinoma. The mean age of diagnosis (+/-s.d.) was 64.4 +/- 13.1 years. The male to female ratio was 1.15. Polyps were noted in 470 patients (14%). Polyps detected concomitantly with a colorectal cancer were noted in 55 patients (2%). Four patients (0.1%) were diagnosed to have familial adenomatous polyposis coli. Of the 228 patients 209 (92%) had tumours at only one site whereas 19 (8%) had synchronous lesions. Tumours were mainly left sided [198 of 248 patients (80%)] with the majority located in the recto-sigmoid region. Detailed records of treatment were available only in 176 patients. A total of 147 of 176 patients (84%) underwent surgery and 50 (28%) also received adjuvant or palliative chemotherapy (28%). Seven of 154 patients (5%) were diagnosed to have stage A cancers, 64 (42%), stage B, 23 (15%), stage C and 60 (39%), stage D. Multivariate analysis using multiple logistic regression analysis showed that age \> or =65 years (OR = 1.78; 95% CI: 1.35- 2.36) and Malay (OR = 2.09; 95% CI: 1.30-3.35) and Chinese (OR = 1.77; 95% CI: 1.77-2.69) race were significant independent predictive factors for colorectal cancer. CONCLUSIONS: The demography of colorectal cancer is different from western patients. Tumours were mainly left sided in our patients. However, no differences in anatomic location were found between races, men and women and younger and older age groups. Colorectal cancer presented in an advanced stage in the majority of patients.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14558, title = {How well can signs and symptoms predict AMI in the Malaysian population?}, author = {A M Bulgiba and M Razaz}, url = {http://ac.els-cdn.com/S0167527304004619/1-s2.0-S0167527304004619-main.pdf?_tid=62db71ba-e12c-11e5-bfb3-00000aacb361\&acdnat=1457001825_00b3fe38b080f3e038a4dea8db33e1c0}, doi = {10.1016/j.ijcard.2004.04.002}, issn = {0167-5273 (Print) 0167-5273}, year = {2005}, date = {2005-01-01}, journal = {Int J Cardiol}, volume = {102}, number = {1}, pages = {87-93}, abstract = {The aim of the study was to use data from an electronic medical record system (EMR) to look for factors that would help us diagnose acute myocardial infarction (AMI) with the ultimate aim of using these factors in a decision support system for chest pain. We extracted 887 records from the electronic medical record system (EMR) in Selayang Hospital, Malaysia. We cleaned the data, extracted 69 possible variables and performed univariate and multivariate analysis. From the univariate analysis we find that 22 variables are significantly associated with a diagnosis of AMI. However, multiple logistic regression reveals that only 9 of these 22 variables are significantly related to a diagnosis of AMI. Race (Indian), male sex, sudden onset of persistent crushing pain, associated sweating and a history of diabetes mellitus are significant predictors of AMI. Pain that is relieved by other means and history of heart disease on treatment are important predictors of a diagnosis other than AMI. The degree of accuracy is high at 80.5%. There are 13 factors that are significant in the univariate analysis but are not among the nine significant factors in the multivariate analysis. These are location of pain, associated palpitations, nausea and vomiting; pain relieved by rest, pain aggravated by posture, cough, inspiration and exertion; age more than 40, being a smoker and abnormal chest wall and face examination. We believe that these findings can have important applications in the design of an intelligent decision support system for use in medical care as the predictive capability can be further refined with the use of intelligent computational techniques.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14559, title = {Are examination findings important in screening for angina in the Malaysian patient?}, author = {A M Bulgiba}, url = {http://ac.els-cdn.com/S009174350400461X/1-s2.0-S009174350400461X-main.pdf?_tid=3e740508-e12c-11e5-a293-00000aab0f6c\&acdnat=1457001764_675a90935083a907689b33836da9f2bc}, doi = {10.1016/j.ypmed.2004.09.010}, issn = {0091-7435 (Print) 0091-7435}, year = {2005}, date = {2005-01-01}, journal = {Prev Med}, volume = {40}, number = {6}, pages = {696-701}, abstract = {BACKGROUND: The objective of this study is to look at how well patient history and examination findings can be used in screening for angina. METHODS: A total of 887 records were extracted from the electronic medical record system (EMR) in Selayang Hospital, Malaysia. The data was cleaned; 69 possible variables were extracted, and univariate and multivariate analyses were performed. RESULTS: From the univariate analysis, it was found that 19 variables are significantly associated with a diagnosis of angina. However, multiple logistic regression reveals that only 11 of these 19 variables are significantly related to a diagnosis of angina. Chest pain aggravated by exertion, history of diabetes mellitus, and history of heart disease (regardless of whether on treatment or not) are significant predictors of angina. Sudden onset chest pain, pain that is persistent, pain relieved by other means, pain aggravated by inspiration, and findings of rhonchi are important predictors of a diagnosis other than angina. The degree of overall accuracy is high at 71.3%. There are eight factors which are significant in the univariate analysis but are not significant in the multivariate analysis. These are marital status, pain relieved by glyceryl trinitrate (GTN), pain relieved by rest, associated nausea, pain aggravated by posture, pain aggravated by cough, history of hypertension, and history of smoking. CONCLUSIONS: These findings suggest that examination findings do not play a significant role in screening for angina.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @book{RN760, title = {Notes on Family Health}, author = {H Yadav}, isbn = {983-100-216-4}, year = {2004}, date = {2004-01-01}, publisher = {University of Malaya Press}, address = {Kuala Lumpur, Malaysia}, keywords = {}, pubstate = {published}, tppubtype = {book} } @article{RN800, title = {Attitudes of Paramedics Towards Mentally Ill Patients}, author = {H Ahmad and Mas Ayu and R Rawiyah}, issn = {0128-8628}, year = {2004}, date = {2004-01-01}, journal = {Malaysian Journal of Psychiatry}, volume = {12}, number = {1}, pages = {25-31}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN801b, title = {Coronary heart disease risk assessment among the security staff in a public university}, author = {G W Lua and F M Moy and A S Atiya}, url = {http://www.myjurnal.my/public/article-view.php?id=62393}, year = {2004}, date = {2004-01-01}, journal = {Malaysian Journal of Public Health Medicine}, volume = {4}, number = {1}, pages = {29-34}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN803, title = {The use of nominal group technique in promotion of healthy lifestyle}, author = {F M Moy and A S Atiya}, year = {2004}, date = {2004-01-01}, journal = {Malaysian Journal of Public Health Medicine}, volume = {4}, number = {1}, pages = {19-21}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN802, title = {A worksite wellness program in Kuala Lumpur baseline characteristics}, author = {F M Moy and A S Atiya}, year = {2004}, date = {2004-01-01}, journal = {International Medical Journal}, volume = {3}, number = {2}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN805, title = {Hepatitis A outbreak in Hulu Langat District, Selangor State, Malaysia during April--October 2002}, author = {B Venugopalan and N A Nik Rubiah and T Meftahuddin and M Ayu and R Prema and I Ruhaini and S Murugan}, issn = {0300-5283 (Print) 0300-5283}, year = {2004}, date = {2004-01-01}, journal = {Med J Malaysia}, volume = {59}, number = {5}, pages = {670-3}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16069, title = {Effect of treating lower urinary tract symptoms on anxiety, depression and psychiatric morbidity: a one-year study}, author = {K F Quek and A H Razack and C B Chua and W Y Low and C S Loh}, doi = {10.1111/j.1442-2042.2004.00903.x}, issn = {0919-8172 (Print) 0919-8172}, year = {2004}, date = {2004-01-01}, journal = {Int J Urol}, volume = {11}, number = {10}, pages = {848-55}, abstract = {BACKGROUND: The present study aimed to evaluate the effects of treating lower urinary tract symptoms (LUTS) on anxiety, depression and psychiatric morbidity following one year of follow-up. METHODS: A total of 297 patients were involved in this study. Patients were recruited into a surgical group (patients underwent transurethral resection of the prostate}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16068, title = {Reliability and validity of the Spielberger State-Trait Anxiety Inventory (STAI) among urological patients: a Malaysian study}, author = {K F Quek and W Y Low and A H Razack and C S Loh and C B Chua}, issn = {0300-5283 (Print) 0300-5283}, year = {2004}, date = {2004-01-01}, journal = {Med J Malaysia}, volume = {59}, number = {2}, pages = {258-67}, abstract = {To validate the English version of the Spielberger State-Trait Anxiety Inventory (STAI) in a sample of Malaysia patients with and without urinary symptoms. Validity and reliability were studied in patients with lower urinary tract symptoms (LUTS) and patients without LUTS. Reliability was evaluated using the test-retest method and internal consistency was assessed using Cronbach's alpha. Sensitivity to change was expressed as the effect size in the pre-intervention versus post-intervention score in additional patients with LUTS who underwent transurethral resection of the prostate (TURP). Internal consistency was excellent. A high degree of internal consistency was observed for each of the 40 items with Cronbach's alpha value = 0.38 to 0.89 while the Cronbach's alpha for the total scores was 0.86. Test-retest correlation coefficients for the 40 items score were highly significant. Intraclass correlation coefficient was high (ICC=0.39 to 0.89). A high degree of sensitivity and specificity to the effects of treatment was observed. A high degree of significant level between baseline and post-treatment scores was observed across nearly half of the items in surgical group but not in the non-LUTS group (control subjects). The STAI is reliable, valid and sensitive to clinical change in a sample of Malaysian patients with and without urinary symptoms.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16070, title = {Toxoplasmosis in HIV/AIDS patients: a current situation}, author = {V Nissapatorn and C Lee and K F Quek and C L Leong and R Mahmud and K A Abdullah}, issn = {1344-6304 (Print) 1344-6304}, year = {2004}, date = {2004-01-01}, journal = {Jpn J Infect Dis}, volume = {57}, number = {4}, pages = {160-5}, abstract = {The seroprevalence of toxoplasmosis among 505 of human immunodeficiency virus (HIV)/AIDS patients was 226 (44.8%; 95% CI 42.64-51.76): 27 (47.4%) and 199 (44.4%) showed Toxoplasma seropositivity with and without toxoplasmic encephalitis (TE), respectively (P \<0.05). The majority of these patients were in the 25-34 age group (44 versus 39%), male (86 versus 76%), and Chinese (49 versus 53%), though no statistical significance was found between the two. Significant differences between these two groups were noted, however, in terms of marital status, occupation, and present address. The heterosexual exhibited the most frequent behavior at risk for HIV infection, and accounted for 51 and 59% of patients with and without TE, respectively. Only 17/260 (6.5%) and 1/137 (0.7%) of them later acquired TE after receiving primary chemoprophylaxis (cotrimoxazole) and antiretroviral therapy including HAART (P \<0.05). Fifty-seven (11.3%) out of those 505 patients were diagnosed with AIDS-related TE. The most common clinical manifestation was headache (56%). The computed tomography scan findings showed most lesions to be multiple (96.4%), hypodense (66.7%), and in the parietal region (39.3%). Twenty-seven (47.4%) patients had chronic (latent) Toxoplasma infection as evidenced by seropositivity for anti-Toxoplasma (IgG) antibody. At the time of diagnosis, the range of CD4 cell count was from 0-239 with a median of 25 cells/cumm. We also found that a CD4 count of less than 100 cells/cumm was significantly associated with development of TE (P \<0.05). Clinical outcomes showed that among those who survived, 21 (36.8%), 16 (28.1%), and 2 (3.5%) of patients had completed treatment, transferred out, and were lost to follow up, respectively. Unfortunately, 18 (31.6%) of the cases were officially pronounced dead. Overall, 7 (12.3%) patients were detected as recurrent TE in this study.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16075, title = {The role of general practitioners in the management of erectile dysfunction-a qualitative study}, author = {C J Ng and W Y Low and N C Tan and W Y Choo}, doi = {10.1038/sj.ijir.3901141}, issn = {0955-9930 (Print) 0955-9930}, year = {2004}, date = {2004-01-01}, journal = {Int J Impot Res}, volume = {16}, number = {1}, pages = {60-3}, abstract = {The objective of this study was to explore the roles and perceptions of general practitioners (GPs) in the management of erectile dysfunction (ED). This qualitative study used focus group discussions and in-depth interviews. This study was conducted based on 28 GPs from an urban area in Malaysia who had managed patients with ED and prescribed anti-ED drugs. Main outcome measures included the roles of GPs in managing patients with ED (active or passive), perceptions regarding ED and the treatment, and factors influencing their decision to prescribe. Majority of the GPs assumed a passive role when managing patients with ED. This was partly due to their perception of the disease being nonserious. Some also perceived ED as mainly psychological in nature. The anti-ED drugs were often viewed as a lifestyle drug with potentially serious side effects. The fear of being perceived by patients as 'pushing' for the drug and being blamed if the patients were to develop serious side effects also hampered the management of this disease. GPs who participated in this study remained passive in identifying and treating patients with ED and this was attributed to their perception of the disease, drug treatment and patient's background.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14561, title = {Body mass status of school children and adolescents in Kuala Lumpur, Malaysia}, author = {F M Moy and C Y Gan and M K Zaleha}, issn = {0964-7058 (Print) 0964-7058}, year = {2004}, date = {2004-01-01}, journal = {Asia Pac J Clin Nutr}, volume = {13}, number = {4}, pages = {324-9}, abstract = {Lifestyle and disease patterns in Malaysia have changed following rapid economic development. It is important to find out how these changes have affected the nutritional status and health behaviour of the population, especially school children and adolescents. Therefore a survey on school children's and adolescents' health behaviours and perception in Kuala Lumpur was initiated. This paper only reports the observed body mass status of the school children. A total of 3620 school children were selected in this survey using the method of multi-stage sampling. The students were surveyed using pre-tested questionnaires while weight and height were measured by the research team in the field. Using the cut-off of BMI-for-age \>or= 95th percentile and \<5th percentile for overweight and underweight respectively, there were a total of 7.3% of overweight students and 14.8% of underweight students. When analysed by gender; 7.5% of boys and 7.1% girls were overweight, while 16.2% of the boys and 13.3% of the girls were underweight. The youngest age group (11 years old) had the highest prevalence of underweight as well as overweight. With increasing age, the prevalence of underweight and overweight decreased and more children were in the normal weight range. The overall prevalence of overweight among the three ethnic groups was similar. However the prevalence of underweight was highest among the Indian students (24.9%), followed by Malays (18.9%) and Chinese (9.5%) (P \<0.001). The results showed that both the problems of under- and over-nutrition co-exist in the capital city of Malaysia. The promotion of healthy eating and physical activities is required to address the problems of under- and over-nutrition in order to build up a strong and healthy nation in the future.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16071, title = {Management of erectile dysfunction: barriers faced by general practitioners}, author = {W Y Low and C J Ng and N C Tan and W Y Choo and H M Tan}, issn = {1008-682X (Print) 1008-682x}, year = {2004}, date = {2004-01-01}, journal = {Asian J Androl}, volume = {6}, number = {2}, pages = {99-104}, abstract = {AIM: To explore the barriers faced by general practitioners (GPs) in the management of patients with erectile dysfunction (ED). METHODS: This was a qualitative analysis of focus group discussions and in-depth interviews involving 28 Malaysian GPs. RESULTS: GPs' perception of ED being not a serious condition was a major determinant of their prescribing practice. Doctor's age (younger), gender (female), short consultation time and lack of experience were cited as barriers. The GPs' prescribing habits were heavily influenced by the feedback from the first few patients under treatment, the uncertainty of etiology of ED without proper assessment and the profit margin with bulk purchase. Other barriers include Patients' coexisting medical conditions, older age, lower socio-economic status, unrealistic expectations and inappropriate use of the anti-impotence drugs. Cardiovascular side effects and cost were two most important drug barriers. CONCLUSION: The factors influencing the management of ED among the general practitioners were multiple and complex. An adequate understanding of how these factors (doctors, patients and drugs) interact can assist in the formulation and implementation of strategies that encourage GPs to identify and manage ED patients.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16067, title = {Awareness and knowledge of common eye diseases among the academic staff (non-medical faculties) of University of Malaya}, author = {Y K Chew and S C Reddy and R Karina}, issn = {0300-5283 (Print) 0300-5283}, year = {2004}, date = {2004-01-01}, journal = {Med J Malaysia}, volume = {59}, number = {3}, pages = {305-11}, abstract = {A cross sectional study was conducted to assess the level of awareness and knowledge of common eye diseases (cataract, glaucoma, diabetic retinopathy and refractive errors) among 473 academic staff (non-medical faculties) of University Malaya. The awareness of cataract was in 88.2%, diabetic retinopathy in 83.5%, refractive errors in 75.3% and glaucoma in 71.5% of the study population. The knowledge about all the above common eye diseases was moderate, except presbyopia which was poor. Multivariate analysis revealed that females, older people, and those having family history of eye diseases were significantly more aware and more knowledgeable about the eye diseases. Health education about eye diseases would be beneficial to seek early treatment and prevent visual impairment in the society.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14549, title = {Information technology in health care--what the future holds}, author = {A M Bulgiba}, url = {http://aph.sagepub.com/content/16/1/64.full.pdf}, issn = {1010-5395 (Print) 1010-5395}, year = {2004}, date = {2004-01-01}, journal = {Asia Pac J Public Health}, volume = {16}, number = {1}, pages = {64-71}, abstract = {In 1998, Malaysia opened its first hospital based on the "paperless and filmless" concept. Two are now in operation, with more to follow. Telemedicine is now being used in some hospitals and is slated to be the technology to watch. Future use of technology in health care will centre on the use of centralised patient databases and more effective use of artificial intelligence. Stumbling blocks include the enormous capital costs involved and difficulty in getting sufficient bandwidth to support applications on a national scale. Problems with the use of information technology in developing countries still remain; mainly inadequate skilled resources to operate and maintain the technology, lack of home-grown technology, insufficient experience in the use of information technology in health care and the attitudes of some health staff. The challenge for those involved in this field will not be in building new "paperless and filmless" institutions but in transforming current "paper and film-based" institutions to "paperless and filmless" ones and changing the mindset of health staff. Universities and medical schools must be prepared to respond to this new wave by incorporating elements of medical/health informatics in their curriculum and assisting governments in the planning and implementation of these projects. The experience of the UMMC is highlighted as an example of the difficulty of transforming a paper-based hospital to a "paperless and filmless" hospital.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14564, title = {Caregiving burden is associated with short rather than long duration of care for older persons}, author = {J Zainuddin and J T Arokiasamy and P J Poi}, issn = {1010-5395 (Print) 1010-5395}, year = {2003}, date = {2003-01-01}, journal = {Asia Pac J Public Health}, volume = {15}, number = {2}, pages = {88-93}, abstract = {This is a preliminary cross-sectional study of 51 caregivers of older persons attending the Geriatric Clinic at an urban hospital in Kuala Lumpur, Malaysia. A questionnaire helped determine how the duration of caregiving affects the outcome of caregiver burden. The short version of Zarit's Burden Interview (BI) allowed the burden level to be grouped as low or high burden. The duration of caregiving was also grouped into short (two or less years) or long (more than two years) durations. One third of the caregivers, 31% (16 out of 51) reported high burden and within this group 81%, (13 out of 16) are short duration caregivers. Majority of the longer duration caregivers, 88% (21 out of 24) reported low level of burden. This was a significant finding (p-value 0.008). The study also showed that a higher proportion of caregivers are employed, working in the private sector, and earn less than RM2,000 per month. However, these findings were not significantly associated with high burden. It is concluded that although this study showed low level of caregiver burden, shorter duration of caregiving is associated with higher level of burden and longer duration of caregiving is associated with lower level of burden.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16084, title = {The male marital satisfaction following treatment for lower urinary tract symptoms}, author = {K F Quek and C S Loh and W Y Low and A H Razack and N Dublin}, issn = {0092-623X (Print) 0092-623x}, year = {2003}, date = {2003-01-01}, journal = {J Sex Marital Ther}, volume = {29}, number = {2}, pages = {173-6}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16077, title = {Toxoplasmosis: prevalence and risk factors}, author = {V Nissapatorn and M A Noor Azmi and S M Cho and M Y Fong and I Init and M Rohela and A Khairul Anuar and K F Quek and H M Latt}, doi = {10.1080/01443610310001604376}, issn = {0144-3615 (Print) 0144-3615}, year = {2003}, date = {2003-01-01}, journal = {J Obstet Gynaecol}, volume = {23}, number = {6}, pages = {618-24}, abstract = {A total of 200 pregnant women were recruited in this cross-sectional study. The overall seroprevalence of toxoplasmosis in pregnant women was found to be 49%, in which 39%, 4% and 6% for anti-Toxoplasma IgG, IgM and both anti-Toxoplasma IgG and IgM antibodies, respectively. We found the differences in Toxoplasma seroprevalence rates among the races were significant: the highest rate was in the Malays (55.7%), followed by the Indian (55.3%) and the Chinese (19.4%) (P\<0.05) populations. An increase in Toxoplasma seroprevalence with increasing parity was detected (P\<0.05). Women with no children had a prevalence of 39.7%, while women with one or more than two children had a prevalence of 44.2% and 62.9%, respectively. In this study, there was no significant association between Toxoplasma seroprevalence and various possible risk factors in pregnant women (P\>0.05). When multivariate analysis was performed, no significant association between Toxoplasma seroprevalence and history of contact with cats, consumption of undercooked meat and blood transfusion was found (P\>0.05). We did not find any newly diagnosed cases of acute acquired toxoplasmosis in pregnancy during the study period.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16087, title = {Toxoplasmosis in HIV/AIDS patients in Malaysia}, author = {V Nissapatorn and C K Lee and S M Cho and M Rohela and A K Anuar and K F Quek and H M Latt}, issn = {0125-1562 (Print) 0125-1562}, year = {2003}, date = {2003-01-01}, journal = {Southeast Asian J Trop Med Public Health}, volume = {34 Suppl 2}, pages = {80-5}, abstract = {Three hundred and one sera of HIV/AIDS patients were tested for anti-Toxoplasma IgG antibody by ELISA technique. The seroprevalence of toxoplasmosis was 41.2% (95% CI: 35.5-46.9) in HIV/AIDS patients. The seroprevalence was significantly higher in the Malay (57.9%) than the Chinese (38.7%), followed by the Indian patients (29.6%) (p\<0.05). No possible risk factor, such as contact with cats, consumption of uncooked meat, and history of blood transfusions was found to have any significant association with the presence of anti-Toxoplasma antibody in the study sample (p\>0.05). Multivariate analysis was employed to find any association between Toxoplasma seroprevalence and a single subject having single or multiple risk factors. It was found that the association was not statistically significant (p\>0.05). Among the HIV/AIDS study samples, 124 (41.2%) samples were found to have positive anti-Toxoplasma antibody, the association between the presence of anti-Toxoplasma antibody and CD4 cell count was determined but no statistically significant association was found (p\>0.05). During the study period, only one case of active CNS toxoplasmosis was registered and the diagnostic criteria included: clinical presentations, CT scan finding, serological evidence of anti-Toxoplasma IgG antibody, and respose to anti-Toxoplasma therapy.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16086, title = {Tuberculosis: clinical manifestations and outcomes}, author = {V Nissapatorn and I Kuppusamy and A K Anuar and K F Quek and H M Latt}, issn = {0125-1562 (Print) 0125-1562}, year = {2003}, date = {2003-01-01}, journal = {Southeast Asian J Trop Med Public Health}, volume = {34 Suppl 2}, pages = {147-52}, abstract = {A total of 290 HIV/AIDS patients were recruited into this retrospective study, which was carried out at the National Tuberculosis Center (NTBC), Kuala Lumpur. The age range was 18 to 75 years with a mean age of 36.10 (SD +/- 7.44) years. Males outnumbered females by a ratio of 31:1. In this study, the majority of patients were male (96.9%), Malay (47.2%), single (66.9%), unemployed (81%), and smoked (61.4%). The main risk marker identified was injecting drug use (74.5%). The most common clinical manifestations were cough, fever, sputum, lymphadenopathy, and chest infiltrations. More than half of the patients (85.9%) were diagnosed with localized tuberculosis (pulmonary) and the others (14.1%) had extra-pulmonary or disseminated tuberculosis. At the time of this study, the majority of the patients (16.9%) had CD4 cell counts of less than 200 cell/mm3, with a median of 221 cell/mm3. Clinical outcomes demonstrated that among those who survived, 11.0% and 20.7% of the patients had completed treatment either \> or = 6 or \> or = 9 months, respectively, whereas 54.8% of patients were lost to follow-up, including 0.7% for MDR-TB. Diagnostic criteria for tuberculosis in this study were mainly clinical symptoms/signs and chest x-ray findings (31.0%).}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14563, title = {Waist circumference as a screening tool for weight management: evaluation using receiver operating characteristic curves for Malay subjects}, author = {F M Moy and A S Atiya}, issn = {1010-5395 (Print) 1010-5395}, year = {2003}, date = {2003-01-01}, journal = {Asia Pac J Public Health}, volume = {15}, number = {2}, pages = {99-104}, abstract = {Body Mass Index (BMI) is the most established anthropometric indicator used for assessment of nutritional status. Other anthropometric indicators which are related closely to BMI are waist hip ratio (WHR) and waist circumference. In this paper, receiver operating characteristics (ROC) curves were constructed to assess the value of waist circumference and waist hip ratio as a screening measure for the need of weight management using BMI as the reference test. Sensitivity and specificity were calculated at several cut-offs. The areas under the ROC curve calculated by comparing waist circumference with BMI were high (0.70 - 0.86) while the areas calculated for WHR were low (0.46 - 0.67). Sensitivities of 0.745 and 0.800 were observed at cut-off points of waist circumference at 90cm and 80cm for males and females respectively, while the false positive rates were 0.233 for males and 0.250 for females. These cut-off points could be considered as a fair trade-off. Therefore it is concluded that waist circumference performed better than WHR as a screening test. It is indicative that waist circumference could be used as a tool in raising awareness of weight management in this population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14565, title = {A knowledge, attitude and practices (KAP) study on dengue among selected rural communities in the Kuala Kangsar district}, author = {F Hairi and C H Ong and A Suhaimi and T W Tsung and M A Anis Ahmad and C Sundaraj and M M Soe}, url = {http://aph.sagepub.com/content/15/1/37.full.pdf}, issn = {1010-5395 (Print) 1010-5395}, year = {2003}, date = {2003-01-01}, journal = {Asia Pac J Public Health}, volume = {15}, number = {1}, pages = {37-43}, abstract = {A cross-sectional survey was conducted to assess the level of knowledge, attitude and practices concerning dengue and its vector Aedes mosquito among selected rural communities in the Kuala Kangsar district from 16-25th June, 2002. It was found that the knowledge of the community was good. Out of the 200 respondents, 82.0% cited that their main source of information on dengue was from television/radio. The respondents' attitude was found to be good and most of them were supportive of Aedes control measures. There is a significant association found between knowledge of dengue and attitude towards Aedes control (p = 0.047). It was also found that good knowledge does not necessarily lead to good practice. This is most likely due to certain practices like water storage for domestic use, which is deeply ingrained in the community. Mass media is an important means of conveying health messages to the public even among the rural population, thus research and development of educational strategies designed to improve behaviour and practice of effective control measures among the villagers are recommended.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14562, title = {IT usage, perceptions and literacy of medical students}, author = {A M Bulgiba and M H Noran}, url = {http://aph.sagepub.com/content/15/2/127.full.pdf}, issn = {1010-5395 (Print) 1010-5395}, year = {2003}, date = {2003-01-01}, journal = {Asia Pac J Public Health}, volume = {15}, number = {2}, pages = {127-34}, abstract = {A cross-sectional study of medical students using a self-administered questionnaire was carried out in the Faculty of Medicine, University of Malaya, Malaysia from December 2000 to January 2001 to determine IT usage, perceptions and literacy of medical students. 366 of 653 (56.0%) students reported owning some type of personal computer. Students mainly used the computer to get onto the Internet, do word-processing and make presentations. Junior (Year One and Two) students and those who had used computers before entering university were more likely to use the Internet. Those who own computers were more likely to feel comfortable with software (OR 1.61, 95% CI: 1.09, 2.38). Students who use the Internet were more likely to perceive that IT facilitated their studies (OR 4.61, 95% CI: 2.35, 9.05). The highest self-reported IT skill was e-mailing followed by surfing the World Wide Web and word-processing. Male students and junior students had significantly higher self-reported IT literacy scores compared to female students and senior students. Significant predictors for an IT identifier score after adjusting for other variables were self-reported rating of computer knowledge, number of siblings, parents' income and gender.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @book{RN756, title = {Health Economics Issues in Malaysia}, author = {A S Nabilla and N A Abdul Mohsein}, isbn = {983-100-141-9}, year = {2002}, date = {2002-01-01}, publisher = {University of Malaya Press}, address = {Kuala Lumpur, Malaysia}, keywords = {}, pubstate = {published}, tppubtype = {book} } @article{RN796, title = {A profile of injuries in four villages in the Jasin District of Malacca, Malaysia}, author = {Moe Htay}, doi = {10.1177/101053950201400211}, issn = {1010-5395 (Print) 1010-5395}, year = {2002}, date = {2002-01-01}, journal = {Asia Pac J Public Health}, volume = {14}, number = {2}, pages = {118-22}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN125b, title = {Critical appraisal - is there a need to train medical students how to read the literature?}, author = {R Karina and S Nooriah}, issn = {0300-5283 (Print) 0300-5283}, year = {2002}, date = {2002-01-01}, journal = {Med J Malaysia}, volume = {57 Suppl E}, pages = {78-82}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN798, title = {Overview of the Findings}, author = {A Khairul Anuar and M S Nooriah and M H Farizah and P Merina}, url = {https://jummec.um.edu.my/index.php/jummec/article/view/4502}, issn = {2289-392X}, year = {2002}, date = {2002-01-01}, journal = {JUMMEC: Journal of Health and Translational Medicine (Formerly known as Journal of the University of Malaya Medical Centre)}, volume = {7}, number = {1}, pages = {80-81}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN799, title = {Effective triaging in Putrajaya health clinic}, author = {Nora'i Mohd Said and Jumiatin Othman and F Hairi}, url = {http://www.mjphm.org.my/mjphm/journals/Volume%202%20(2)%20:%202002/58-62.pdf}, year = {2002}, date = {2002-01-01}, journal = {Malaysian Journal of Public Health Medicine}, volume = {2}, number = {2}, pages = {58-62}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN137b, title = {Breastfeeding practices among mothers in an urban polyclinic}, author = {C K Siah and H Yadav}, issn = {0300-5283 (Print) 0300-5283}, year = {2002}, date = {2002-01-01}, journal = {Med J Malaysia}, volume = {57}, number = {2}, pages = {188-94}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14569, title = {Community Residency Programme (CRP)--a tool for research and rural health training for medical students}, author = {H Yadav}, issn = {0300-5283 (Print) 0300-5283}, year = {2002}, date = {2002-01-01}, journal = {Med J Malaysia}, volume = {57 Suppl E}, pages = {94-8}, abstract = {Rural health training is an important element in the training of medical students in the University of Malaya. There is a need for the undergraduates to be familiar with the rural health infrastructure and to understand the social and economic aspects of the rural poor. The objective of the training is to make the students understand the problems faced by the poor in the rural areas so that when they practice in rural health areas, after graduation, they will understand the problems of the rural poor. They will have the knowledge of the diseases in the rural areas and also understand the community and the environmental factors that contribute to the disease. The training lasts' for 4 weeks, one week for lectures on health survey, two weeks for the field trip and one week of data analysis and presentation of their findings to an expert panel. During the field trip the students are divided into groups and they go to different parts of the country. Each group will do a field survey to find out the socio-demography, environmental, economic, nutritional and health problems in the village. In addition to the survey they also do a research project on any topic. The students also do social work, visit places of public health interest like the water treatment plant, sewage disposal, factory visits and others. Apart from technical skills in statistics and epidemiology, various other managerial skills like leadership, teamwork, communications and public relations are also learnt during the training. In conclusion this rural health training is an important aspect of the medical students training as it imparts several skills to them that are needed as a doctor.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16090, title = {Impairment of psychomotor responses after conscious sedation in cirrhotic patients undergoing therapeutic upper GI endoscopy}, author = {A E Vasudevan and K L Goh and A M Bulgiba}, doi = {10.1111/j.1572-0241.2002.05831.x}, issn = {0002-9270 (Print) 0002-9270}, year = {2002}, date = {2002-01-01}, journal = {Am J Gastroenterol}, volume = {97}, number = {7}, pages = {1717-21}, abstract = {OBJECTIVES: The aim of this study was to determine whether the number connection test (NCT) times of a group of cirrhotic patients without clinically overt hepatic encephalopathy and a group of healthy patients without liver disease who were undergoing endoscopy were prolonged after sedation with short acting i.v. benzodiazepines. METHODS: All patients were administered the NCT in a standard fashion for 30 min before sedation for an upper GI endoscopy and then 2 h after sedation postprocedure. Two NCTs were carried out before and 2 h after sedation, and the mean of the tests pre- and postsedation calculated. Based on the upper limit of the 95% CI of the presedation NCT of patients without liver disease as the cut-off level for hepatic encephalopathy, the proportion of cirrhotic patients with subclinical encephalopathy before and after sedation were also determined. RESULTS: A total of 61 consecutive cirrhotic patients who underwent therapeutic upper GI endoscopy completed the study. The mean presedation NCT time was 43.5 s (95% CI = 39.0-48.1 s) and the mean postsedation NCT time 60.0 s (95% CI = 50.7-69.3 s). The difference between the mean pre- and postsedation NCT times was 16.4 s (95% CI = 9.8-23.1 s; p \< 0.001). A total of 38 consecutive patients without clinical or biochemical evidence of liver disease who presented for upper GI endoscopy completed the NCT as described for the group of cirrhotic patients. The mean (+/- SD) baseline NCT time was 34.7+/-7.9 s (95% CI = 32.1-37.2 s), whereas the mean postsedation NCT time was 33.7+/-8.5 s (95% CI = 30.9-36.5 s). This difference was not statistically significant (p = 0.177). Using the upper limit of the 95% CI of the mean (37.4 s) of the presedation time in the patients without liver disease as the cut-off between normal and encephalopathy, the number of cirrhotic patients with abnormal presedation NCT times was 33 patients (54.1%), and this number rose to 46 patients (75.4%) after sedation with midazolam. This increase in proportion of cirrhotic patients with prolonged NCT time was statistically significant (p \< 0.001).}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14575, title = {Breastfeeding practices among mothers in an urban polyclinic}, author = {Yadav H C K Siah and H Yadav}, issn = {0300-5283 (Print) 0300-5283}, year = {2002}, date = {2002-01-01}, journal = {Med J Malaysia}, volume = {57}, number = {2}, pages = {188-94}, abstract = {A cross sectional descriptive study on breast feeding practices in an urban clinic was conducted among 136 mothers aged between 21-49 years who were interviewed using a questionnaire. Malays constituted 61% of the respondents, Chinese 22.8% and Indians 16.2%. Mojority of these were working mothers and although the initiation of breastfeeding was high (99.3%), exclusive breastfeeding was only 12.5%. A large proportion (33.8%) dtopped prior to 3 months. Majority of the Chinese mothers (61.3%) stipped before 3 months as compared to the Indian (40.9%) and Malay (21.7%) mothers (p\<0.001). Mean age of introducing complementary foods at 3 months is below the accepted age of 4 to 6 months for weaning. Ever-breast feeding rate is high in this urban setting but more efforts are needed to effect a higher rate of exclusive breastfeeding and longer duration of breastfeeding.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14568, title = {Introduction to management: Organization and Management of Health Services (OMHS) in Malaysia}, author = {I Saimy and S N Ghani and S T Teoh}, issn = {0300-5283 (Print) 0300-5283}, year = {2002}, date = {2002-01-01}, journal = {Med J Malaysia}, volume = {57 Suppl E}, pages = {99-101}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16089, title = {The feasibility of the Golombok-Rust Inventory of Marital State (GRIMS) in assessing marital satisfaction in a Malaysian population}, author = {K F Quek and W Y Low and A H Razack and C B Chua and C S Loh}, issn = {0092-623X (Print) 0092-623x}, year = {2002}, date = {2002-01-01}, journal = {J Sex Marital Ther}, volume = {28}, number = {5}, pages = {423-6}, abstract = {The purpose of this study is to validate the English version of the Golombok-Rust Inventory of Marital State (GRIMS) in a Malaysian population. Using the test-retest method and Cronbach's alpha, we assessed reliability and internal consistency. Sensitivity to change was expressed as the effect size. Internal consistency was excellent (Cronbach's alpha value = 0.59 to 0.91) Test-retest correlation coefficient and intraclass correlation coefficient were highly significant in majority items (ICC = 0.62 and above), and there was a high degree of sensitivity and specificity. The GRIMS is suitable, reliable, valid, and sensitive to clinical change in a Malaysian population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16085, title = {The effects of treating lower urinary tract symptoms on health-related quality of life: a short-term outcome}, author = {K F Quek and C S Loh and W Y Low and A H Razack and C B Chua}, issn = {0037-5675 (Print) 0037-5675}, year = {2002}, date = {2002-01-01}, journal = {Singapore Med J}, volume = {43}, number = {8}, pages = {391-8}, abstract = {OBJECTIVES: This study examined the effects of treatment of lower urinary tract symptoms (LUTS) on the health-related quality of life (physical/functional, mental, social and global aspect), pain and prostatic symptoms. PATIENTS AND METHODS: The study consisted of 123 LUTS patients on medical treatment (alpha blockers) and 52 who underwent surgical treatment (TURP). The patients were assessed one week before and three months after medical and surgical treatment by using the Health-Related Quality of Life (HRQOL-20), the Visual Analogue Scale of Pain (VAS), the Present Pain Intensity (PPI) and the International Prostate Symptom Score (I-PSS) inventories and questionnaires. RESULTS: Prior to treatment, the surgically treated patients were found to suffer more pain, severe prostatic symptoms, bothersomeness and deterioration in health-related quality of life than the medically treated patients. Postoperatively, the surgical group showed a significant reduction and improvement in all aspects of pain, prostatic symptoms, bothersomeness and overall health-related quality of life, as compared with the medication group. The mean ages of the surgical and medical treated groups were 69.56 years (SD=7.94 years) and 64.62 years (SD=7.94 years) respectively. CONCLUSIONS: The result showed that operative procedure had significantly improved the overall health-related quality of life of LUTS patients compared to those on medical treatment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16088, title = {Seroepidemiology of toxoplasmosis among HIV-infected patients and healthy blood donors}, author = {V Nissapatorn and A Kamarulzaman and I Init and L H Tan and M Rohela and A Norliza and L L Chan and H M Latt and A K Anuar and K F Quek}, issn = {0300-5283 (Print) 0300-5283}, year = {2002}, date = {2002-01-01}, journal = {Med J Malaysia}, volume = {57}, number = {3}, pages = {304-10}, abstract = {A cross-sectional study was carried out in University of Malaya Medical Centre, Kuala Lumpur. Blood samples from 100 HIV-infected patients and 203 Healthy Blood Donors (HBD) were collected and anti-Toxoplasma antibodies were detected by using conventional ELISA. The seroprevalence of toxoplasmosis in HIV/AIDS and Healthy Blood Donors were found to be 21% and 28.1% respectively. There was no significant association between the seroprevalence of toxoplasmosis and various possible risk factors i.e. contact with cat, consumption of undercooked meat and history of blood transfusion in both groups. No significant differences between Toxoplasma seroprevalence in HIV/AIDS and Healthy Blood Donors in association with presence of single or multiple risk factors were found. The mean CD4 count among HIV/AIDS patients in this study was 202.23 cell/cumm. There was no significant association between CD4 count and seropositivity for Toxoplasma antibodies in HIV/AIDS patients.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14571, title = {Is input on Complementary and Alternative Medicine (CAM) necessary in our medical curriculum? A perspective from a survey on medical practitioners}, author = {A S Nabilla and J Safura and R Karina and H Noran and M Norizan and M Sabariah and A A Noorlaili}, issn = {0300-5283 (Print) 0300-5283}, year = {2002}, date = {2002-01-01}, journal = {Med J Malaysia}, volume = {57 Suppl E}, pages = {37-43}, abstract = {A cross-sectional study was carried out through a postal survey of a random sample of registered medical practitioners in Malaysia to explore the pursuit and practice of CAM among them. A response rate of 42% was acquired. 27.1% of the medical practitioners are currently using CAM on themselves or their own families and 22.2% actually have referred patients to CAM practitioners. Analysis showed that only 14.9% of the medical practitioners who responded were exposed to CAM during their undergraduate days. Out of 28 respondents graduated from USM, 15 (53.6%) were exposed while out of the 80 graduates of UM, only 6 (7.5%) were exposed and out of 58 respondents graduates of UKM, only 5 (8.6%) were exposed to CAM during their undergraduate teaching. These differences are statistically different (p \< 0.001). Analysis also showed that more (72.6%) medical practitioners are for having training in CAM during the medical undergraduate studies. Only 9.1% of the respondents have attended any training in CAM post graduation and 36.8% would like further training on CAM postgraduate and would pay for it. The findings illustrate the need for training in CAM in medical undergraduate education especially in this new age where alternative therapy is in demand by the consumers.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14576, title = {Anthropometry and dietary intake of type 2 diabetes patients attending an outpatient clinic}, author = {F Moy and S Rahman}, issn = {1394-035X (Print) 1394-035x}, year = {2002}, date = {2002-01-01}, journal = {Malays J Nutr}, volume = {8}, number = {1}, pages = {63-73}, abstract = {A cross sectional study on Type 2 diabetes patients seeking treatment in the Primary Health Care outpatient clinic of the University Malaya Medical Centre, Kuala Lumpur was undertaken. Two hundred and thirty-three subjects participated. They were asked questions on biodata and dietary intake using face-to-face interview techniques. Dietary intake was assessed using the 24-hour dietary recall. Anthropometric measurements including weight and height were taken and Body Mass Index (BMI) was computed to establish the extent of obesity. Of the 196 subjects, 66.8% were overweight (BMI \>/=25 kg/m2) with 15.8% obese (BMI \>/=30 kg/m2). The mean BMI of males and females were 25.9+/-4.3 kg/m2 and 27.2+/-4.7 kg/m2 respectively. The findings from the dietary survey showed that the mean energy intake of the subjects only achieved about 72% of the Recommended Daily Allowance (RDA) for Malaysia while protein intake of all subjects was adequate. The macronutreint contribution to the total calorie was consistent with the recommendation of the Malaysian Diabetic Association for a healthy diet for diabetes patients. The male subjects were found to meet the RDA requirements for all nutrients while the female subjects did not have sufficient intake of calcium, vitamin A and niacin. No consistent pattern in energy and nutrient intake was observed among different age groups. On the other hand, the Malay subjects seemed to have lower energy and all nutrient intake (except vitamin A and vitamin C) compared to the Chinese and Indian subjects. The Indian subjects seemed to have the highest intake of calcium compared to the others. Advice needs to be given to those who did not have adequate nutrient intake as well as those who need to reduce their weight.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14572, title = {Stigma in mental illness: attitudes of medical students towards mental illness}, author = {A Mas and A Hatim}, issn = {0300-5283 (Print) 0300-5283}, year = {2002}, date = {2002-01-01}, journal = {Med J Malaysia}, volume = {57}, number = {4}, pages = {433-44}, abstract = {BACKGROUND: Negative attitudes towards people with mental illness can be attributed to stigma. The objective of this study was to determine the attitudes of medical students towards mental illness by comparing those who have had contact with mental patients and those who have not. This study also assesses to what extent knowledge about mental illness can affect the students' attitude. METHODS: A vignette and two dependent measures (social distance scale and dangerousness scale) were used to assess the attitudes of medical students towards mental illness. They comprised of 108 first year and 85 final year medical students in University of Malaya, Kuala Lumpur. The first year students didn't have any prior psychiatric training. RESULTS: The final year students who had knowledge and contact (undergone 8 weeks of clinical psychiatric training) were less stigmatizing toward mentally ill patients. There were no significant differences in the attitudes towards mentally ill patient among the first year students (no knowledge) regardless they had previous contact or not. CONCLUSION: Knowledge seems to have the effect in inculcating greater tolerance of mental illness. Contact by itself is not sufficient for attitude changes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14570, title = {Critical appraisal--is there a need to train medical students how to read the literature?}, author = {R Karina and S Nooriah}, issn = {0300-5283 (Print) 0300-5283}, year = {2002}, date = {2002-01-01}, journal = {Med J Malaysia}, volume = {57 Suppl E}, pages = {78-82}, abstract = {Critical appraisal refers to the skill of reading a piece of research in a very objective and structured way. It allows for the reader to assess the quality and validity of the evidence put forward. With the emphasis on evidence-based practice in the medical profession, the ability to critically appraise the literature should be instilled into medical students. Currently, the push to encourage research shows great effort in the medical curriculum, through the incorporation of elective research programmes, by many medical institutions. But how ready are the students to even understand the research literature, let alone conduct a research? The current system throws these students into 'the deep end' of research conduct without equipping them with the tools necessary to do so. Very often this becomes a problem that snowballs through specialist training right up to the practice of medicine. The possibilities and means of introducing the skills of critical appraisal via the curriculum should be explored. In this age of self-directed and problem-based learning, a purely didactic teaching method of "how to read the literature" is surely outdated. The concept should be integrated into medical teaching, including within the implementation of the PBL system, in both the clinical and non-clinical settings, and by the introduction of the 'journal club' concept. Training of the trainers should also be considered. With the early training of critical appraisal, it can hopefully become an unconscious competence of medical graduates, who not only can produce quality research, but also able to identify quality information.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16158, title = {Medical schools in Malaysia--meeting the future}, author = {M A Jalaludin and J T Arokiasamy}, issn = {0300-5283 (Print) 0300-5283}, year = {2002}, date = {2002-01-01}, journal = {Med J Malaysia}, volume = {57 Suppl E}, pages = {3-4}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14566, title = {A profile of injuries in four villages in the Jasin District of Malacca, Malaysia}, author = {Moe Htay}, issn = {1010-5395 (Print) 1010-5395}, year = {2002}, date = {2002-01-01}, journal = {Asia Pac J Public Health}, volume = {14}, number = {2}, pages = {118-22}, abstract = {Injuries are a major public health problem in Malaysia. A cross-sectional study on the profile of injuries was conducted in four villages in the Jasin District of Malacca using a prepared questionnaire among the residents. A sample of 199 households was selected from the total of 385 by using the simple random method and personal interviews were carried out. Injuries were common (56%) among the family members within the period of one year prior to the survey. Home and residential injuries were the most common type (60.2%) followed by road traffic injuries and injuries at work place. Among the home injuries (68 cases), falls were the most common type of injuries encountered with most occurring in the evenings within the house compounds. For all types of injuries (113 cases), the majority (46.9%) preferred to seek treatment at government clinics and hospitals. Among the road injuries (29 cases), most occurred in the evenings and at nights. They were more severe in nature and some required admission to the hospital. The extremities were the most severe injuries among the home and road ones. Preventive strategies should be targeted towards the home and road injuries by environmental and behavioural changes together with community participation on injury prevention and control at district level.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14567, title = {Teaching of evidence-based medicine to medical undergraduates}, author = {A S Atiya}, issn = {0300-5283 (Print) 0300-5283}, year = {2002}, date = {2002-01-01}, journal = {Med J Malaysia}, volume = {57 Suppl E}, pages = {105-8}, abstract = {Medical practice is changing, and the foundations of the paradigm shift lie in the development in research over the last four decades. Today, it is no longer adequate to treat a patient purely on clinical experience alone without a clear demonstration of evidence based on research, particularly the use of randomised controlled clinical trials. What is thought to be an effective mode of treatment currently may not necessarily hold true by the time medical students begin his/her medical practice. As a consequence, many medical schools worldwide are increasingly promoting evidence-based medicine (EBM) teaching in their medical curriculum along with problem-based learning (PBL). Teaching of EBM requires a paradigm shift in itself, as students must possess additional skills that are not traditionally part of medical training. These include the ability to acquire the skills in 'means of answering questions' than just 'knowing the answer to questions'. This paper aims to describe what EBM is and to highlight the formative experience of the teaching of EBM at the medical undergraduate level in the University of Malaya. Challenges and opportunities towards successful adoption of evidence-based practice are discussed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN795, title = {Does Integration of Information and Communication Technology (ICT) in a Primary Health Care Clinic Improves Client’s Satisfaction?}, author = {Nora'i Mohd Said and Hamzah Abdul Ghani and Farizah Hairi}, url = {https://www.mjphm.org.my/mjphm/journals/Volume%201%20:%202001/30-38.pdf}, year = {2001}, date = {2001-01-01}, journal = {Malaysian Journal of Public Health Medicine}, volume = {1}, pages = {30-38}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14574, title = {Patient confidentiality, ethics and licensing in telemedicine}, author = {H Yadav and W Y Lin}, url = {https://www.ncbi.nlm.nih.gov/pubmed/12109246}, issn = {1010-5395 (Print) 1010-5395 (Linking)}, year = {2001}, date = {2001-01-01}, journal = {Asia Pac J Public Health}, volume = {13 Suppl}, pages = {S36-8}, abstract = {Telemedicine is fast becoming popular in many countries in the world. It has several advantages such as being cost saving and providing better access to health care in the remote areas in many parts of the world. However, it has some disadvantages as well. One of the major problems is the problem of patients' rights and confidentiality in the use of telemedicine. There are no standard guidelines and procedures in the practice of telemedicine as yet. Both the patient and the physician are unsure of the standard of practice and how to maintain confidentiality. The patient is uncertain as to how to protect her/his rights in the use of telemedicine. The issue of litigation is also unclear as to where the physician is practicing when he/she uses telemedicine. Is she/he practicing in the country where the patient is or is the physician practicing in the country of her/his origin? These issues need to be addressed urgently so that telemedicine will have standards of ethical practice and the patient's rights and confidentiality will be protected.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14573, title = {Teleprimary care in Malaysia: a tool for teleconsultation and distance learning in health care}, author = {H Yadav and W Y Lin}, url = {https://www.ncbi.nlm.nih.gov/pubmed/12109251}, issn = {1010-5395 (Print) 1010-5395 (Linking)}, year = {2001}, date = {2001-01-01}, journal = {Asia Pac J Public Health}, volume = {13 Suppl}, pages = {S58-61}, abstract = {Malaysia enjoys a comprehensive range of health services, the government being committed to the principles of universal access to high quality health care, which the Ministry of Health provides through a wide variety of nation wide network of clinics and hospitals. One of the major problems is the availability of comprehensiveness and quality of health care in remote health centres. When patients are transferred from the health centres to the hospitals for further treatment, this not only incurs inconvenience to the patients and their family but also increases the cost to the health care system. Teleprimary care is one of the tools to overcome this problem. The doctors in the remote clinics are able to discuss the problem cases through teleconsultation with the doctors and specialist in the hospitals using an audiovisual system to provide better care in the health centers without transferring the patients to the hospitals. Only the essential and needy patients are referred to the hospitals. This has not only reduced the number of patients referred to the hospitals but it has reduced the cost to the health care system. It has also provided a more comprehensive care to the patients in the health centres. The doctors in the health centers are also provided training and are also updated on the latest in medicine. This method of training has made doctors in the health centers more efficient and satisfied.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14577, title = {A study of marketing and its effect on infant feeding practices}, author = {A Suleiman}, url = {https://www.ncbi.nlm.nih.gov/pubmed/11732077}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {2001}, date = {2001-01-01}, journal = {Med J Malaysia}, volume = {56}, number = {3}, pages = {319-23}, abstract = {A baby milk market was created in the late nineteenth and early twentieth centuries and was conceived through the mutual attraction of the manufacturers and doctors. This has partly attributed to the change from breast to artificial feeding. This study was conducted to determine whether marketing had any effect on infant feeding practices. Fifty Malay mothers whose last child was aged less than five years were asked, by questionnaire and by interview, to identify whether several marketing methods influenced their decision on the selection of infant feeding practice. It was found that these mothers felt milk advertisements on television were attractive (72%), were influenced by others to buy a particular brand of formula (38.4%), were influenced by free milk samples to buy a particular brand of milk formula (65.2%) and were not influenced by their doctors on the chosen method of feeding (68%). More studies should be conducted on a bigger sample in other settings and targeting other methods of marketing to substantiate the above results. Further, similar studies among Chinese and Indian mothers are also required.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN1690, title = {Case management services for work related upper extremity disorders. Integrating workplace accommodation and problem solving}, author = {W S Shaw and M Feuerstein and A E Lincoln and V I Miller and P M Wood}, url = {https://www.ncbi.nlm.nih.gov/pubmed/11760633}, issn = {0891-0162 (Print) 0891-0162 (Linking)}, year = {2001}, date = {2001-01-01}, journal = {AAOHN J}, volume = {49}, number = {8}, pages = {378-89}, abstract = {A case manager's ability to obtain worksite accommodations and engage workers in active problem solving may improve health and return to work outcomes for clients with work related upper extremity disorders (WRUEDs). This study examines the feasibility of a 2 day training seminar to help nurse case managers identify ergonomic risk factors, provide accommodation, and conduct problem solving skills training with workers' compensation claimants recovering from WRUEDs. Eight procedural steps to this case management approach were identified, translated into a training workshop format, and conveyed to 65 randomly selected case managers. Results indicate moderate to high self ratings of confidence to perform ergonomic assessments (mean = 7.5 of 10) and to provide problem solving skills training (mean = 7.2 of 10) after the seminar. This training format was suitable to experienced case managers and generated a moderate to high level of confidence to use this case management approach.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16102, title = {Reliability and validity of the International Prostate Symptom Score in a Malaysian population}, author = {K F Quek and W Y Low and A H Razack and C S Loh}, url = {https://www.ncbi.nlm.nih.gov/pubmed/11446839}, issn = {1464-4096 (Print) 1464-4096 (Linking)}, year = {2001}, date = {2001-01-01}, journal = {BJU Int}, volume = {88}, number = {1}, pages = {21-5}, abstract = {OBJECTIVE: To validate the English version of the International Prostate Symptom Score (IPSS) in patients with and without urinary symptoms in a Malaysian population. PATIENTS AND METHODS: Validity and reliability were assessed in patients with lower urinary tract symptoms (LUTS) and in patients with no LUTS. Reliability was evaluated using the test-retest method and internal consistency using Cronbach's alpha. Sensitivity to change was expressed as the effect size in the score before and after intervention in additional patients with LUTS who underwent transurethral resection of the prostate (TURP). RESULTS: Internal consistency was excellent; there was a high degree of internal consistency for each of the seven domains and for the total score (Cronbach's alpha \> or = 0.60 and \> or = 0.79, respectively) in the populations studied. The test-retest correlation coefficient for the seven domain scores was highly significant. The intra-class correlation coefficient was high (\> or = 0.59). There was a high level of sensitivity and specificity for the effects of treatment, with a very significant change between the seven scores domains in the treated group but not in the control group. CONCLUSIONS: The IPSS is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16100, title = {Reliability and validity of the General Health Questionnaire (GHQ-12) among urological patients: a Malaysian study}, author = {K F Quek and W Y Low and A H Razack and C S Loh}, url = {https://www.ncbi.nlm.nih.gov/pubmed/11555347}, doi = {10.1046/j.1440-1819.2001.00897.x}, issn = {1323-1316 (Print) 1323-1316 (Linking)}, year = {2001}, date = {2001-01-01}, journal = {Psychiatry Clin Neurosci}, volume = {55}, number = {5}, pages = {509-13}, abstract = {This present study was undertaken to validate the English version of the General Health Questionnaire (GHQ-12) in urological patients. Validity and reliability were studied in patients with lower urinary tract symptoms (LUTS) and patients without LUTS. Reliability was evaluated using the test-retest method and internal consistency was assessed using Cronbach's alpha. Sensitivity to change was expressed as the effect size in the pre-intervention versus post-intervention score in additional patients with benign prostatic hyperplasia (BPH) who underwent transurethral resection of the prostate (TURP). Internal consistency was excellent. A high degree of internal consistency was observed for each of the 12 items with Cronbach's alpha value of 0.37-0.79, while total scores was 0.79 in the population study. Test-retest correlation coefficient for the 12 items score were highly significant. Intraclass correlation coefficient was high (0.35-0.79). It showed a high degree of sensitivity and specificity to the effects of treatment. A high degree of significant level between baseline and post-treatment scores were observed across all 12 items in the treatment cohort but not in the control group. The GHQ-12 is suitable, reliable, valid and sensitive to clinical change in urological disorders.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16098, title = {Beck Depression Inventory (BDI): a reliability and validity test in the Malaysian urological population}, author = {K F Quek and W Y Low and A H Razack and C S Loh}, url = {https://www.ncbi.nlm.nih.gov/pubmed/11732072}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {2001}, date = {2001-01-01}, journal = {Med J Malaysia}, volume = {56}, number = {3}, pages = {285-92}, abstract = {This study aimed to validate the Beck Depression Inventory (BDI) in the Malaysian urological population. Reliability and internal consistency were evaluated using the test-retest method and internal consistency was assessed using Cronbach's alpha. Responsiveness was expressed as the effect size. Internal consistency was high (Cronbach's alpha value = 0.56 to 0.87). Test-retest correlation coefficient and intraclass correlation coefficient were significant (ICC = 0.56 to 0.87) and a high degree of sensitivity and specificity. The BDI is thus a reliable and a valid instrument to be used in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16097, title = {A Malaysian Study on the reliability and validity of the Health-Related Quality of Life Questionnaire (HRQOL-20) in urological patients}, author = {K F Quek and W Y Low and A H Razack and C S Loh}, url = {https://www.ncbi.nlm.nih.gov/pubmed/11732073}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {2001}, date = {2001-01-01}, journal = {Med J Malaysia}, volume = {56}, number = {3}, pages = {293-301}, abstract = {Main objective of this study is to validate the Health-Related Quality of Life (HRQOL-20) in the Malaysian population. Reliability and internal consistency were evaluated using the test-retest method and Cronbach's alpha. Responsiveness was expressed as the effect size. Internal consistency was excellent (Cronbach's alpha value = 0.68 to 0.87). Test-retest correlation coefficients and intraclass correlation coefficient were significant (ICC = 0.58 and 0.91) as well as the high degree of sensitivity and specificity. The HRQOL-20 is a reliable, valid and sensitive to clinical changes in the Malaysian urological population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16095, title = {Quality of life assessment before and after transurethral resection of the prostate in patients with lower urinary tract symptoms}, author = {K F Quek and C S Loh and W Y Low and A H Razack}, url = {https://www.ncbi.nlm.nih.gov/pubmed/11760785}, issn = {0724-4983 (Print) 0724-4983 (Linking)}, year = {2001}, date = {2001-01-01}, journal = {World J Urol}, volume = {19}, number = {5}, pages = {358-64}, abstract = {OBJECTIVES: The aim of this study was to determine the effects of surgical treatment of lower urinary tract symptoms (LUTS) in a Malaysian population by evaluating the quality of life before and after treatment. PATIENTS AND METHODS: The study group comprised 111 LUTS patients (age 69.56 +/- 7.94 years, mean +/- SD ) who were assessed 1 week before and at 3, 6 and 12 months after treatment using the health-related quality of life (HRQOL-20) questionnaire, a visual analogue scale (VAS), the present pain intensity (PPI) scale and the international prostate symptom score (I-PSS). RESULTS: Preoperatively the patients suffered more pain, severe prostatic symptoms, impaired disease-specific quality of life and a reduction in health-related quality of life. Postoperatively the patients showed a significant reduction and improvement in pain, prostatic symptoms, and disease-specific and health-related quality of life. CONCLUSIONS: The results showed that the operative procedure significantly improved the overall quality of life of patients with LUTS.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16099, title = {Relationship between symptoms and objective measures of airway obstruction in asthmatic patients}, author = {C K Liam and C T Goh and M Isahak and K H Lim and C M Wong}, issn = {0125-877X (Print) 0125-877x}, year = {2001}, date = {2001-01-01}, journal = {Asian Pac J Allergy Immunol}, volume = {19}, number = {2}, pages = {79-83}, abstract = {The objective of this study was to determine the relationship between asthma symptoms and the degree of airway obstruction as measured by the forced expiratory volume in one second (FEV1) and peak expiratory flow rate (PEFR) in a group of 64 asthmatic patients with clinically stable disease attending a university-based urban asthma clinic. Asthma symptoms did not correlate with the degree of airway obstruction as measured by prebronchodilator PEFR (total asthma symptom score vs PEFR: r = -0.214}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16101, title = {Encouraging learning how to fish: an uphill but worthwhile battle}, author = {N M Azila and S M Sim and A S Atiya}, url = {https://www.ncbi.nlm.nih.gov/pubmed/11503543}, issn = {0304-4602 (Print) 0304-4602 (Linking)}, year = {2001}, date = {2001-01-01}, journal = {Ann Acad Med Singapore}, volume = {30}, number = {4}, pages = {375-8}, abstract = {INTRODUCTION: Encouraging teaching practices such as problem-based learning (PBL) amongst undergraduate students within a lecture-based, system-based integrated curriculum is a challenge. Students are apprehensive about developing an organised framework for acquiring knowledge while lecturers are required to reframe their views on the educational process and their role as educators. MATERIALS AND METHODS: Lecturers and students in the Phase (Year) II programme were asked to fill questionnaires following the second and fourth PBL cases. The two sets of survey responses were compared to see whether the students' and teachers' perceptions had changed over the 5-month period. RESULTS: Students' responses from both surveys (1 and 2) were similar in that a majority agreed that the PBL tutorials had encouraged the seeking of information (66% and 67%, respectively), had improved understanding (57% and 56%), integration (65% and 70%) and application (50% and 64%) of knowledge. However, the views given in the form of written comments, following their positive responses, were somewhat contradictory. A large number of students (38% and 40%) faced difficulties in getting involved in discussions during the PBL tutorial and a majority (73% and 82%) preferred the normal subject-based tutorials. The reasons given by approximately 20% of the students were that the subject-based tutorials were more efficient for obtaining information and/or that the information had been pre-selected by the lecturers. More than 80% of the lecturers (in both surveys) perceived that the students had identified the appropriate learning objectives and covered the subject matter. The percentage of lecturers who agreed that PBL tutorials encouraged rapport and teamwork amongst students had increased in the second survey, from 70% to 92% and 55% to 83% respectively. CONCLUSION: Implementing PBL is not simply a matter of developing new teaching materials and new effective ways of presenting them. It requires a paradigm shift, a change in the roles of students and teachers, and time.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN794, title = {Improving Internet Access in the UMMC - A Nadi IT Innovation}, author = {Awang Mahmud Bulgiba}, url = {https://ejournal.um.edu.my/index.php/jummec/article/view/4471}, issn = {2289-392X}, year = {2000}, date = {2000-01-01}, journal = {JUMMEC: Journal of Health and Translational Medicine (Formerly known as Journal of the University of Malaya Medical Centre)}, volume = {5}, number = {2}, pages = {93-97}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN793, title = {Home Injury in Malaysia: Finding from the 1996 NHMS}, author = {Jamaiyah Haniff and Tahir Aris and Farizah Hairi}, year = {2000}, date = {2000-01-01}, journal = {Malaysian Journal of Public Health Medicine}, volume = {1}, pages = {48-54}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16094, title = {The quality of life outcome following treatment for lower urinary tract symptoms}, author = {K F Quek and W Y Low and A H Razack and C S Loh and C B Chua}, url = {https://www.ncbi.nlm.nih.gov/pubmed/11836919}, doi = {10.1177/101053950001200210}, issn = {1010-5395 (Print) 1010-5395 (Linking)}, year = {2000}, date = {2000-01-01}, journal = {Asia Pac J Public Health}, volume = {12}, number = {2}, pages = {107-17}, abstract = {This study aims to assess the impact of medical and surgical treatment on treating lower urinary tract symptoms (LUTS) on pain, prostatic symptoms, disease-specific quality of life and health-related quality of life. Patients scheduled for medical (alpha-blockers) and surgical treatment (transurethral resection of the prostate, TURP) were recruited in the study. The patients were assessed using the Visual Analogue Scale (VAS), Present Pain Intensity (PPI), International Prostate Symptom Score (I-PSS) and Health-Related Quality of Life (HRQOL) at 3-month, 6-month and 12-month (baseline). Before treatment, most of the patients with LUTS had severe pain, LUTS and deterioration of health-related quality of life. Following treatment, both medical and surgical treatment improved their pain, LUTS and health-related quality of life. Both treatments are effective in relieving the symptoms of pain, LUTS and health-related quality of life.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16103, title = {The psychological effects of treatments for lower urinary tract symptoms}, author = {K F Quek and W Y Low and A H Razack and C S Loh}, url = {https://www.ncbi.nlm.nih.gov/pubmed/11069367}, issn = {1464-4096 (Print) 1464-4096 (Linking)}, year = {2000}, date = {2000-01-01}, journal = {BJU Int}, volume = {86}, number = {6}, pages = {630-3}, abstract = {OBJECTIVE: To assess and evaluate the level of depression, anxiety and psychiatric status in patients with lower urinary tract symptoms (LUTS) before and after treatment by surgery or drugs. PATIENTS AND METHODS: The study included 123 patients (mean age 64.6 years, SD 7. 95) with LUTS who were treated medically (with alpha-blockers, i.e. terazosin, prazosin, doxazosin and alfuzosin), and 52 patients (mean age 69.6 years, SD 7.94) with LUTS and confirmed to have benign prostatic hyperplasia (BPH) who underwent transurethral resection of the prostate (TURP). Both groups were assessed at baseline and 3 months after treatment using standardized questionnaires (the Beck Depression Inventory, the State-Trait Anxiety Inventory and the General Health Questionnaire-12). RESULTS: Patients before TURP were significantly more depressed, worried and psychiatrically morbid than were those before medical treatment. Three months after medical and surgical treatment, there was significantly less depression, anxiety and psychiatric morbidity in the TURP than in the medication group. CONCLUSIONS: TURP is a better treatment than medication for minimising anxiety, depression and psychiatric morbidity after treatment in patients with LUTS, but causes greater psychological stress before treatment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16226, title = {Developing a Website-The Department of Social Preventive Medicine Experience}, author = {Awang Bulgiba Mahmud}, issn = {2289-392X}, year = {2000}, date = {2000-01-01}, journal = {JUMMEC: Journal of Health and Translational Medicine (Formerly known as Journal of the University of Malaya Medical Centre)}, volume = {5}, number = {1}, pages = {36-40}, abstract = {In 1999, the Department of Social and Preventive Medicine set up its website on the Internet (http://jummc.med.um.edu.my/spm/). Setting up the website was a whole new experience for the author and many new things were learnt along the way. This paper describes how the website was constructed, the problems, and solutions to all these problems. The experience of the author in setting up the SPM website may be useful to others wishing to set up their own department websites.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14581, title = {The prevalence of recurrent abdominal pain in 11- to 16-year-old Malaysian schoolchildren}, author = {C Boey and S Yap and K L Goh}, url = {https://www.ncbi.nlm.nih.gov/pubmed/10760006}, issn = {1034-4810 (Print) 1034-4810 (Linking)}, year = {2000}, date = {2000-01-01}, journal = {J Paediatr Child Health}, volume = {36}, number = {2}, pages = {114-6}, abstract = {OBJECTIVE: To determine the prevalence of recurrent abdominal pain (RAP) among Malaysian school children aged from 11 to 16 years. METHODOLOGY: A preliminary cross-sectional survey in which three urban schools and three rural schools were selected randomly. Two classes were selected randomly from each year. A questionnaire was given to each child asking him or her about whether they had experienced abdominal pain occurring at least three times over a period of at least 3 months, interfering with normal daily activity. 1 Interfering with normal daily activity was defined as missing school and/or having to stop doing a routine daily activity on account of the pain. Girls whose pains were related to periods were excluded. After the forms had been completed, each child was again interviewed to ensure that Apley's criteria1 was fulfilled in cases of RAP. RESULTS: The overall prevalence of RAP among 1549 schoolchildren (764 boys; 785 girls) was 10.2% (95% confidence interval (CI), 8.8-11.8). There appeared to be a higher prevalence in rural schoolchildren (P = 0.008; odds ratio (OR) 1.58), in those with a lower family income (P \< 0.001; OR 2.02) and in children whose fathers have a lower educational attainment (P = 0.002; OR 1. 92). There were no significant differences in the prevalence of RAP among children of different sex, age, ethnic group and family size. CONCLUSION: : In spite of differences in time and culture, the overall prevalence of 10.2% found in this study is similar to that determined by Apley.1 There are significant differences in the prevalence of RAP between children from rural and urban schools, among children with different family incomes and among children whose parents have different educational backgrounds.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @mastersthesis{RN770, title = {Determinants of Treatment Defaulting among Tuberculosis Patients at the Respiratory Institute, Kuala Lumpur , Malaysia}, author = {Ahmed Osman Ahmed Ali}, year = {1999}, date = {1999-01-01}, urldate = {1999-01-01}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN769, title = {Treatment Outcome and Prognostic Predictors of Childhood Acute Myeloblastic Leukemia, University Hospital, Kuala Lumpur, Malaysia}, author = {Abdel Latif Mohamed El-Amin}, year = {1999}, date = {1999-01-01}, urldate = {1999-01-01}, address = {Kuala Lumpur}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, note = {Master of Public Health (Epidemiology)}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @article{RN14578, title = {Analysis of birth weight data from the Malaysian Family Life Survey II}, author = {A B Mahmud and A A Sallam}, url = {https://www.ncbi.nlm.nih.gov/pubmed/11195161}, doi = {10.1177/101053959901100204}, issn = {1010-5395 (Print) 1010-5395 (Linking)}, year = {1999}, date = {1999-01-01}, journal = {Asia Pac J Public Health}, volume = {11}, number = {2}, pages = {71-6}, abstract = {An analysis of birth weight was undertaken on secondary data derived from the Malaysian Family Life Survey II. A total of 1629 last singleton live birth infants was analysed with the aim of identifying from the variables available potential risk factors for low birth weight. Univariate and subsequently multivariate analyses were carried out for this purpose. The incidence of low birth weight was 11.8 percent. Race, parity and prematurity were found to be significantly associated with low birth weight after controlling of the other variables. The findings indicate that more work needs to be done to establish the underlying reasons for low birth weight in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16157, title = {Malaysia's ageing population: challenges in the new millennium}, author = {J T Arokiasamy}, url = {https://www.ncbi.nlm.nih.gov/pubmed/11072458}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1999}, date = {1999-01-01}, journal = {Med J Malaysia}, volume = {54}, number = {4}, pages = {429-32}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN778, title = {Home Injuries and Prevention among children in Batu Gajah , Malaysia}, author = {Htay Moe}, year = {1998}, date = {1998-01-01}, journal = {Journal of the Malaysian Society of Health}, volume = {16}, pages = {1-7}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14582, title = {Tobacco usage among rural Bajaus in Sabah, Malaysia}, author = {C Y Gan}, issn = {0125-1562 (Print) 0125-1562}, year = {1998}, date = {1998-01-01}, journal = {Southeast Asian J Trop Med Public Health}, volume = {29}, number = {3}, pages = {643-8}, abstract = {As part of a larger study to bring attention to smoking and smokeless tobacco use among the indigenous people of Sabah State in Malaysia, the Bajaus were interviewed in a cross-sectional survey. 74.4% of the men smoked compared to 3.3% of the women and 77% of women used smokeless tobacco compared to 4.3% of men. Local handrolled cigarettes called kirais were popular and smokeless tobacco was used as an ingredient in the ritual of betel-quid chewing. Tobacco was also used because it was thought to have medicinal effects. The prevalence of smokeless tobacco use was significantly lower among the better educated women but for smoking, education had no relation with prevalence. Both habits could be easily maintained as they were cheap practices which were socially and culturally accepted. Awareness of the adverse effects of such tobacco habits was poor and intervention programs to curb tobacco use is required.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16156, title = {Malaysia's ageing issues}, author = {J T Arokiasamy}, url = {https://www.ncbi.nlm.nih.gov/pubmed/10968084}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1997}, date = {1997-01-01}, journal = {Med J Malaysia}, volume = {52}, number = {3}, pages = {197-201}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14579, title = {Social problems and care of the elderly}, author = {J T Arokiasamy}, url = {https://www.ncbi.nlm.nih.gov/pubmed/10968091}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1997}, date = {1997-01-01}, journal = {Med J Malaysia}, volume = {52}, number = {3}, pages = {231-7}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14580, title = {The elderly in Malaysia: demographic trends}, author = {H A Karim}, url = {https://www.ncbi.nlm.nih.gov/pubmed/10968086}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1997}, date = {1997-01-01}, journal = {Med J Malaysia}, volume = {52}, number = {3}, pages = {206-12}, keywords = {}, pubstate = {published}, tppubtype = {article} } @book{RN758, title = {National House Health Expenditure Survey 1996 (NHHES96)}, author = {A A Sallam and H M Latt and Hamidah Abd Karim and S T Teoh and A S Nabilla and Raja Latifah Raja Jalalludin and Soe Nyunt-U}, year = {1996}, date = {1996-01-01}, publisher = {Department of Social and Preventive Medicine}, address = {Kuala Lumpur, Malaysia}, keywords = {}, pubstate = {published}, tppubtype = {book} } @inproceedings{RN779, title = {Epidemiology of Road Injuries In Malaysia - An Overview}, author = {Htay Moe}, year = {1996}, date = {1996-01-01}, booktitle = {International Conference on Environment And Public Health.}, pages = {35-36}, publisher = {University of Malaya}, keywords = {}, pubstate = {published}, tppubtype = {inproceedings} } @article{RN16227, title = {Factors and Behaviour Concerning Coronary Heart Disease in Urban Malaysian Workers}, author = {John T Arokiasamy}, year = {1996}, date = {1996-01-01}, journal = {Journal of the University of Malaya Medical Centre}, volume = {1}, number = {1}, pages = {33-36}, abstract = {A group of 265 urban private workers in Kuala Lumpur and adjacent Petaling Jaya responded to a self-administered questionnaires. Their knowledfe of cardio-pulmonary resuscitation, risk factors for and prevention measures against cardiovascular disease and when these should be started are relatively weak, through knowledge on symptoms of heart attack are satisfactory. Relatively more males than females are currently smokers and consumers of alcohol. Males tended to start smoking and drinking in their teen years while female tended to do so later in their non-teen years.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14583, title = {Microbial diseases in Malaysia: recent experiences}, author = {J T Arokiasamy}, url = {https://www.ncbi.nlm.nih.gov/pubmed/10967972}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1996}, date = {1996-01-01}, journal = {Med J Malaysia}, volume = {51}, number = {1}, pages = {4-11}, abstract = {Microbial diseases continue to occur in Malaysia despite the marked socio-economic development that has been taking place in the country along with improvements in the medical, health, and environmental sectors. This paper highlights the continuing presence of the numerous microbial diseases including the emergence of new problems such as AIDS. Local publications dealing with work on several microbial diseases is reviewed to show that this group of diseases will pose challenges for a long while. Undoubtedly several other diseases that were relatively unrecognised in the past are increasingly being identified owing to recent availability of diagnostic facilities and equipments. The need for continued vigilance is emphasised.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14584, title = {Smokeless tobacco use among rural Kadazan women in Sabah, Malaysia}, author = {C Y Gan}, issn = {0125-1562 (Print) 0125-1562}, year = {1995}, date = {1995-01-01}, journal = {Southeast Asian J Trop Med Public Health}, volume = {26}, number = {2}, pages = {291-6}, abstract = {A survey was conducted to document and bring attention to the use of smokeless tobacco among rural Kadazan women in Sabah, East Malaysia. Of the 472 women interviewed, 59.5% had used tobacco among the ingredients that they habitually chewed. Women with low education were more likely to be chewers. The chewing habit was usually acquired during the teenage years and the practice was perceived mainly as a cultural norm. 73.3% of these smokeless tobacco users were unaware of any adverse health effect of this type of tobacco use as compared to 53.9% of the non-tobacco users. The high prevalence of smokeless tobacco use is easily maintained as tobacco is cheap, locally produced and its use is socially accepted. The low level educational status of the women compounds the problem and intervention programs to curb this form of tobacco use is warranted.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16111, title = {Cyclospora sp causing diarrhea in man}, author = {B Sinniah and B Rajeswari and S Johari and K Ramakrishnan and S W Yusoff and M Rohela}, url = {https://www.ncbi.nlm.nih.gov/pubmed/7825021}, issn = {0125-1562 (Print) 0125-1562 (Linking)}, year = {1994}, date = {1994-01-01}, journal = {Southeast Asian J Trop Med Public Health}, volume = {25}, number = {1}, pages = {221-3}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16110, title = {Blastocystis hominis infection, a cause of human diarrhea}, author = {B Sinniah and B Rajeswari}, url = {https://www.ncbi.nlm.nih.gov/pubmed/7777913}, issn = {0125-1562 (Print) 0125-1562 (Linking)}, year = {1994}, date = {1994-01-01}, journal = {Southeast Asian J Trop Med Public Health}, volume = {25}, number = {3}, pages = {490-3}, abstract = {Blastocystis hominis has long been described as a non pathogenic protozoan parasite until recently when claims have been made that it can result in pathogenic conditions. Of the 729 stool samples (614 from survey and 115 from pediatric wards) examined, 18.1% of them were found to be positive for one or more intestinal protozoan cyst. The commonest was Giardia intestinalis (8.4%) Followed by Entamoeba coli (7.1%) and Entamoeba histolytica (5.1%) in the normal children without symptoms of diarrhea. When diarrheic stools were examined, the commonest parasite encountered was Giardia (20.4%), followed by E. coli (15.9%) and E. histolytica (9.7%). Blastocystis was observed in 4.4% of the children who had diarrhea and 1.1% among the children taken from the normal population in the rural areas.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14585, title = {Socio-economic factors associated with intestinal parasites among children living in Gombak, Malaysia}, author = {B Rajeswari and B Sinniah and H Hussein}, url = {https://www.ncbi.nlm.nih.gov/pubmed/8074940}, doi = {10.1177/101053959400700104}, issn = {1010-5395 (Print) 1010-5395 (Linking)}, year = {1994}, date = {1994-01-01}, journal = {Asia Pac J Public Health}, volume = {7}, number = {1}, pages = {21-5}, abstract = {Fecal specimens collected from 456 school children in Gombak, Malaysia, revealed an overall prevalence rate of 62.9%. The most common parasite found was Trichuris trichiura (47.1%) followed by Giardia intestinalis (14.7%), Entamoeba coli (11.4%), Entamoeba histolytica (9.9%) and Ascaris lumbricoides (7.9%). Infection rates were high among the Indonesian immigrant workers' children (90%) followed by the Orang Asli (79.5%), Malay (59.4%) and Indians (36.4%). Females (66.3%) had a higher prevalence rate than the males (58.5%). The prevalence of infection was found to be associated with the socio-economic status, water supply, sanitary disposal of feces and family size. Albendazole administered as a single dose (400 mg) was found to be effective against Ascaris (100%) and hookworm (92.3%) but was not effective against Trichuris (39.2%).}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14586, title = {Some epidemiological aspects and economic costs of injuries in Malaysia}, author = {J T Arokiasamy and R Krishnan}, url = {http://aph.sagepub.com/content/7/1/16.full.pdf}, issn = {1010-5395 (Print) 1010-5395}, year = {1994}, date = {1994-01-01}, journal = {Asia Pac J Public Health}, volume = {7}, number = {1}, pages = {16-20}, abstract = {Injuries are one of the leading causes of death in the world. In Malaysia, injuries form one of the three main causes of mortality. They are also an important cause of permanent and temporary disability and work absenteeism in the productive age group. Increasing affluence and industrialization coupled with growing population and transportation needs in rapidly developing countries like Malaysia have resulted in a surge of road and occupational injuries. Three quarters of fatalities due to road, occupational, drowning and home injuries occur in those below 45 years of age. A majority of injuries in these categories are attributed to "human" factors and therefore can be prevented by public education and enforced training of workers. The total annual economic loss due to all types of injuries is estimated to be 2 billion Malaysian Ringgit (US$1 = MR2.76 approximately). The government is currently in the process of setting up full-time departments for road safety and occupational health and safety.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16155, title = {Accidental poisoning: selected aspects of its epidemiology and prevention}, author = {J T Arokiasamy}, url = {https://www.ncbi.nlm.nih.gov/pubmed/8090087}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1994}, date = {1994-01-01}, journal = {Med J Malaysia}, volume = {49}, number = {2}, pages = {109-12}, keywords = {}, pubstate = {published}, tppubtype = {article} } @inproceedings{RN776, title = {Knowledge and Attitude about AIDS and Drug Addiction among villagers in Tumpat District, Kelantan , Malaysia}, author = {H Moe and J T Arokiasamy}, editor = {B Sinniah}, year = {1994}, date = {1994-01-01}, booktitle = {The First Congress of Parasitology and Tropical Medicine}, pages = {197-204}, publisher = {Malaysian Society of Parasitology and Tropical Medicine.}, keywords = {}, pubstate = {published}, tppubtype = {inproceedings} } @article{RN16114, title = {Strategy for child immunization in Malaysian plantations}, author = {D Sinniah and B Rajeswari and F Harun and C R Maniam}, url = {https://www.ncbi.nlm.nih.gov/pubmed/7945748}, issn = {0251-2432 (Print) 0251-2432 (Linking)}, year = {1994}, date = {1994-01-01}, journal = {World Health Forum}, volume = {15}, number = {3}, pages = {236-7}, abstract = {An outline is given of a simple cost-effective strategy aimed at the immunization of all children and pregnant women residing in the plantation sector of Malaysia. It is based on a partnership between government, nongovernmental organizations and the private sector, and is supported by UNICEF. A cost-effective strategy aimed at the immunization of all children and pregnant women residing in the plantation sector of Malaysia is outlined. It is based on a partnership between government, nongovernmental organizations and the private sector, and is supported by UNICEF. Over a million people reside on the Malaysian plantation estates: only 17% of the estates have their own hospitals; immunization services exist on only 1.5%; 40% of the estates are at least 5 kilometers from the nearest government health facility; and 64% lack transport for workers and their dependents to seek care away from the plantations. Two nongovernmental organizations, the Malaysian Paediatric Association and the Malaysian Society of Health, initiated discussions with the United Planting Association of Malaysia. A pilot study was undertaken by the groups on 6 estates in Selangor State, which included all the children at their first birthday. Tuberculosis, diphtheria/pertussis/tetanus, poliomyelitis, and measles immunization coverages were 88%, 44%, 59%, and 66%, respectively. The association of plantations accepted the organizations' proposals for all estates to: register all births; provide free transportation to government health clinics for the immunization of all eligible children and pregnant women; and enforce immunization schedules and record-keeping. The Ministry of Health agreed to provide free immunization of children and pregnant women; send mobile teams to estates that could assemble 20 or more eligible people for immunization; provide the estates with educational materials dealing with immunization; arrange that the maintenance of the cold chain be supervised by local medical officers of health; consider the training of estate hospital assistants with the help of the nongovernmental organizations. The total immunization plan was launched in September 1990. A manual was distributed to the estate managers, hospital assistants on the estates, and the medical officers who would implement and monitor the program. It is expected that total child immunization will be achieved in the foreseeable future in the estate sector. eng}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14655, title = {Prevalence of sexually transmitted diseases among female drug abusers in Malaysia}, author = {A R Isa and H Moe and S Sivakumaran}, issn = {0300-5283 (Print) 0300-5283}, year = {1993}, date = {1993-01-01}, journal = {Med J Malaysia}, volume = {48}, number = {2}, pages = {124-8}, abstract = {The prevalence of sexually transmitted diseases (STD) among female drug abusers was determined by screening 130 new inmates of a rehabilitation centre. The majority of the subjects (77.7%) were self-confessed sex workers. A high prevalence of syphilis (50.8%), hepatitis B (52.2%), moniliasis (23.8%) and trichomoniasis (19.2%) were noted. Gonorrhoea vaginitis was seen in 8.5%, which was low compared to previous studies. Six subjects were seropositive for human immunodeficiency virus (HIV), with 5 of them admitting to needle sharing and working as prostitutes. More than half of them harboured 2 or more STD. A rich reservoir of STD was seen among the drug abusers. With more evidence now available concerning the ease of HIV transmission associated with ulcerative STD, a stage could be set for greater heterosexual HIV transmission. As part of the rehabilitation process, female drug abusers need a thorough screening for STD followed by aggressive treatment regimens. PIP: Drug users may be considered to be at high risk for having sexually transmitted diseases (STD). The government of Malaysia has therefore established facilities in which they incarcerate and attempt to rehabilitate such individuals. 5472 drug users had been imprisoned in the country's fourteen facilities by the end of 1991. Since 97.8% of drug users in Malaysia are male, only on facility exists for female users. The authors determined and report the prevalence of STDs among 130 new female resident drug users at the facility. The women were admitted over the period May 1989-July 1991, and 104 were IV-drug users. They were aged 18-44 years, with 87.7% in the 20-40-year range. Further, 77.7% were sex workers and 13.1% were salaried workers in other fields. 50.8% had syphilis, 52.2% hepatitis B, 23.8% moniliasis, 19.2% trichomoniasis, and 8.5% gonorrhea vaginitis. 6 were HIV-seropositive, of whom 5 admitted to needle sharing and prostitution. More than half of the women were infected with 2 or more STDs. STDs were not found in 14.6% of subjects, however, even though 10 acknowledged being sex workers. Given the high prevalence of STDs in this population and the ease of HIV transmission with ulcerative STDs, the authors recommend that incarcerated female drug users be routinely screened and treated for STDs as part of their rehabilitation program. eng}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14588, title = {Utilization of maternal and child health facilities by the urban poor of Kuala Lumpur}, author = {C Y Gan and K Yusof}, url = {https://www.ncbi.nlm.nih.gov/pubmed/8266233}, issn = {0125-1562 (Print) 0125-1562 (Linking)}, year = {1993}, date = {1993-01-01}, journal = {Southeast Asian J Trop Med Public Health}, volume = {24}, number = {2}, pages = {302-6}, abstract = {A survey conducted to assess the extent which the urban poor in rapidly expanding Kuala Lumpur utilize maternal and child health services available to them. The sample consisted of 1,380 households with children below 6 years and yielded 1,233 children below 6 years of age. 74% of the children had been delivered in government hospitals and 86% of the pregnancies had antenatal care in governmental establishments. 89.2% had BCG immunization before they were 1 year old but 13.3% had not received DPT by that age. Immunization was mainly done in government clinics. The overall immunization coverage for the whole of Kuala Lumpur is expected to be higher than these figures limited to the urban poor. Health planners should increase health facilities in the city to accommodate the expanding population. There is a need to continually campaign for immunization to improve coverage among the urban poor.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14589, title = {Nutritional status of Kadazan children in a rural district in Sabah, Malaysia}, author = {C Y Gan and B Chin and S T Teoh and M K Chan}, url = {https://www.ncbi.nlm.nih.gov/pubmed/8266232}, issn = {0125-1562 (Print) 0125-1562 (Linking)}, year = {1993}, date = {1993-01-01}, journal = {Southeast Asian J Trop Med Public Health}, volume = {24}, number = {2}, pages = {293-301}, abstract = {The nutritional status of 896 Kadazan children below 6 years of age from 23 villages of Tambunan District were studied. When stunting and wasting were defined as those who were below two standard deviations of height-for-age and weight-for-height (Waterlow et al, 1977) and based on the National Center for Health Statistics reference population, 67.6% of boys and 66.8% of girls were stunted while 12.3% of boys and 8.3% of girls were wasted. Weaning foods and toddler feeding practices were unsatisfactory. The role of health education on child care and feeding practices is emphasized.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14587, title = {A blood pressure profile of rural Kadazans and Bajaus in Sabah, east Malaysia}, author = {C Y Gan and M K Chan}, url = {https://www.ncbi.nlm.nih.gov/pubmed/8160073}, issn = {0125-1562 (Print) 0125-1562 (Linking)}, year = {1993}, date = {1993-01-01}, journal = {Southeast Asian J Trop Med Public Health}, volume = {24}, number = {3}, pages = {583-9}, abstract = {A survey was conducted to document the blood pressures of two indigenous groups (Kadazans and Bajaus) who reside in rural Sabah in East Malaysia. Their health knowledge status is also recorded. Fifty percent of those surveyed were unable to associate high blood pressure with a risk factor and as high as 38% were unaware of the consequences of high blood pressure. A total of 16.2% had blood pressures \> or = 140/or 90mm Hg while 3.9% had blood pressures \> or = 160/or 95mm Hg. While these figures are low compared to those of developed countries, lifestyle changes associated with rapid urbanization in Malaysia may be expected to increase hypertension prevalence. The strengthening of health education programs is timely as health knowledge is limited and many hypertensives default treatment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @mastersthesis{RN125c, title = {A study of the knowledge and attitudes towards Acquired Immune Deficiency Syndrome (AIDS) among upper secondary school students in the district of Limbang, Sarawak. (6.4.82-18.4.92)}, author = {Hajl Muhi Haji Jamail}, year = {1993}, date = {1993-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN137c, title = {A study of two cholera epidemics in the district of Tawau, Sabah (1989-1991)}, author = {Soo Beng Alan Khoo}, year = {1993}, date = {1993-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN138b, title = {A study of the knowledge, attitudes and practices towards Acquired Immune Deficiency Syndrome (AIDS) among electronic factory workers in the Prai Industrial Free Trade Zone in Penang}, author = {Ramly Rushidi}, year = {1993}, date = {1993-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN139g, title = {Three year review of all registered diabetic patients and the study of knowledge and practice of 255 diabetic attendees of the diabetic clinic in General Hospital, Kelang 1992}, author = {Ganason Thavamalaar}, year = {1993}, date = {1993-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN133b, title = {An explanatory study on some aspects of diarrhoeal disease in the Mukah District, Sarawak}, author = {Balan K Venugopalan}, year = {1993}, date = {1993-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @article{RN16224, title = {Epidemiology of dengue/dengue hemorrhagic fever in Malaysia--a retrospective epidemiological study 1973-1987. Part I: Dengue hemorrhagic fever (DHF)}, author = {K C Shekhar and O L Huat}, url = {https://www.ncbi.nlm.nih.gov/pubmed/1308765}, doi = {10.1177/101053959300600203}, issn = {1010-5395 (Print) 1010-5395 (Linking)}, year = {1992}, date = {1992-01-01}, journal = {Asia Pac J Public Health}, volume = {6}, number = {2}, pages = {15-25}, abstract = {Dengue hemorrhagic fever (DHF), though endemic in the sixties, emerged as a major public health problem in Malaysia from 1973 onwards. The incidence rate of DHF which was 10.1 per 100,000 in 1973 has fallen down to 1.9 per 100,000 in 1987 with a mean case fatality rate of 6.4 per 100 persons. The Chinese appear to be more prone to DHF with the highest mean morbidity rate of 5.5 per 100,000 and case fatality rate of 6.1%. The incidence of DHF is higher in the males with a higher case fatality rate in females. Male Chinese appear to be mainly affected. The overall age-specific incidence rate is highest in two age groups, viz. 5-9 years and 10-19 years of age with a mean morbidity rate of 4.9 cases per 100,000. The mean age-specific case fatality rate was highest in the 0-4 years age group. Dengue hemorrhagic fever is predominantly an urban disease in Malaysia with a mean incidence rate of 5.3 cases per 100,000 as opposed to 1.2 cases per 100,000 being reported from rural areas. The mean overall incidence of deaths in the urban area is 0.5 compared to 0.1 per 100,000 for rural areas. There is a marked seasonal correlation between DHF cases and rainfall, with a peak in August. While all four serotypes of dengue viruses are found in Malaysia, Den 2 appears to be isolated with greater frequency during all the epidemics.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16159, title = {Trends and dietary implications of some chronic non-communicable diseases in peninsular Malaysia}, author = {G L Khor and C Y Gan}, url = {https://www.ncbi.nlm.nih.gov/pubmed/24323170}, issn = {0964-7058 (Print) 0964-7058 (Linking)}, year = {1992}, date = {1992-01-01}, journal = {Asia Pac J Clin Nutr}, volume = {1}, number = {3}, pages = {159-68}, abstract = {Non-communicable diseases with dietary implications, ischaemic heart disease, diabetes mellitus and cancers of the breast and colon are discussed in relation to their prevalence and mortality rates in peninsular Malaysia during the past few decades. The mortality rate due to diseases of the circulatory system has more than doubled since 1970, deaths due to ischaemic heart disease being the major cause. The prevalence of diabetes mellitus has risen from 0.65% in 1960 to about 4% currently. The mortality risk for both ischaemic heart disease and diabetes is highest in the Indian compared to Malay and Chinese populations. The Chinese show the highest mortality rate for cancers of the breast and colon. This could reflect, partly, because more people especially in the urban areas are seeking treatment and improved diagnosis. Empirical dietary data indicate an increase in the prevalence of hypercholesterolaemia among urban adults and overweight among urban and rural adults. Aggregate data from food balance sheets indicate increased availability of energy intake from fats and oils, sugar, and animal products, with concomitant decline in available energy from plant products. Continued public health education on the important linkage between diet and disease is called for.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16229, title = {Promoting Child Survival in Rural Districts in East Malaysia}, author = {Chong-Ying Gan}, issn = {0917-5040}, year = {1992}, date = {1992-01-01}, journal = {Journal of Epidemiology}, volume = {2}, number = {2sup}, pages = {229-232}, abstract = {In developing countries, local health authorities do improve health care delivery system based on the results from the studies conducted by the Institutes and Universities. This paper is to introduce an example of such project in East Malaysia. Project to promote child survival has been carrying out for one rural district in Sabah, East Malaysia. The phase I study is collection of baseline data or situational analysis, Phase II is intervention program (health education) and Phase III is evaluation of the intervention program. In Phase I study, five categories of variable for determinants of child survival were socioeconomic determinants, maternal factors, environmental factors, nutritional factors and health service utilization factors. Based on the findings from Phase I study, a number of intervention programs are now being implemented.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16225, title = {Self-reliance in health among village women}, author = {Mee Lian Wong and Paul CY Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/1859597}, year = {1991}, date = {1991-01-01}, journal = {World Health Forum}, volume = {12}, number = {1}, pages = {43-8}, abstract = {A project in a remote region in Sarawak, Malaysia, in which village women were mobilized to plan and implement a kindergarten and child feeding program, illustrates the potential of carefully conceptualized community participation. Permission was obtained from village elders to train 18 mothers (all of whom has at least 4 years of education) to conduct a community needs survey. III health among children emerged as the problem of greatest concern to villagers and a health committee was formed to plan an intervention. Although a team of outside professionals was available for technical support, the emphasis from he onset was on developing self-reliance and community involvement in all decisions. To build confidence and develop leadership, a month-long participatory training course in promotive health care was organized by village health volunteers. Preparation for the project included conversion of an unused hut into a kindergarten and construction of furniture by village men, registration of preschool children, preparation of educational materials, and organization of a kitchen and duty roster for the feeding program. Project funding came from local bake sales and kindergarten subscriptions. Monitoring during the initial phase identified several problems, such as food shortages brought about by drought, some parents' inability to pay for kindergarten services, and a lack of trust in the teacher's abilities. These problems were corrected by the field team, but subsequent supervisory visits focused on teaching problem-solving skills to the local women. An evaluation conducted 1 year after program implementation revealed dramatic increases in the proportion of households producing fruits and vegetables, a higher percentage of breastfeeding mothers, and improvements in weight-for-age among kindergartners.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14654, title = {Fireworks related injuries during Hari Raya festival in Hospital Universiti Sains Malaysia--1986 to 1990}, author = {A R Isa and H Moe}, url = {https://www.ncbi.nlm.nih.gov/pubmed/1840441}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1991}, date = {1991-01-01}, journal = {Med J Malaysia}, volume = {46}, number = {4}, pages = {333-7}, abstract = {A total of 38 cases of fireworks related injuries from Hospital USM over a 5-year period from 1986 to 1990 during Hari Raya festival were analysed. The majority (68.5%) of the patients were teenagers, between 10 to 19 years of age. All the cases were Malays and most of the accidents occurred before the Hari Raya Idilfitri festive seasons. Fourteen cases were caused by self-made fireworks and another 16 cases were due to modified fire-works. Twenty-four cases suffered permanent disabilities mostly finger amputations. Such injuries could be prevented by law enforcement coupled with public health education to modify social behaviour especially when the ban against the use of fireworks is lifted on religious grounds.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14590, title = {Hepatitis B infection among Chinese STD patients in Kuala Lumpur, Malaysia}, author = {C Y Gan and S F Yap and Y F Ngeow and H C Wong}, issn = {0148-5717 (Print) 0148-5717}, year = {1991}, date = {1991-01-01}, journal = {Sex Transm Dis}, volume = {18}, number = {2}, pages = {84-8}, abstract = {This study documents the prevalence of Hepatitis B serological markers among STD patients who have had multiple sexual partners in Kuala Lumpur, Malaysia, and compares the rates with those of a sample of the population with single or no sexual partners. A total of 336 Chinese STD patients (multiple partners group) and 234 Chinese control subjects (non-multiple partner group) were screened. Those with a history of blood transfusion or parenteral drug abuse had been excluded from the study, and all study subjects were heterosexuals. The overall carrier rate was 9.2% for the multiple partner group (MP group) and 6.8% for the non-multiple partner group (NMP group). Infection rates were 64.3% for the MP-group and 38.9% for the NMP group. After adjustments for age and sex, there was no significant difference in carrier rates between the two groups, but infection rates were significantly different with the MP group, being 3.2 times more likely to acquire infection than the NMP group. The study concludes that in heterosexuals, those with multiple sexual partners have increased chances of acquiring HBV infection.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @mastersthesis{RN119b, title = {The outpatient service utilisation pattern of Rumah Suring, Sarawak before and after the interaction of village health representative}, author = {Mansoor Faisal}, year = {1991}, date = {1991-01-01}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @article{RN777, title = {Fireworks-Related Injuries During Hari Raya Festival Among Children in Kelantan}, author = {A M Wan Nik and Htay Moe}, year = {1991}, date = {1991-01-01}, journal = {Malaysian Journal of Child Health}, volume = {58}, number = {Suppl}, pages = {152-162}, keywords = {}, pubstate = {published}, tppubtype = {article} } @mastersthesis{RN105b, title = {A review of notified cases of dengue and dengue haemorrhagic fever in Kuala Lumpur (1985-1990)}, author = {Ismail Raman}, year = {1991}, date = {1991-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Method: review the epidemiological aspects of dengue since the year 1985 to 1990 with more variables described for the year 1990 because of the availability of data. For this purpose, dengue notification and investigation were studied and analysed from the vector control unit, Health Department City Hall, Kuala Lumpur. A total of 1992 cases of dengue notified in Kuala Lumpur from 1985 to 1990. Dengue is endemic in Kuala Lumpur with the mean incidence rate of 28.09 cases per 100,000 population and case fatality rate was 1.19%. Result: Dengue was notified in all Health Zones in Kuala Lumpur with the Bandar Tun Razak Zone having the highest percentage that was 22.04 of all dengue cases in Kuala Lumpur from the year 1985 to 1990. The 20 - 24 years age group has the highest percentage of dengue for the six years period. The ratio of male to female was 1.17 : 1. The incidence of dengue was the highest among Chinese 64.39%, followed by the Malay 31.04%, Indian 3.18%, then other races 1.39%. Dengue fever seems to be the commonest type of dengue compared to the other two types namely, DHF and DSS. There was an obvious declining of DHF cases from the year 1985 to 1990. The aetiological result of dengue cases from 1985 to 1990 was based on HI method. Because of 2 blood samples required to get result, therefore many patients did not come back to give the second blood sample that resulted small percentage of positive cases and bigger percentage of unknown. People staying in the urban residential houses seems to have higher chances of having dengue. In the 1990 figure, it was shown that 57% of dengue cases were from urban houses followed by semideveloped area 22%, flats 12% and squatters 10%. School children has the highest incidence that was 256 cases last year (1990). Professional has the least, i.e. 9 cases. The main clinical presentations of dengue are fever 100%, petechiae 24%, ache and pain 22% and frank bleeding 4.9%. There is a definite seasonal pattern with vector density. The number of positive-containers increases whenever the rainfall was heavy. However the number of cases were less when the vector density was high and when the rainfall was heavy. The number of cases occurred more during the dry months such as July, August and September.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN106b, title = {A study of risk behaviors for HIV infection among drug abusers seen at the drug ward in General Hospital, Kota Bharu, Kelantan}, author = {Parim Singh Ranjit Kaur}, year = {1991}, date = {1991-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Method: A study of the risk factors for HIV infection among the drug abusers was carried out at the Drug Detection and Detoxification Ward at the General Hospital, Kota Bharu, from 10th December 1990 to 7th January 1991 comparing the IVDUs and non-IVDUs. In this descriptive study, all the subjects seen in the ward during this period were interviewed whether they were admitted to the ward or seen on an outpatient basis. Altogether 140 subjects were interviewed, using a pretested questionnaire as a study instrument. Six of the subjects were excluded from the analysis as they denied drug abuse. Of the 13 subjects, 57.5% were IVDUs and 42.5% were non - IVDUS. Result: About three-quarter (72.4 %) of the subjects were from the border towns that also had a greater proportion of the intravenous abusers. IVDUs belonged to the older age group as compared to the non-IVDUs. A higher proportion of the IVDUs was also married. Both the groups were mostly educated up to the secondary level but there was a greater proportion of employed IVDUs as compared to non-IVDUs. The subjects were generally from the lower socioeconomic group. There were twenty-four subjects (17.9 %) who were HIV infected, twenty-two of whom were IVDUs. The other two were non-IVDUs but had a history of high risk sexual activity. None of the subjects admitted to any homosexual relationships. Of the heterosexuals, 67% had risk sexual contact with prostitutes and acquaintances and two thirds of them were IVDUs. More than 809'o of the heterosexuals did not use condoms, a greater proportion of whom were IVDUs . There were more IVDUs who were HIV positive with respect to high risk sexual activity as compared to non-IVDUs. The drug most commonly abused was morphine and most of the subjects maintained their habit with their earnings. The drug supply was either obtained from dealers or through friends. The duration of intravenous drug abuse varied from one month to ten years. About sevent-four percent of the IVDUs had been doing so over the last four years since when AIDS was first reported here Twenty-two percent had began intravenous use less than six months before the interview. Three-quarters of the IVDUs shared needles and syringes mainly because of inavailability and none of them cleaned or sterilised their injecting equipment before use . The number of partners sharing injecting equipment varied from one to fifty. Of the eighty-one subjects who had other risk factors of sharing razors, toothbrushes, tatooing or blood transfusion, seventeen (21 %) were positive for HIV and posed a threat to the individuals sharing these articles with them. Eighty-nine (66.4%) of the subjects were aware of AIDS. A majority of whom were IVDUs and sharing injecting equipment of whom eighteen were HIV positive. None of the heterosexual who indulged in risk sexual activity and were aware of AIDS had changed their sexual behaviour in any way. Conclusion: Recommendations of this study are limited to the Drug Detection and Detoxication Ward in General Hospital, Kota Bharu, Kelantan . More importantly this study provides a framework for more detailed investigations.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN118c, title = {A study of various factors that influence nutritional status of orang Asli children in selected villages in Tapah, in the district of Batang Padang, Perak Darul Ridzuan}, author = {Syed Amran Syed Mud Puah}, year = {1991}, date = {1991-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @article{RN16154, title = {Communicable diseases: a continuing threat in Malaysia}, author = {J T Arokiasamy}, url = {https://www.ncbi.nlm.nih.gov/pubmed/2152078}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1990}, date = {1990-01-01}, journal = {Med J Malaysia}, volume = {45}, number = {3}, pages = {181-6}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14592, title = {Nutritional problems of Malaysian children and approaches taken to overcome them}, author = {J T Arokiasamy}, url = {http://aph.sagepub.com/content/4/1/65.full.pdf}, issn = {1010-5395 (Print) 1010-5395}, year = {1990}, date = {1990-01-01}, journal = {Asia Pac J Public Health}, volume = {4}, number = {1}, pages = {65-71}, abstract = {Nutritional status of children is an important factor in child survival, especially in developing countries. It is therefore important that nutritional problems are addressed and overcome. This paper reviews the many studies conducted in Malaysia on nutritional problems among children. It also documents the approaches, including intersectoral approaches, that have been taken to overcome these problems. Possible actions that have to be taken in the future to further improve the nutritional status of Malaysian children are discussed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14591, title = {Industrialization and urbanization--the impact on health: the experience of Peninsular Malaysia}, author = {J T Arokiasamy}, url = {https://www.ncbi.nlm.nih.gov/pubmed/2130092}, issn = {0300-8134 (Print) 0300-8134 (Linking)}, year = {1990}, date = {1990-01-01}, journal = {J Hum Ergol (Tokyo)}, volume = {19}, number = {2}, pages = {201-12}, keywords = {}, pubstate = {published}, tppubtype = {article} } @mastersthesis{RN93b, title = {A study of knowledge, attitudes and practices on typhoid among secondary school students in Tumpat district, Kelantan}, author = {Haji Ismail Ab Azizal Safi}, year = {1990}, date = {1990-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN87k, title = {A study on some aspects of the epidemiology of the sezually transmitted diseases in Malaysia from July 1986 to December 1986}, author = {Lingam Arumugam}, year = {1990}, date = {1990-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: The aim of the study is to assess the epidemiological profile of STDs in Malaysia, with regards to disease incidence, sociodemography characteristics and treatment seeking behaviour. Introduction (if necessary): A total of 4454 STD cases were reported during the six months period from lst July, 1986 to 31st December, 1986. Peninsular Malaysia, Sabah and Sarawak reported 70.5%, 17.1% and 10.5% of the cases respectively. The Federal Territory of Kuala Lumpur alone accounted for 32.7% of the cases. The results showed that the incidence of STDs in 1986 for Malaysia was 54.2/100,000 population. It was 46.2, 116.6, 60.4 per 100,000 population respectively, in Peninsular Malaysia, Sabah and Sarawak. Result: The commonest STD was gonorrhoea accounting for 65.5% of the cases, followed by syphilis (15.1%), NSU (9.7%), genital herpes (2.7%), chancroid (1.5%) and mixed infections (4.7%T. The results showed that the incidence of the various STDs in Malaysia in 1986 was 37.0, 8.5, 6.7, 2.0, 0.8 and 0.5 per 100,000 population for gonorrhoea, syphilis, NSU, genital. herpes, chancroid and venereal warts respectively. The incidence of gonorrhoea in Peninsular Malaysia, Sabah and Sarawak were 28.2, 101.1 and 50.3 per 100,000 population respectively, Sabah having 4 times the national rate and Sarawak slightly less than twice. The laboratory confirmed cases of PPNG in the Social and Hygiene Clinics in Kuala Lumpur, Penang, and the Skin Department of the General Hospital of Seremban were 11.7%, 7.5% and 61% respectively. The incidence of syphilis was 9.1, 4.1 and 6.9 per 100,000 population in Peninsular Malaysia, Sabah and Sarawak. At least 61% of the cases were infectious. The incidence of NSU was 9.5, 6.9, and 1.7 per 100,000 population respectively in Sabah. Peninsular Mal aysia and Sarawak. The male:female ratio was greater than 7.4:1 in all the types of STDs except for syphilis where the ratio was 2.5:1. In Peninsular Malaysia, the incidence of STDs was found to be highest among the Indians (81.6/100,000) followed by the Chinese (33.9/100,000) and Malays (27.5/100,000). Most of the cases were found among the 25-29 year old males (28.9%) and in the 20-24 year old among the females (28.4%). The study showed that 65% of the males and 68.9% of the infected females come from the 20-34 year age group. Among the males the incidence was highest among the labourers (17.7%) and sales personnels (12.4%). Among the females the incidence was highest among the housewife (53.2%) and prostitute (15.0%). The results showed 53.9% and 75% of the males and females were exposed to STD infection for the first time respectively. Four or more episodes of STD infections were reported in 8.6% of males and 6.8% of female patients. Prostitutes and spouses were the main source of infection in the males (82.3%) and females (63.3%) respectively. The infection was acquired in 79% of the cases from within Malaysia, 12.6% from Thailand and the rest mainly from the other South East Asian countries. The government and private sector treated 53.2% and 46.2% of the reported cases respectively. 40.5% were treated clinically while 58.8% were confirmed by laboratory methods. In the treatment of gonorrhoea, in both the PPNG and non PPNG strains, Kanamycin was widely used (54.9% and 46.5% respectively). For the treatment of syphilis and chancroid, Penicillin was used in 74.7% and Tetracycline group in 77.6% of the cases respectively. In NSU 84.4% were treated with the Tetracycline group of drugs. Only 59.7% of the patients responded well to treatment while in 31.1% the response to treatment was not known. In non gonococcal urithritis, gonorrhoea, syphilis and chancroid good clinical response to treatment was seen in 86.1%, 69.5%, 38.9% and 31.9% of the cases respectively. 83.3% of the patient received health education. In 19.3% of the cases contact tracing was undertaken.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN88k, title = {Nutritional assessment of primary schoolchildren in Kemaman district, Trengganu Darul Iman}, author = {Abdullah Che Mohd Shabri}, year = {1990}, date = {1990-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: This study aims to assess the nutritional characteristics of primary schoolchildren in a rural setting. Method: A total of 482 standard-six schoolchildren in Kemaman District, Terengganu Darul Iman were studied. All of them were from ten primary schools that had been selected randomly from 34 primary schools in the district. About 78% of them were Malays and the rest were Chinese. Information on the aetiological factors were collected using guided questionnaires. Their weights were measured by a SECA platform beam balance and their heights by a microtoise. Harvard Standards were used as a standard of reference. Result: The results show that malnutrition is still a problem in the district. The Malay students had a higher percentage of malnutrition (75%) compared to the Chinese (46.7%). About two thirds of the malnutrition in both ethnic groups was due to past malnutrition. Among the Malay students, household size, live sibling, educational status of parents and income per capita seem to have an effect on the prevalence of wasting. Whereas for the Chinese students, the relationship between the various socioeconomic characteristics and wasting was not so clear cut. In terms of environmental sanitation, more of the Chinese students had access to safe water supply than the Malay. A larger percentage of the Chinese students consumed vegetables and fruits frequently and had breakfast at home than the Malays. More of the Malay students spent their pocket money on junk food, said that they practiced food taboos during illness, avoided a larger number of foods during illness and gave more reasons for the practice as compared to the Chinese.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN83k, title = {A study of paediatric outpatients and inpatients at Sungei petani district hospital Kedah}, author = {Ebenezer Chelladurai}, year = {1990}, date = {1990-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN82l, title = {Assessment of the knowledge and attitude of AIDS among secondary school students in the municipality of Petaling Jaya}, author = {Chee Kheong Chong}, year = {1990}, date = {1990-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN77q, title = {A study of knowledge attitude and practice towards Hepatitis B amongst mothers attending maternal and child health clinics in Kuala Lumpur}, author = {Sarmisda Devi}, year = {1990}, date = {1990-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: The study aims to obtain a profile of mothers attending maternal and child health clinics in Kuala Lumpur, with regards to their knowledge, attitude and practice towards Hepatitis B. Method: This is a descriptive cross-sectional study carried out at the maternal and child health clinics in the Federal Territory. A pretested questionnaire was used to interview the mothers. The study population consisted of 300 mothers of which 170 (57%) were Malays followed by 90 (30%) Chinese and 30 (13%) Indians. Result: This study shows that a large percentage of mothers did not have knowledge on the disease. Only a small number had some knowledge on the cause, signs and symptoms, spread and carriers. A larger number (70%) had knowledge on the seriousness of the disease. On the other hand, just more than half of the respondents had good knowledge on the immunisation process. Among the 3 different ethnic groups, the Chinese respondent mothers had a better knowledge of the disease and on immunisation against the disease. The Malay respondent mothers had poor knowledge on the disease but their knowledge on immunisation against the disease was satisfactory. The Indian mothers had poor knowledge on the disease and just half of them had knowledge on immunisation against the disease. The mothers appeared to have a positive attitude towards the disease. The practice of the Chinese was better when compared to that of the Malay and Indian mothers. The Chinese respondent mothers had better knowledge on the disease and on immunisation because it may not be wrong to say that they were the group at the higher risk than the other races. They may have been aware of this fact, hence more receptive to information on the disease. Conclusion: Majority of the respondents had been exposed to health education. In spite of that, their knowledge on disease was not satisfactory. This could likely be due to the fact that health education on the disease was not emphasised; emphasis was on immunisation against the disease. This is not surprising as the objective of the Ministry of Health was to get maximum coverage an the immunisation of infants. Immunisation is the only way of preventing the spread of the disease. Therefore, health education should emphasize on the importance of immunisation as well as on the disease entity. This should promote better understanding and change in behaviour.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN79r, title = {Certain morbidity experiences among a sample of recruits of Batch 119/89 at the Army Recruit Training Centre, Port Dickson: July-December 1989}, author = {Mohamad Dinon}, year = {1990}, date = {1990-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN76l, title = {Socio-cultural factors influencing the utilization of maternal and child health services among the orang Asli in resettlement areas, Bentong district, Pahang Darul Makmur}, author = {Mohd Taibi Hj Muhd Khairi}, year = {1990}, date = {1990-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN81q, title = {Survey of measles knowledge, attitudes and practices among mothers in Kulim district Kedah Darulaman 1989}, author = {Ahmad Jamaluddin}, year = {1990}, date = {1990-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: The study aims to assess the knowledge, attitudes and practice of mothers towards measles and measles immunisation. Method: This is a cross-sectional survey on one aspect out of the multiple factors that could account for the low coverage of measles immunisation in Kulim district, Kedah. The aspect chosen was the knowledge, attitudes and practices among the mothers residing in the district. The survey was carried out by selecting a a multi-stage sampling procedure in which 200 households were obtained among the 8324 households. The data were obtained by interview using a structured questionnaire and these were compiled, processed using a microcomputer and statistical package EPI-INFO software. Result: This survey revealed that mothers have good knowledge about measles and its immunisation, though some aspects of it were lacking. Majority of them obtained them through interpersonal communication either from the health staff via health education programmes or from parents and neighbour. The age-group and parity of the mothers does not influenced the level of knowledge about the disease. However, this survey showed that Malay mothers and those being housewives have a higher level of knowledge. The majority of the mothers have good attitude towards the immunisation. They agreed that immunisation was useful to their children in protecting against infection. As the seeking of treatment is concerned, majority of the mothers preferred modern treatment, but still a moderate proportion would rather seek traditional treatment. The sociocultural factors could be an important determinant in the acceptance of the modern treatment to some extent in this community. Conclusion: From this study it is strongly shown that knowledge, attitude and practices do not seem to be a major factor responsible for the low measles immunisation coverage in the disrtict. Therefore further survey should be carried out to look at other factors simultaneously so that a rational approah to improve the coverage can be planned for this district.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN80u, title = {A study of the Malaria situation in the state of Selangor (1984-1988)}, author = {Mansor Karim}, year = {1990}, date = {1990-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: The study aims to produce an epidemiological profile of Malaria cases in Selangor in a 5-year time period. Method: This is a descriptive epidemiologic study of the malaria cases from 1984 to 1988 in Selangor. During that five year period, there were 2,533 malaria cases reported. Result: The finding of this study showed that the three most affected districts are Hulu Selangor, Gombak and Hulu Langat whereby part of the.the district contained an area of forested hills, mountain and jungles. More than half of all malaria cases was detected among the aborigines (Orang Asli) who lived in these areas and moved into the forest frequently. The Malays were the main predominant ethnic group affected followed by Indians and Chinese. The malaria incidence was higher in males than females. Children below 15 years reported a higher incidence.than adult age group. There was a downward trend in malaria transmission over the five years period. This was seen by the reduction of malaria incidence from 2.7 per 10,000 population in 1984 to 1.9 per 10,000 population in l988, reduction of falciparum ratio, reduction of indigenous cases, and reduction of the malaria incidence among the children. The reasons for this improvement may be due to: (i) the strengthening of the surveillance and case detection system as shown by the improvement of ABER from 2.7% in 1984 to 4.2% in 1988, (ii) the residual DDT spraying and the implementation of the new approach in the control of active malaria transmission in malarious area. In 1987, there was a sudden increase of malaria incidence to 4.4 per 10,000 population, that is due to a variety of causes outlined. The main reason was due to an outbreak of malaria in an aboriginal settlements in the district of Hulu Selangor. The other reason is the strengthening of surveillance and case detection system. Anopheles maculatus was the main vector in Selangor and still susceptible to DDT. Conclusion: Based on the findings in this study, a few recommendations have been made to reduce the incidence of malaria in the state of Selangor.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN78q, title = {A review of typhoid cases and their investigation procedures, Trengganu 1984-1988}, author = {Jusoh Mohd}, year = {1990}, date = {1990-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: to review reported cases of confirmed typhoid cases in Terengganu from 1984 to 1988.The purpose of this study is to identify some of the epidemiological characteristics of investigated typhoid cases in Terengganu with emphasis on the procedures of investigation, so that some measures to improve the investigation procedures could be made. Method: The study was carried out using secondary data, in December 1989. The data was obtained from the notification form of communicable diseases and individual case investigation forms. Result: A total of 446 typhoid cases were reported during this period of study. Out of these 446 cases, 261 cases were investigated and analysed. The commonest affected age group was 5 to 34 years old with males having a higher prevalence than females (1.3 : 1.0). Malays constituted 95.0 % of the cases. Majority of the cases were confirmed by Widal test and/or with isolation of Salinonella typhi in blood, stool and urine cultures. Poor standard of environmental sanitation was observed in this study where only 21.5% of patients had safe water supply and 67.8 % used sanitary latrine in their homes. The number of typhoid cases being investigated had declined from year to year with only 31.0% of them being investigated within two days after of the receipt of notification. The source of contamination could not be determined in the majority of the cases. The investigation dealing with contacts tracing and chlorination of wells has been followed in most of the investigated cases. The average number of contacts identified and examined during contact tracing was 7.4 contacts per investigated case. Conclusion: In general, investigation procedure was not carried out properly will lead to lack of information on case characteristics and contacts, poor control and prevention, and thus will increase the occurrence of typhoid fever. Necessary action should be taken to improve the effectiveness of the prevention and control procedures of typhoid fever in Terengganu. The actions include improvement in case investigation, provision of safe water supply and sanitary latrine, detection of carriers and health education to the patient and public. Further survey should be done in future in relation to the prevalence and control of typhoid cases in Terengganu.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN84k, title = {A comparative study on breastfeeding of urban and rural Malay mothers, Selangor}, author = {Mohd Ghazali Roslan Johari}, year = {1990}, date = {1990-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN85k, title = {Some factors which may influence the occurrence of childhood diarrhoea in a Malay community in Kelantan}, author = {Syed Abu Bakar Sharifah Rohani}, year = {1990}, date = {1990-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @article{RN16162, title = {The nutritional status of children in an urban squatter community in Malaysia}, author = {S B Yap and S T Teoh}, url = {http://journals.sagepub.com/doi/abs/10.1177/101053958900300409?url_ver=Z39.88-2003\&rfr_id=ori:rid:crossref.org\&rfr_dat=cr_pub%3dpubmed}, doi = {10.1177/101053958900300409}, issn = {1010-5395 (Print) 1010-5395}, year = {1989}, date = {1989-01-01}, journal = {Asia Pac J Public Health}, volume = {3}, number = {4}, pages = {297-300}, abstract = {An anthropometric assessment was conducted on a sample of 309 children, aged twelve years and below, from an urban squatter community in Kuala Lumpur, Malaysia. The community consists mainly of Malays and Indians and is fairly established with a mean length of residence of about fifteen years. There was not much difference between the two ethnic groups with regard to educational status or income. Most of the residents were unskilled or semiskilled workers employed in factories and government agencies. About 40 percent of the infants and toddlers were found to be wasted, while about one-third of the older children were stunted. There appears to be some association between income per capita and nutritional status.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16203, title = {Knowledge, attitude and practice factors in childhood acute respiratory infections in a peninsular Malaysia health district}, author = {A Vasanthamala and J T Arokiasamy}, url = {https://www.ncbi.nlm.nih.gov/pubmed/2620023}, doi = {10.1177/101053958900300308}, issn = {1010-5395 (Print) 1010-5395 (Linking)}, year = {1989}, date = {1989-01-01}, journal = {Asia Pac J Public Health}, volume = {3}, number = {3}, pages = {219-23}, abstract = {This study compares the knowledge, attitudes and practice of mothers in two ethnic groups with regard to acute respiratory infections (ARI) in their child. Most had traditional beliefs as to the cause of ARI with only a minority knowing the causes. Most mothers were aware of the effect of frequent attacks of ARI on the health status of their child and of the importance of early treatment. Reasons for their becoming worried during an episode of ARI in their child indicated that problems of distance, transportation and arrangements for care of their other children predominate. A large proportion of the respondents felt that their present knowledge of ARI was inadequate and were thus interested in obtaining more information. Nurses interviewed 100 Malay and 100 Chinese mothers with a child 5 years old who attended child health clinics in Negri Sembilan, Malaysia about acute respiratory infections (ARIs). The mean age and family size, educational status, and income levels were similar between the 2 groups. The mothers believed the leading causes of ARIs in children to be germs, food, and change in climate. 70% of Malays worried when their child had a mild ARI and 85% would seek treatment as soon as possible. 57% of the Chinese worried when their child had a mild ARI and 70% would seek treatment as soon as possible. No mother would wait to seek treatment in a case of severe ARI. The leading reason for worry for both the Malays and Chinese was that the child could become weak. The 2nd reason for the Malays was that the child could die whereas for the Chinese it was that the ill child could infect others. 68% of the Malays and 57% of the Chinese would not give cooling foods (fruits and vegetables) to their ill child. 20% of the Malays and 36% of the Chinese did not believe in food taboos. Most mothers had some knowledge about the type of diet suitable during an ARI. 93% of the Malays would take their child to a health center or hospital for treatment, while only 69% of the Chinese would do so. 24% of the Chinese would purchase medicine to treat their child. The Chinese had more problems taking their child for treatment of ARI than the Malays. For the Chinese, the health was too far or they had no time. Most mothers (Malays 68%, Chinese 71%) admitted not knowing much about ARIs and wished to learn more (Malays 89%, Chinese 92%). Most mothers wanted the information from health personnel. 21% of the Chinese could obtain information from reading. Health personnel should inform mothers more often about ARIs. eng}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16193, title = {Enterotoxigenic Escherichia coli in the domestic environment of a Malaysian village}, author = {J Vadivelu and R G Feachem and B S Drasar and T J Harrison and N Parasakthi and V Thambypillai and S D Puthucheary}, url = {https://www.ncbi.nlm.nih.gov/pubmed/2691267}, issn = {0950-2688 (Print) 0950-2688 (Linking)}, year = {1989}, date = {1989-01-01}, journal = {Epidemiol Infect}, volume = {103}, number = {3}, pages = {497-511}, abstract = {The membrane-filter assay, GM1-ELISA, and DNA-DNA hybridization assay, were used to detect enterotoxigenic Escherichia coli (ETEC) in samples of water, weaning food, food preparation surface swabs, fingerprints of mothers, and the fingerprints and stools of children under 5 years of age, in 20 households in a Malaysian village. Weaning food and environmental samples were frequently contaminated by faecal coliforms, including ETEC. The membrane-filter assay detected and enumerated faecal coliforms and LT-ETEC in all types of water and weaning food samples. Highest concentrations of faecal coliforms and LT-ETEC were found in weaning food, followed by well-water, stored water and stored drinking water. The GM1-ELISA detected LT-ETEC in weaning food, food preparation surfaces, fingerprints and stool samples. The DNA-DNA hybridization assay detected a larger proportion of STa2-ETEC than the other toxotypes, either singly or in combination. All the assays in combination detected the presence of ETEC in all types of samples on at least one occasion in each household. It was not possible to classify households as consistently more or less contaminated with ETEC. On individual occasions it was possible to show a significant association of the presence of LT-ETEC between the fingerprints of children and their stools, fingerprints of mothers and children, and weaning food and the stools of the child consuming the food.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16201, title = {Health care in Sarawak's jungles}, author = {Paul CY Chen}, year = {1989}, date = {1989-01-01}, journal = {World Health Forum}, volume = {10}, pages = {190-192}, keywords = {}, pubstate = {published}, tppubtype = {article} } @book{RN750, title = {A Socio-health Action-oriented Study to Increase Case-finding and Case-holding in the Leprosy Control Programme in Sarawak, Malaysia}, author = {CY Paul}, year = {1989}, date = {1989-01-01}, publisher = {Department of Social and Preventive Medicine}, address = {Kuala Lumpur, Malaysia}, keywords = {}, pubstate = {published}, tppubtype = {book} } @mastersthesis{RN75k, title = {A study of initial medical board records of hypertensive cases in the Malaysian Armed forces 1983-1987}, author = {Suleiman Adlina}, year = {1989}, date = {1989-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN74b, title = {A study of Occupational Dermatoses in 3 leather processing factories in Selangor state and Wilayah Persekutuan}, author = {Baba Noor Aini}, year = {1989}, date = {1989-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @article{RN16235, title = {Bringing leprosy into the open}, author = {Paul CY Chen}, year = {1988}, date = {1988-01-01}, abstract = {A study in Sarawak, Malaysia, revealed diverse opinions, prejudices and degrees of knowledge about leprosy among various ethnic groups. The information gathered was used as the base on which a health education package relating to the disease was established. It is intended that this will lead to the early detection and treatment of a higher propotion of cases than has previously been posible.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16121, title = {Longhouse dwelling, social contact and the prevalence of leprosy and tuberculosis among native tribes of Sarawak}, author = {P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/3393924}, issn = {0277-9536 (Print) 0277-9536 (Linking)}, year = {1988}, date = {1988-01-01}, journal = {Soc Sci Med}, volume = {26}, number = {10}, pages = {1073-7}, abstract = {In Sarawak, some tribes stay in communal longhouses whilst others live in villages of single dwellings. The present study looks into the question of whether there is an association between the prevalence of leprosy and tuberculosis with the quantum of social contact that occurs in these two types of settlement patterns. It was found that the prevalence of leprosy and tuberculosis is significantly higher among longhouse dwellers compared with single house dwellers. It was also noted that social groups tended to be larger and to persist for much longer among longhouse dwellers than among those in single dwellings. This lends support to the evidence that social contact in longhouses is more extensive and contributes towards a higher prevalence of leprosy and tuberculosis.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16194, title = {Children's opinions and attitudes about smoking}, author = {V Thambypillai}, issn = {0264-0325 (Print) 0264-0325}, year = {1987}, date = {1987-01-01}, journal = {J R Soc Health}, volume = {107}, number = {3}, pages = {84-7, 91}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16173, title = {Intestinal parasitism among Penan children of the Upper Baram, Sarawak}, author = {S P Kan and S B Yap and P L Yap}, url = {https://www.ncbi.nlm.nih.gov/pubmed/3452378}, doi = {10.1177/101053958700100110}, issn = {1010-5395 (Print) 1010-5395 (Linking)}, year = {1987}, date = {1987-01-01}, journal = {Asia Pac J Public Health}, volume = {1}, number = {1}, pages = {38-41}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16139, title = {Aging in Malaysia}, author = {P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/3506635}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1987}, date = {1987-01-01}, journal = {Med J Malaysia}, volume = {42}, number = {3}, pages = {144-5}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14593, title = {Family support and the health of the elderly Malaysian}, author = {P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/24389805}, doi = {10.1007/BF00116672}, issn = {0169-3816 (Print) 0169-3816 (Linking)}, year = {1987}, date = {1987-01-01}, journal = {J Cross Cult Gerontol}, volume = {2}, number = {2}, pages = {187-93}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16207, title = {The dental status of the Kayans of Long Atip, Baram, Sarawak}, author = {C J Ai}, url = {https://www.ncbi.nlm.nih.gov/pubmed/3503183}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1987}, date = {1987-01-01}, journal = {Med J Malaysia}, volume = {42}, number = {2}, pages = {110-2}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16195, title = {Utilization of formal social support services by non-institutionalized ill elderly}, author = {V Thambypillai}, url = {https://www.ncbi.nlm.nih.gov/pubmed/2948279}, issn = {0037-5675 (Print) 0037-5675 (Linking)}, year = {1986}, date = {1986-01-01}, journal = {Singapore Med J}, volume = {27}, number = {4}, pages = {281-7}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16192, title = {Coping among the non-institutionalised ill elderly}, author = {V Thambypillai}, issn = {0300-5283 (Print) 0300-5283}, year = {1986}, date = {1986-01-01}, journal = {Med J Malaysia}, volume = {41}, number = {2}, pages = {116-22}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16140, title = {Child health delivery in Asia}, author = {P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/3796358}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1986}, date = {1986-01-01}, journal = {Med J Malaysia}, volume = {41}, number = {1}, pages = {93-8}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16187, title = {A knowledge atitude and practice (KAP) study on dengue/dengue haemorrhagic fever and the Aedes mosquitoes}, author = {Uma Deavi Ayyamani and Gan Chong Ying and Ooi Guat San}, year = {1986}, date = {1986-01-01}, journal = {Medical Journal of Malaysia}, volume = {41}, number = {2}, pages = {108-115}, abstract = {A KAP study on dengue/dengue haemorrhagic fever (DF/DHF) was carried out in three areas in the Federal Territory. The three areas were selected based on their ethnic group composition and were Jinjang North (Chinese), Kampung Bahru (Malays) and Sentul (Indians). Houses were selected by a systematic sampling method and house-to-house interviews were carried out with a pre-tested, predesigned questionnaire. 546 (87.62%) of the households responded. The study indicated that all three communities knew of DF/DHF with the majority describing it as a disease caused by mosquitoes. Though a large number were able to give some sign or symptom of DF/DHF, many Chinese were unable to do so. Knowledge about the mosquito, its habits and habitats was generally good and many realised that unclean surroundings and storage of water would cause mosquitoes to breed. This knowledge, however, did not always lead to good practices and discrepancies between knowledge and practice were seen. Knowledge about legislation, though widespread, lacked specificity with many admitting ignorance about the duration ofjail sentence and amount of fine that could be imposed. More than half the respondents did not know abate and the majority of these were Chinese. Health personnel did not seem to participate actively in health education. The mass media was found to be the main source ofinformation.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16171, title = {Health literacy and food beliefs among Ibans, Sarawak}, author = {Sim Bee Yap}, year = {1985}, date = {1985-01-01}, journal = {Medical Journal of Malaysia}, volume = {40}, number = {4}, pages = {294-300}, abstract = {A morbidity survey was carried out on a csample of eight longhouses in the Entabai areacof the Sixth Division, Sarawak. Of the 645crespondents interviewed, only 148 (22.9%)chad experienced at least one spell of illnesscduring the one month prior to the survey. A total of 161 spells of illness was reported, giving a rate of three spells per person per year for the community. Most of the complaints were mild in nature, with fever and aches being the commonest reported. About two thirds of the illnesses were seen by the village aide or at the klinik desa, while the remaining preferred to be treated by the manang. A sub-sample of 49 heads of household were interviewed on their views of the causation, prevention and spread offive common conditions. About 14-43% of the respondents had no knowledge of the causesoffever, cough, diarrhoea or worms. Among those who mentioned some causative factors, only a portion had correct concepts of the various aspects of diseases. Food taboos associated with the five conditions were not too numerous or extensive enough to affect dietary intakes. However, this is not so during the post-partum period where the mother is not allowed to eat many vegetables and meat which are common items in their everyday diets.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16196, title = {Smoking among urban Malaysian school children}, author = {V Thambypillai}, url = {https://www.ncbi.nlm.nih.gov/pubmed/4071118}, issn = {0277-9536 (Print) 0277-9536 (Linking)}, year = {1985}, date = {1985-01-01}, journal = {Soc Sci Med}, volume = {21}, number = {7}, pages = {819-23}, abstract = {A questionnaire on smoking habits was administered to 4106 Form IV school children in Kuala Lumpur. The period of survey was from 9 to 20 April 1984. 2099 boys and 2007 girls were studied and their mean age was 16.1 years. 32.8% of the students had been initiated to smoking and the mean age of initiation was 13.3 years. The prevalence of smoking was found to be 9.8% and the mean duration of smoking was 2.5 years. Most of the smokers and occasional smokers were boys. About 42% of the smokers wished to stop smoking and only 1% of the non-smokers intended to smoke in the future. The study recommended that health education programmes should be started earlier in school.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16198, title = {Concentrations of lead in maternal blood, cord blood, and breast milk}, author = {C N Ong and W O Phoon and H Y Law and C Y Tye and H H Lim}, url = {https://www.ncbi.nlm.nih.gov/pubmed/4037861}, issn = {1468-2044 (Electronic) 0003-9888 (Linking)}, year = {1985}, date = {1985-01-01}, journal = {Arch Dis Child}, volume = {60}, number = {8}, pages = {756-9}, abstract = {Lead concentrations in maternal blood, umbilical cord blood, and breast milk from 114 women who were not occupationally exposed to lead were determined by graphite atomic absorption spectrophotometry. The mean concentrations of lead in maternal blood, umbilical cord blood and breast milk were 0.7, 0.55, and 0.23 mumol/l, respectively. A significant correlation was observed between maternal and umbilical cord blood (r = 0.63). A lower correlation was noted between maternal blood and breast milk (r = 0.29). These results suggest that lead freely crosses the placental barrier from mother to fetus and the transfer of this heavy metal from maternal tissues to breast milk is possible, but the metabolic mechanisms are more complicated. In addition, a longitudinal study was conducted of concentrations of lead in breast milk in nine lactating women. Results suggested no significant change in the content of lead in breast milk during early lactation.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16200, title = {Blood lead levels in Malaysian urban and rural pregnant women}, author = {H H Lim and C N Ong and Z Domala and W O Phoon and H E Khoo}, url = {http://dx.doi.org/10.1016/S0033-3506(85)80123-2}, doi = {10.1016/S0033-3506(85)80123-2}, issn = {0033-3506}, year = {1985}, date = {1985-01-01}, journal = {Public Health}, volume = {99}, number = {1}, pages = {23-29}, abstract = {A cross-sectional study was carried out in Malaysia to determine blood lead levels in a group of 60 pregnant women living in an urban area and another group of 63 pregnant women from a rural district. The mean blood lead level of the urban women (17·3 ?g/100 ml) was significantly higher than that of the rural women (15·5 ?g/100 ml). The higher urban levels probably reflect greater environmental exposure to lead. The study did not demonstrate any statistical relationship of blood lead levels with age or duration of pregnancy.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16143, title = {Life-styles and health-related behaviour}, author = {P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/3834288}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1985}, date = {1985-01-01}, journal = {Med J Malaysia}, volume = {40}, number = {2}, pages = {60-1}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16142, title = {Innovations in child health care in Asia}, author = {P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/3842713}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1985}, date = {1985-01-01}, journal = {Med J Malaysia}, volume = {40}, number = {3}, pages = {177-84}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16141, title = {Child health in Malaysia: 1870-1985}, author = {P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/3916210}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1985}, date = {1985-01-01}, journal = {Med J Malaysia}, volume = {40}, number = {3}, pages = {165-76}, keywords = {}, pubstate = {published}, tppubtype = {article} } @mastersthesis{RN15_299, title = {A study of Motor Vehicle Accident Cases as seen in the Accident and Emergency Unit, University Hospital Kuala Lumpur}, author = {Sahai Madhu}, year = {1985}, date = {1985-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: This study is carried out to collect some data to project the overall situation in the Accident Emergency Unit of the University Hospital, Kuala Lumpur. Introduction (if necessary): The increasing use of motor vehicles at a steady rate compared to the rate of development of road and other facilities, brings in another disease, that is, motor vehicle accidents, causing injury to the users and others, ultimately leading to increased death or disability. Method: The study was conducted with effect from 7th December 1984 for a period of 15 days in respect of all cases of motor vehicle accidents attending the A \& E Unit of the University Hospital. The frequency and the severity of the injury were analysed in relation to age, sex, ethnic group and occupation with the view of type of the vehicle involved in accident. Injury pattern in motor vehicle accident in general and also in relation to the vehicle was analysed. Result: A total of 218 motor vehicle accident cases attended the A \& E Unit of the University Hospital during the study period. This constituted 9.6% of the total cases reported to the A \& E Unit during this period. Drivers (67.0%) sustained more injuries than other road users such as pillion riders (11.5%) or car passengers or pedestrians (9.2%). The drivers having more than five years of driving experience (23.3%) were less involved in accidents than those having 0-5 years of experience (49.3%). Conclusion: This suggests that drivers or operators of vehicles are at more risk of injures compared to road users. More studies need to be done on the causes of motor vehicle accidents.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN19b, title = {Nutritional Assessment of Malay Settlers in a Land Development Scheme in Ulu Tebrau, Johore}, author = {Abdul Hamid Maimunah}, year = {1985}, date = {1985-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN14_272, title = {A study of the inpatients Admitted for the first time to the University Hospital, Malaysia in 1982}, author = {Woibun Marcus}, year = {1985}, date = {1985-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: To study admissions to the University Hospital in 1982. Method: A study of the patients admitted for the first time into the University Hospital for the year 1982 is presented. A total of 15,251 admissions were analysed. The data was derived from the computerized medical records on patients of the hospital. Readmissions and normal deliveries were excluded from the analysis. Result: The study showed that the highest number of admissions during the study period were the Chinese (43%). The Medical Unit was found to have the highest number of admissions (23.7%). The overall average length of stay per patient for the University Hospital was 8.5 days. The two leading I.C.D. major cause groups for admission were found to be Injury and Poisoning (13%) and Infectious and Parasitic Diseases(8.9%). This study revealed that the majority of the patients (70.5%) were non-referrals but presented themselves at the hospital. Conclusion: Admissions to the University Hospital in 1982 followed the expected pattern for an urban population in Malaysia.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN13n, title = {A Comparative Study of Selected Aspects of Health Among a Malay Migrant Group and a Malay Non-Migrant Group in Mersing, Peninsular Malaysia}, author = {Ramu K R Devan}, year = {1985}, date = {1985-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: The objective is to compare selected aspects of health between a Malay migrant group and a Malay non-migrant group in four villages in Mersing, Peninsular Malaysia. Method: This comparative study of selected aspects of health was conducted among a Malay migrant group and a Malay non-migrant group in four villages in Mersing, Peninsular Malaysia. Result: Migrant households had larger family size compared to non-migrant households. On the whole knowledge, attitude and practices of personal hygiene among the migrants appeared to be lacking as compared to the non-migrants. The child care practices among the migrants were lower as compared to the non-migrants. More non-migrant mothers were aware and practised good nutrition and antenatal care during pregnancy. Migrants resorted to modern medical treatment but some preferred the more traditional forms of treatment. Conclusion: Disparities exist between migrant and non-migrant communities in many aspects of attitudes to health as well as health practices. Imrpovement can be brought about by targetting specific communities.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN16_310, title = {Disease Pattern and Bed Utilization in Special Care Nursery, University Hospital, Kuala Lumpur}, author = {Krishnan Revathi}, year = {1985}, date = {1985-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: To determine the disease pattern of admissions and utilization of beds in the Special Care Nursery, University Hospital, Kuala Lumpur over a two and a half month period from lst November 1984 to 16th January 1985. Method: Data from the Special Care Nursery, University Hospital were analysed. Result: 24.4% of the babies were preterm in gestation while 37.4% of the babies had low birth weights. About 31% of the babies were born to mothers who were unbooked. These mothers had a significantly higher incidence of low birth weights (63,2%) compared to booked mothers (25.9%). Mild to moderate and severe asphyxia neonatorum were observed in 19.5% and 12.2% of the babies respectively. Hyaline membrane disease, pneumonia and transient tachypnoea were the commonest causes of respiratory distress. 28.4% of babies had infections, with septicaemia and pneumonia being the commonest manifestations.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @article{RN16145, title = {The elderly Malaysian}, author = {P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/6544929}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1984}, date = {1984-01-01}, journal = {Med J Malaysia}, volume = {39}, number = {4}, pages = {254-6}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16144, title = {Child nutrition among the Penans of the Upper Baram, Sarawak}, author = {P C Chen}, issn = {0300-5283 (Print) 0300-5283}, year = {1984}, date = {1984-01-01}, journal = {Med J Malaysia}, volume = {39}, number = {4}, pages = {264-8}, keywords = {}, pubstate = {published}, tppubtype = {article} } @mastersthesis{RN7_71, title = {Dengue Vector Control Activities in the Health District of Larut and Matang%B Department of Social and Preventive Medicine}, author = {Majid Abu Talib}, year = {1984}, date = {1984-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: This dissertation attempts to assess the dengue vector distribution in the Larut and Matang Health District and the control activities of the health authorities during the period of three years from January 1980 to December 1982. Method: The study utilised data gathered from dengue vector control activities in the districts of Larut and Matang Result: During the period of the study, a total of 40,796 premises were inspected for breeding habitats. Out of this, 1181 (2.9%) of the premises were found to be breeding Aedes larvae. The commonest habitats being ant-traps found indoors and discarded containers like tin cans and jars found outdoors. The only two species of stegomycia found in this district are Aedes aegypti and Aedes albopictus. An attempt was made to relate the vector density to rainfall, and breeding was seen to increase during the rainy months of August to October in this district. The incidence of Dengue/Dengue Hemorrhagic Fever is also found to be directly related to the vector density. Conclusion: Dengue is still a serious problem in the districts of Larut and Matang. Prevention of the disease should be directed at vector control activities.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN6c, title = {A Study of Knowledge, Attitude, and Practices of Smoking among soldiers in a battalion of the Royal Malay Regiment, 1984}, author = {Othman Ahmad Badrus}, year = {1984}, date = {1984-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: This study was conducted to determine the knowledge, attitudes and practices of cigarette smoking among soldiers in the Malaysian Armed Forces. Method: The 4th Royal Malay Regiment was selected as the study population. The study was conducted using personal interviews and self-administered questionnaires. Soldiers who were within the camp parameter, were considered and the study was done company by company. A total of 359 soldiers took part, giving a response rate of 42.2%. Result: The study showed that the factors which influenced a soldier to take up smoking, are the social background, level of education, parental and sibling influence, peer pressure at work, advertisement, curiosity, boredom, and anticipation of adulthood. Smoking by Army medical personnel could also be a contributory factor. About two fifths of the smokers had acquired the habit after joining the Army. Smoking was also higher among the lower ranks and younger age groups. Most of them started smoking before the age of 25 years. Conclusion: Social factors play a very important role in influencing soldiers to take up smoking. Preventive action must be done before the age of 25.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN1_896, title = {Study of Socio-cultural Aspects of Diarrhoeal Diseases in a Malay and an Indian Community}, author = {S K Akhtar Ahmad}, year = {1984}, date = {1984-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: The aim of the study is to look into the sociocultural aspects of diarrhoeal diseases in a Malay and an Indian community Introduction (if necessary): Diarrhoea was understood by most of the respondents in both the communities as frequent passage of watery stools with or without vomiting. Among both the Malays and Indians, physical causes such as food are believed to be the commonest cause of diarrhoea. Biological causes were also mostly recognized though the idea of bacteria was not clear. Method: The study was carried out in two villages of Kuala Langat district in the State of Selangor from 5th December 1983 to 17th December 1983. Two samples of 66 Malay and 54 Indian households were surveyed using questionnaires. The interviews were carried out by author with the help of two interpreters. Other sources of information were the village headman and the officer in-charge of the health subcentre. Result: 62.1% of the Malays and 77.8% of the Indians choose the hospital or clinic for the treatment of diarrhoea. Restriction of food or giving special food to persons with diarrhoea were practised by 47.0% of Malays and 63.0% of Indians. Withholding of breast-feeding from children with diarrhoea were practised by 27.3% of the Malays and 42.6% of the Indians. Older households had tendency to withhold breast-feeding from children with diarrhoea (p \< 0.01 in Malay households and p \< 0.02 in Indian households). The vast majority of households both Malays (95.4%) and Indians (96.3%) did not know about oral rehydration salts. Malay households who had education above primary level or with higher income had a tendency to use pour-flush latrines (p \< 0.05) while in Indian households no such association has been found. Major problems mentioned by the communities were lack of pipe water supply, improper disposal of refuse and poor drainage system. Conclusion: Most Malays and Indians choose to go for modern medicine in the treatment of diarrhoea. However socio-cultural aspects are still important factors in these two communities.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN12d, title = {A study of Malaria Cases reported in Sungai Sipit, Kuala Kangsar District %V Master of Public Health}, author = {Ariffin Anuar}, year = {1984}, date = {1984-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN10d, title = {Knowledge and Attitudes to Tuberculosis amongst Health Workers and Tuberculosis Patients}, author = {Festus Pawa}, year = {1984}, date = {1984-01-01}, urldate = {1984-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: This study was carried out to determine the knowledge and attitudes of patients and health workers to tuberculosis. Result: Education level was found to affect the attitudes to tuberculosis. Tuberculosis tends to be more common in the lower socioeconomic groups. Age, religion and race do not seem to affect the attitudes towards tuberculosis. A high proportion of the patients do not seem to understand well, the natural history of tuberculosis, especially factories such as transmission where 49.0% did not know how the disease is transmitted. On the treatment of tuberculosis, majority 88.7% of the patients believed that it can be cured. Similarly, a high percentage said that patients should be treated in hospitals (contrary to health departments efforts in promoting domiciliary care). Conclusion: Knowledge of tuberculosis is high among patients and health care providers. Nevertheless, more needs to be done to change people's perception regarding the mode of treatment.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN8_113, title = {A comparison of some aspects of Child Health Services in Kuala Langat District Peninsular Malaysia and East Sipik Province, Papua New Guinea%C Kuala Lumpur}, author = {John Sairere}, year = {1984}, date = {1984-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: This study attempted to compare the child health services in the Kuala Langat district, Peninsular Malaysia to the same service in East Sepik Province, Papua New Guinea. Result: The data collection and compilation carried out by the health care system in Kuala Langat district (KLD) was more thorough and more complete than that carried out by the health care system in East Sepik Province (ESP), thus making comparison difficult. The two study areas are different in terrain, population and level of development. While facilities in KLD are partly hospital-based and partly community-based, that of ESP is more community-based. KLD had a doctor-population ratio of 1:4604. ESP had a ratio of 1:27,736. But KLD had a nursing staff to population ratio of 1:670 compared to ESP which had a ratio of 1:499. There was no programme on vector control, domiciliary care or applied nutrition. Morbidity and mortality figures were compared. Conclusion: Although it is difficult to compare the districts of Kuala Langat and East Sepik Province due to lack of data, a number of lessons learnt in the Kuala Langat District may be applicable to the East Sepik Province.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN4c, title = {Review of Aircraft Accidents in the Royal Malaysian Air Force, 1972-81 and a Preliminary Study of self-imposed stress among a sample of pilots}, author = {Meer Ahmed}, year = {1984}, date = {1984-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: The aim was to analyse aircraft accidents from RMAF records from 1972-81 and to correlate the habits of RMAF pilots with thir personal accident-rating. Method: An epidemiological study was done in two parts: the first part involved compiling and analysing records concerning accidents to aircraft in flight occurring in the RMAF for the period 1972~81; the second part of the study was a questionnaire study attempting to correlate the habits of a sample of pilots in the RMAF with their personal accident-rating. Result: There were a total of 109 accidents occurring during flight and taxiing. Accident rates in the RMAF showed an increasing trend during that period. Major accident rates and fatal accident rates in the RMAF for the period 1977~81 were much higher than that experienced by the U.S. Air Force currently and approximate those experienced by the U.S. Air Force in the 1950's. Helicopters, by far, were the most common type of aircraft involved, followed by fixed-wing jet-fighters and the largest number of accidents, by far, occurred during training missions. “Pilot error" was found to be commonest causative factor of the accidents. "Pilot-error" as a causative factor occurred more frequently among rotary-wing aircraft. There was increased incidence of aircraft accidents during the Muslim fasting month compared to the non-fasting month. Risk factors in aircraft accident causation in the RMAF were flying within 18-hours of having consumed alcohol, inadequate sleep, in control of an aircraft while fasting and in control of an aircraft without food for the preceding 10-hours. Conclusion: There was an increasing rate of aircraft accidents in the RMAF from 1977-81. The most common aircraft involved were helicopters. Pilot error was the most common causative factor.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN2f, title = {Sarawak Tuberculosis Control Programme: A Ten Year Review (1973-1982)}, author = {Suhaily Mohamad Raily}, year = {1984}, date = {1984-01-01}, urldate = {1984-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: This dissertation aims to study the trend of tuberculosis in the State during the second decade since the inception of the Tuberculosis Control Programme in Sarawak as well as to review the performance of the three main components of the programme within that same period that is, 1973 - 1982. Introduction (if necessary): Method: This study was carried out by going through the records that are kept in the headquarters of Sarawak Tuberculosis Control Programme situated at the ATAS Building in Kuching. The records of a total of 382 TB patients seen in Kuching Chest Clinic for the whole of 1982 were studied. Result: This study reveals that during the ten year period between 1973 and 1982, the reported TB cases have been maintained below one per 1,000 population. In 1973 the number of bacillary pulmonary tuberculosis cases reported was 0.97 per 1,000 population whereas in 1982 the rate dropped to 0.82 per 1,000 population. The first decade of this Control Programme showed a sharper decline compared to this. Racial distribution of the cases does not exactly follow the racial distribution in the general population. The highest number of cases are reported among the Dayaks, followed by the Malays and the Chinese in that order. Vaccination coverage among the newborn has been maintained at over 90% during this period. Those who sought treatment regularly among the ten cohorts (1970 - 1980 cohorts) analysed is consistently below 80%. The rate of abandonment is quite high that is, 10.0%. The sputum conversion rate among these same cohorts are well below 80%. The mortality among those cohorts shows an improving trend. The study of presenting symptoms among 382 TB patients seen at Kuching Chest Clinic reveals that the majority of patients (91.8%) present with cough. 83.2% of the cases gave a history of multiple symptoms, including cough. Only 22 or 8.5% of the records reveal a history of only one symptom, namely cough. Of these cases 73.9% have moderately advanced chest x-ray findings and 20.3% have far advanced lesions. Conclusion: The incidence rate of TB has declined over the years. However, more work needs to be done to reduce defaulter rates among those infected by the disease. Most patients present with moderate or advanced TB.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN9i, title = {A study of Admissions by the Accident and Emergency Unit and some of its Related Services%I University of Malaya}, author = {R Paramalingam}, year = {1984}, date = {1984-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: To study the admissions by the Accident and Emergency Unit in the General Hospital, Malacca. Method: A two week study was carried out on the accident and emergency admissions to the General Hospital, Malacca Result: 30.7% of all patients seen at the A \& E unit were admitted. Majority of the admissions were in the younger age group, with those below 24 years predominating. Accidents, poisoning and violence were the commonest cause of admissions, followed by diseases of the digestive system. Males and females have the highest admissions due to accidents, poisoning and violence and this is also the commonest cause of admissions in all the ethnic groups. The Medical Unit has the highest admissions (35.4%) followed by the Orthopaedic Unit (23.4%). Conclusion: Only one third of all patients seen in the Accident and Emergency Unit need ot be admitted. The majority of cases can be seen as outpatients.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN11m, title = {A study of Otorhinolarygology Diseases among Inpatients at University Hospital, Kuala Lumpur, for year 1981}, author = {Garg Rita}, year = {1984}, date = {1984-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: The main objective of the present study is to study the causes of admission among Otorhinolaryngology in-patients and to assess the utilization of in-patient services with respect to length of stay and bed occupancy rate, at University Hospital, Kuala Lumpur, for a period of one year. Method: The study population consisted of 777 Otorhinolaryngology cases discharged from the hospital during one year period from 1.1.81 31.12.81. The cases discharged include deaths, transfers, abscondances and discharges against medical advice. The data were collected from the University Hospital case records and analysed using computer. Result: This study shows majority of the admissions in children, young adults and adults (0-14 years and 15-44 years age groups). The main causes of admissions fall under diseases of respiratory system, diseases of nervous system and sense organs and neoplasm. Suppurative otitis media and chronic diseases of tonsils and adenoids were leading causes of admission for all three ethnic groups. Suppurative otitis media affected all the three groups more or less equally, while chronic diseases of tonsils and adenoids showed highest frequency in Malays followed by Indians and Chinese. Nasopharyngeal carcinoma showed a high frequency among Chinese followed by Malays. Deflected nasal septum had a higher incidence among Indians. Conclusion: Data utilized in this study are based on hospital case records, which are unfortunately biased samples with some limitations mentioned earlier. Therefore, they cannot be generalized to represent the whole population. On the other hand, careful comparison with such more studies may reveal some useful aspects of Otorhinolaryngology diseases in a local community.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN3k, title = {A Knowledge, Attitude and Practices Study of Filariasis among two Communities in Bukit Kepong, Johor}, author = {Santokh Singh}, year = {1984}, date = {1984-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: To identify behavioural and cultural factors in the epidemiology of filariasis. Method: This study was carried out in two endemic communities (Chinese and Malays) in Bukit Kepong (Johor) to identify behavioural and cultural factors in the epidemiology of filariasis. The study area is approximately 101 square miles and comprises nine villages. The local inhabitants have been re-examined and retreated for filariasis. The study sample consists of 100 Chinese and 100 Malay heads of households. Their views, responses on knowledge of filariasis, attitudes towards the control programme and circadial practices are analysed and discussed Result: The overall knowledge of filariasis was relatively better among the Malays than the Chinese. However the end stage (elephantiasis) of filariasis was better understood than the acute stage particularly among the Chinese. Although a fair number of Malays (22%) knew by its acute symptomatology it was still not a satisfactory picture. The knowledge of causation, transmission and prevention was also grossly limited in both the communities. Some Chinese still held mythological ideas to its causation. Filariasis is considered a serious disease by both the communities. Their co-operation towards the filariasis control programme was encouraging, although a majority of them in both communities were unaware of the rationale of screening and treatment. Conclusion: Knowledge of filariasis is still lacking among the Malay and Chinese communities. More work needs to be done in this area.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN5i, title = {A study of the Immunization Status of Toddlers and Pre-School Children attending the Government Clinics in Kota Baru District 1983}, author = {Seok Kheng Tan}, year = {1984}, date = {1984-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objective: To study the immunisation status of toddler snd pre-school children attending government clinics in Kota Baru District Method: The study was carried out by interviewing the parents/guardians concerning the child's personal data like age. ethnic group etc; the immunizations received and the date at which these immunizations were given; the parents' socioeconomic status; the number and spacing of siblings in the family; the knowledge and attitude of parents towards immunization, and whether they were informed by the health staff concerning the importance and types of immunization required for their children. Result: Of the 293 children, only 68% had completed their immunizations. There is a steady decrease in immunization coverage as immunization is scheduled later in life. coverage of all Only 56% of the children studied received BCG vaccination before one month of age. There is a significant regional variation in immunization coverage by health centres, ranging from 86% in sub-health centre Kedai Lalat to 52% in Main Health Centre Wakaf Cek Yeh. There is a significant relationship between family size and immunization coverage; the larger the family size, the lower the immunization coverage. A trend is noted that children whose parents are of higher socioeconomic status (as measured by parents' occupation, mother's education level, total income of parents) have higher immunization coverage. Mother's education level is the most important factor in this, being shown to be statistically significant. The knowledge about illness against which the immunizations are given apparently have no effect on immunization coverage. Conclusion: Immunisation coverage is still not satisfactory in Kota Baru in 1983.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @article{RN16230, title = {Lead concentrations in breast milk of Malaysian urban and rural mothers}, author = {Heng Huat Lim and Domala Zakariya and Hoon Eng Khoo}, issn = {0003-9896}, year = {1983}, date = {1983-01-01}, journal = {Archives of Environmental Health: An International Journal}, volume = {38}, number = {4}, pages = {205-209}, abstract = {This study was conducted to determine lead concentrations in breast milk among urban and rural mothers in Malaysia, and to determine if lead absorption among urban maternal populations in Malaysia poses a potential health hazard to infants through breastfeeding. Milk samples, which were collected from 89 urban and 91 rural mothers, were analyzed by flameless atomic absorption spectrophotometry. The mean lead level in urban samples was 0.0253 μg/ml, which was significantly higher than that of the rural samples (0.0211 μg/ml). The estimated daily lead intake of breast-fed infants in Malaysia was well below proposed tolerable levels. There also appeared to be no specific pattern in the milk lead levels at different periods of lactation. The significance of the higher milk lead concentrations in urban mothers is also discussed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16219, title = {Occupational health nursing services in two countries}, author = {H H Lim}, url = {https://www.ncbi.nlm.nih.gov/pubmed/6622644}, issn = {0033-3506 (Print) 0033-3506 (Linking)}, year = {1983}, date = {1983-01-01}, journal = {Public Health}, volume = {97}, number = {4}, pages = {221-7}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16217, title = {Occupational exposure to inorganic lead in Malaysian battery-manufacturing factories}, author = {Huat Lim Heng and C M Abu Bakar}, url = {https://www.ncbi.nlm.nih.gov/pubmed/6672564}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1983}, date = {1983-01-01}, journal = {Med J Malaysia}, volume = {38}, number = {3}, pages = {212-6}, abstract = {A study was carried out by the Factories and Machinery Department of Malaysia to assess the problem ofoccupational exposure to inorganic lead in Malaysian battery workers. The eight factories studied were divided into two categories: large, multinational subsidiaries with good industrial hygiene measures and small, locally-owned companies with poor hygiene features. A total of 251 workers (221 males and 30 females) were included in the study. Personal air sampling showed that 47% of the samples in the small factories had lead-in-air levels exceeding 150 ug/m3, compared unth. 29% in the larger establishments. The highest air lead levels were found in the cutting, pasting/mixing and battery assembly sections. 86.7% ofthe female workers and 62.2% of the male workers in the smaller factories had blood lead concentrations above the proposed limits of 70 ug/100 ml (males) and 40 ug/100 ml (females). In contrast, only 7.6% of the male workers in the largerfactories had blood lead levels exceeding the proposed limits. Three workers also had positive signs or symptoms on clinical examination. Legislation of specific regulations to protect the health of lead-exposed workers in Malaysia is currently being drafted by the government.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16221, title = {Training and education of occupational health and safety personnel in a developing country}, author = {Huat Lim Heng}, url = {https://www.ncbi.nlm.nih.gov/pubmed/6644735 https://journals.sagepub.com/doi/10.1177/146642408310300616}, doi = {10.1177/146642408310300616}, issn = {0264-0325 (Print) 0264-0325}, year = {1983}, date = {1983-01-01}, journal = {J R Soc Health}, volume = {103}, number = {6}, pages = {246-8}, abstract = {Increasing urbanisation and industrialisation in many developing countries has brought in its wake new health problems such as occupational diseases, industrial accidents and environmental pollution. ...}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16146, title = {The prevalence, nature and severity of disabilities in a Malaysian community}, author = {P C Chen and J T Arokiasamy and C Y Gan}, url = {http://www.e-mjm.org/1983/v38n3/disabilities.pdf}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1983}, date = {1983-01-01}, journal = {Med J Malaysia}, volume = {38}, number = {3}, pages = {206-11}, abstract = {A total of 2518 persons were screened for disabilities. The overall prevalence of disability was 94.9 per thousand persons, while that of handicapping conditions was 18.3 per thousand. There is an increase in disabled persons with increasing age, with males having a higher prevalence than females. Predominant causes of disabilities were aural, ocular and musculoskeletal conditions, the latter largely involving the lower limbs. Cataracts were an important cause of impaired vision. Poliomyelitis and fractures were largely responsible for disa.b£lities involving the lower limbs. A large proportion of handicapping conditions were due to mental conditions that included mental retardation, mongolism and cerebral palsy.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16148, title = {Ecological basis of malnutrition among the Muruts of Sabah}, author = {P C Chen}, issn = {0300-5283 (Print) 0300-5283}, year = {1983}, date = {1983-01-01}, journal = {Med J Malaysia}, volume = {38}, number = {1}, pages = {9-14}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16147, title = {The modern killer}, author = {P C Chen}, url = {http://www.e-mjm.org/1983/v38n2/motor-vehicular-accidents.pdf https://www.ncbi.nlm.nih.gov/pubmed/6621452}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1983}, date = {1983-01-01}, journal = {Med J Malaysia}, volume = {38}, number = {2}, pages = {90-3}, abstract = {Seven people are killed and 54 others are injured each day as a result of motor vehicular accidents in Peninsular Malaysia. In 1980 a total of 2,568 people were killed as a consequence of motor vehicular accidents in Peninsular Malaysia. Road traffic accidents is increasingly becoming the modern killer of mankind not only in Malaysia but all over the world. In the developed countries, mortality from accidents generally takes third place after cardiovascular diseases and neoplasms. In the age groups from one to 44 years of age, which have relatively low general mortality rates, accidents occupy the first place. For example in the USA, in 1975, for both sexes, 79.5 percent of all deaths in the age group 15 - 24 years were due to accidents of one kind or other. It has been estimated that about 10 percent of all deaths in developed countries is due to accidents and that the proportion of the population admitted to hospitals because of accidents of one kind or other is more than 1 percent of the population. ...}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16218, title = {Ventilatory function in Malay office workers in Malaysia}, author = {A B Che' Man and H H Lim}, url = {https://www.ncbi.nlm.nih.gov/pubmed/6635675}, issn = {0037-5675 (Print) 0037-5675 (Linking)}, year = {1983}, date = {1983-01-01}, journal = {Singapore Med J}, volume = {24}, number = {3}, pages = {135-9}, abstract = {A study was carried out to determine ventilatoy capacity (Forced Expiratory Volume or FEV., and Forced Vital Capacity or FVC) in apparently normal Malay office workers in Malaysia. The subjects, 78 males and 113 females, were interviewed using a standardized questionnaire to exclude those with symptoms or past history of cardiopulmonary disease. Measurements of age, height, weight, FEV, and FVC were made on each subject; the FEV. and FVC were measured using Vitalograph spirometers. The mean FEV. and FVC for males were 3.35 litres and 3.76 litres, respectively. For females, the mean FEV. and FVC were 3.46 and 2.72 litres, respectively. Height was positively correlated with FEV. and FVC (p\<0.01). However, the correlation with age was not significant at the 1% level. Regression equations for predicting FEV, and FVC of Malay male and female office workers were computed. The implications of the findings are discussed, and compared with other studies in Singapore and Britain.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16153, title = {Preventing cancers}, author = {J T Arokiasamy}, url = {https://www.ncbi.nlm.nih.gov/pubmed/6599979}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1983}, date = {1983-01-01}, journal = {Med J Malaysia}, volume = {38}, number = {4}, pages = {261-5}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16206, title = {A family planning study in Kuala Pilah, Peninsular Malaysia}, author = {Thambypillai Vimala}, issn = {0300-5283 (Print) 0300-5283}, year = {1982}, date = {1982-01-01}, journal = {Med J Malaysia}, volume = {37}, number = {4}, pages = {326-35}, abstract = {Realizing that family planning is not making a sufficient impact on the rural people as it is on the urban population, it was decided that the authors would study the attitude and knowledge of a rural community towards family planning. The study sample consisted of 200 Malay married women--100 acceptors and 100 nonacceptors from the Kuala Pilah District. The study went from December 4-22, 1978. A healthy climate of knowledge and attitude exist among rural Malay women. Only 2% of the nonacceptors had not heard of any family planning method; 99% of acceptors and 85% of nonacceptors had discussed family planning with their husbands. There was also evidence to show that the birthrate does decrease as literacy increases. On the other hand, however, only 19% of the respondents approved of family planning practices prior to the birth of the 1st child. Also, there is a dearth of information on family planning in the rural areas and not much has been done in utilizing the 2 popular forms of mass media--radio and television as a means of disseminating information on family planning. The study concludes with a recommendation that there is a need for a sustained effort at improving knowledge and disseminating information as well as for developing the proper attitude towards family planning. It is suggested that community leaders, women's clubs, and private organizations be mobilized to participate more fully in the promotion of family planning. eng}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16204, title = {Epidemiology of Malaria in Malaysia}, author = {K M Maqsudur Rahman}, url = {http://www.jstor.org/stable/4452869}, issn = {01620886}, year = {1982}, date = {1982-01-01}, journal = {Reviews of Infectious Diseases}, volume = {4}, number = {5}, pages = {985-991}, abstract = {Malaria is a major public health problem in Malaysia, particularly in peninsular Malaysia and the state of Sabah. An eradication program started in the states of Sabah and Sarawak in 1961 initially was remarkably successful. A similar but staged program was started in peninsular Malaysia in 1967 and was also quite successful. However, a marked upsurge in incidence in Sabah in 1975-1978 showed that malaria is still a major hazard. The disease leads to great economic losses in terms of the productivity of the labor force and the learning capacity of schoolchildren. The topography, the climate, and the migrations of the people due to increased economic activity are similar in peninsular Malaysia, Sabah, and Sarawak. However, the epidemiologic picture differs strikingly from area to area in terms of species of vectors, distribution of parasitic species, and resistance of Plasmodium falciparum to chloroquine. Likewise, the problems faced by the eradication or control programs in the three regions are dissimilar. Because solutions to only some of these problems are possible, the eradication of malaria in Malaysia is not likely in the near future. However, the situation offers an excellent opportunity for further studies of antimalaria measures.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16205, title = {The role of the occupational health nurse}, author = {H H Lim}, url = {https://www.ncbi.nlm.nih.gov/pubmed/7121357}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1982}, date = {1982-01-01}, journal = {Med J Malaysia}, volume = {37}, number = {1}, pages = {90-5}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16199, title = {The epidemiology of cancers in the University Hospital, Kuala Lumpur}, author = {H H Lim}, url = {https://www.ncbi.nlm.nih.gov/pubmed/7121347}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1982}, date = {1982-01-01}, journal = {Med J Malaysia}, volume = {37}, number = {1}, pages = {52-9}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16172, title = {A study on the food and nutritional status of the Armed Forces}, author = {Y H Chong and E S Tee and T K Ng and S B Yap and S K Mok}, url = {https://www.ncbi.nlm.nih.gov/pubmed/7121346}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1982}, date = {1982-01-01}, journal = {Med J Malaysia}, volume = {37}, number = {1}, pages = {46-51}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16129, title = {A primary health care project in Sarawak}, author = {P C Chen and Y K Tan}, url = {https://www.ncbi.nlm.nih.gov/pubmed/7121343}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1982}, date = {1982-01-01}, journal = {Med J Malaysia}, volume = {37}, number = {1}, pages = {25-34}, abstract = {A joint pilot project between the Ministry of Health and the Dept. of Social and Preventive Medicine, University of Malaya, to test the value of village aides in extending the health care system into isolated Iban communities was begun in May 1979 in the Entabai District of Sarawak. A group of 15 village aides consisting of 11 traditional Iban manangs (medicine men) and 4 youths were trained to provide primary health care including simple curative care, preventive care, and to assist in the detection of malaria. Evaluation carreid out 2 years later showed the following. With regard to curative care, the village aides were each, on the average, treating 70.6 patients/month, the most common complaint being headache (30.4%), which along with abdominal pain, constipation, bodyache, diarrhea, vomiting, fever, worm infections, cough, and sore throat, accounted for 89% of all illnesses seen by them. Subsequent to the introduction of village aides in the project area, the number of seriously ill patients requiring admission to the rest beds of the klinik desa dropped by 43.8% and the number of emergency referrals to the backup divisional hospitals fell by 46.1% showing that patients were coming to the klink desa for treatment at an earlier stage. The 11 traditional Iban manangs, who had recently received training had, on their own accord, drastically reduced the use of traditional Iban modes of therapy in preference for modern medicine. During the 24 months immediately after the introduction of village aides into Entabai, 9 gravity feed water supply systems together with related health packages advocating general cleanliness, the use of latrines, and fences were affected, whereas only 6 such systems were installed in the previous 24 months, indicating that it is likely that the village aides were of some assistance in mobilizing the community with respect to self-help efforts. During the same period, the majority of longhouses in the area successfully established a number of vegetable gardens growing foods for home consumption, and continue to vigorously advocate breastfeeding of infants in opposition to bottlefeeding. During the 23 months after village aides were introduced, a total of 1093 blood films were collected by the 15 village aides, the average number of blood films/village aide being 3.2 blood slides/month. Village aides are socially accepted by the Iban community who utilize their curative skills when mild illness disturb them, but who proceed directly to the klinik desa when more serious illness such as fever strike. The project has established clear lines of communication between the health team and the community, and has stimulated the community to organize itself to achieve an increasingly high level of health through community participation and self-reliance. Plans have been approved in principle to train a further 2000 village aides in primary health care for the state of Sarawak. eng}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16149, title = {The prevalence of endemic goitre in the Tinjar area, Sarawak}, author = {P C Chen and P P Lim}, url = {https://www.ncbi.nlm.nih.gov/pubmed/7177010}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1982}, date = {1982-01-01}, journal = {Med J Malaysia}, volume = {37}, number = {3}, pages = {265-9}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16232, title = {The prevalence of endemic goitre in the Tinjar area, Sarawak}, author = {Paul CY Chen and PP Lim}, year = {1982}, date = {1982-01-01}, journal = {Med J Malaysia}, volume = {37}, pages = {265-269}, abstract = {The prevalence of goitre was investigated in a sample from six longhouses and five primary schools located at varying degrees of remoteness along the Tinjar river, Sarawak. Together with this, a survey was made on the type ofsalt used by the households. The main ethnic groups in thesem communities were the KenyahlKayan and the Iban. The overall prevalence of palpable goitre detected from the age group 5-14 years were 71.7 percent and 77.0 percent for males and females respectively and 77.7 percent for females aged 15 years and above. The prevalence for both Iban and KenyahlKayan of either sex and for all age groups varied from 63.4 percent to 80.4 percent. The prevalence at each location did not differ significantly. On questioning 126 households, only 9 (7.1 percent) used iodized salt whilst 74 (58.7 percent) households used only uniodized coarse salt and 7 (5.6 percent) used only uniodized fine salt. The remaining 36 (28.6 percent) households used both fine and coarse uniodized salt. Undoubtedly at this point in time legislation on "table" salt iodization must be interpreted to mean not only the iodization of fine table salt, but in the case of the rural longhouse communities as are found in the Tinjar area, the iodization of coarse salt as well.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16128, title = {The Medical Journal of Malaysia: Past and Future}, author = {P C Chen}, year = {1982}, date = {1982-01-01}, journal = {Medical Journal of Malaysia}, volume = {37}, number = {1}, pages = {1-6}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16188, title = {Transmission of infection among household contacts of cholera patients in the 1978 outbreak in Perak}, author = {Chong Ying Gan}, year = {1981}, date = {1981-01-01}, journal = {Med. J. Malaysia}, volume = {36}, number = {2}, abstract = {In the outbreak of cholera in Perak in 1978, a study on 179 cholera patients (cases) from 8 health districts in the state indicated that those afflicted with the disease were from the rural areas, belonged to the lower socio-economic class and had little or no formal education. Under such conditions, it is expected that personal hygiene may not be satisfactory and person to person contact could play an important role in the transmission of the disease especially among those living in close contact. 34.2 percent of the 164 households of the cholera patients contained injected household contacts. From 1 to 6 infected household contacts per household were found for household size ranging from 2 to 18. Ninetyjive (8.6 percent) of the total 1101 household contacts were injected. Only 8 of these 95 infected household contacts developed clinical symptoms giving a ratio of 1 : 12 symptomatic to inapparent injections. While most of the contacts probably acquired their infection from the patient who constitutes the index case, the role of the asymptomatic carrier in the transmission ofinjection cannot be underestimated.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16127, title = {Endemic goitre: a preventable and yet highly prevalent disease in Sarawak}, author = {P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/7343820}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1981}, date = {1981-01-01}, journal = {Med J Malaysia}, volume = {36}, number = {2}, pages = {67-9}, keywords = {}, pubstate = {published}, tppubtype = {article} } @mastersthesis{RN182, title = {A Study of Inpatients of the Banting District Hospital}, author = {Mu Tha Mu}, year = {1980}, date = {1980-01-01}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {The main objective of this study is to observe the disease pattern of the inpatients of Banting District Hospital which is located in one of the most prosperous states of Peninsular Malaysia. At the same time, the utilization pattern of the hospital can be seen by its bed occupancy rate and length of stay of inpatients. The other characteristics of inpatients such as age, sex, race, time of admission and distance travelled were studied. A sample of 908 inpatients were chosen from the year 1978 for this study. For bed occupancy rate, the calculation was based on a two-week period, from 30th November to 13th December 1979. The ratio of inpatient to outpatient was 1:10 and the sex distribution was 32.3% for male patients and 67.7% for female patients. The distance travelled by inpatients from all parts of the district ranged from less than one mile to 39 miles. But the most frequent visits were made from those patients living around 1-4 miles of the hospital. The disease classification which was based on the World Health Organisation's International Classification of Diseases (Seventh Revision, 1955), showed that the common causes of admission to Banting District Hospital were as follows - deliveries, complications of pregnancy, childbirth and puerperium 49.3%, "accidents, poisonings and violence" 12.8%, disease of digestive system 9.1%, disease of genitourinary system 5.3% and disease of respiratory system 4.6%. Due to lack of information, the correlation of occupational group and social class of inpatients to the disease patterns could not be carried out. The average length of stay, in 1978, of a patient in the hospital was 4.8 days. The longest staying patients were those with diseases of the circulatory system 11.2 days, congenital malformations 11 days, diseases of the skin and cellular tissues 10.5 days. The average bed occupancy rate for the whole hospital was 55%. The maternity ward had a bed occupancy rate of 64% while the male ward had a 62% bed occupancy rate. The study on the time of admission reveals the most of the obstetric cases were admitted during the morning between 7.00 to 10.00 a.m. and for other causes of admissions, several peaks of admissions were seen, that is, between 10.00-11.00 a.m., 2.00 -3.00 p.m., and just before midnight. This can be a useful piece of information for hospital administrators when allocating their staff to increase the efficiency of the hospitals.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @article{RN16126, title = {On whom and how shall we spend our dollars?}, author = {P C Chen}, url = {http://www.e-mjm.org/1980/v35n2/government-expenditure-on-health.pdf}, year = {1980}, date = {1980-01-01}, journal = {Medical Journal of Malaysia}, volume = {35}, number = {2}, pages = {103-108}, abstract = {GOVERNMENT EXPENDITURE ON HEALTH - It is sobering to look around the world and to compare the per capita government expenditure on health in a number of countries and the relative health status of these countries. For 86 developing countries examined by the World Bank, 22 in 1976 spent US$1.00 or less per capita per year on health, the average being US$6.00, Malaysia being one of 14 countries that spent between US$I1.00 to $20.00 per capita per year. In other words, for most of the developing countries, medical care must be provided for with budgets that average US$6.00 per capita per annum but for about one-quarter of the developing countries, the expenditure in 1976 was US$1.00 or less per capita per annum. Examples of such countries include Pakistan, Afghanistan, Nepal, Bhutan, Bangladesh, Burma, Laos, Cambodia, Vietnam, Indonesia, Korea, Mali, Upper Volta, Niger, Chad, Ethiopia, Rwanda, Burundi, Zaire, Mozambique, Yemen, Syria and Haiti (World Bank, 1980). Looking at some developing and developed countries (Table I), it is noted that the range of per capita government expenditure on health in 1976 varies from a low of US$I.00 to a high of US$550 (Sweden), with Malaysia spending the equivalent of US$13 per capita per annum in 1976 (World Bank, 1980). From the Malaysian point of view it is important to bear in mind that the developed countries spent the equivalent of US$217 to $550 per capita per annum on health, and that this is 17 to 42 times what Malaysia can afford. ... more}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16124, title = {A comparison of morbidity patterns in Peninsular Malaysia 1959 and 1974}, author = {J T Arokiasamy and P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/7219259}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1980}, date = {1980-01-01}, journal = {Med J Malaysia}, volume = {34}, number = {4}, pages = {336-42}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16125, title = {Attitudes of 110 married men towards family planning}, author = {J T Arokiasamy}, url = {https://www.ncbi.nlm.nih.gov/pubmed/7253993}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1980}, date = {1980-01-01}, journal = {Med J Malaysia}, volume = {35}, number = {1}, pages = {22-7}, abstract = {A study was conducted at the Army Garrison Hospital at Port Dickson in Peninsular Malaysia to determine the attitudes of 110 married men towards family planning. The sample included 80 Malays and 30 Indians who are army personnel attending the hospital either for medical treatment or a check-up. The study instrument was a pre-tested questionnarie administered by 2 male nurses during the November-December 1975 period. 76 of the respondents were between the ages of 20-34 years. 81 of the respondents had been married for a duration of up to 11 years. A breakdown by religion showed that 80 were Muslims, 25 were Hindus, and 5 were Christians, the latter being all Roman Catholics. All of the respondents were able to read and write in at least 1 language, 36 had had schooling varying from standard 1-6, 40 had had schooling varying between Form 1-Form 3, and 34 had had schooling varying from Form 4-to either Malaysian Certificate of Education Level or Higher School Certificate Level. 103 of the respondents approved of family planning, and of these 63 had always felt this way in the past. 6 respondents indicated that they had not thought about family planning in the past. 87 respondents did not approve of the practice of family planning before having the 1st child. Only 7 of 80 Malays in contrast to 16 of 30 Indian respondents -- a significant difference -- approved of family planning before the 1st child. 89 of the 110 respondents had discussed family planning with their wives; 21 respondents had not. 93 respondents disapproved of induced abortion; 17 approved of it. Only 3 of 80 Malay respondents approved induced abortion, but 14 of 30 Indian respondents indicated approval. 98 of the respondents indicated that they were interested in learning more about family planning, and 96 approved of their wife practicing family planning. 56 respondents were practicing family planning, and 20 indicated that they would do so in the future. 6 said they would not practice family planning, and 28 were uncertain as to whether they would practice family planning. It appears that the better educated approve as well as practice family planning more than those with less education. eng}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{Lim-HH-1979-1, title = {An epidemiological study of cancers in the University Hospital: A preliminary report}, author = {H H Lim}, url = {http://www.e-mjm.org/1979/v34n1/cancers.pdf}, year = {1979}, date = {1979-09-01}, journal = {Med J Malaysia}, volume = {34}, number = {1}, pages = {32-37}, keywords = {}, pubstate = {published}, tppubtype = {article} } @mastersthesis{RN169b, title = {A Study of Inpatients of the Kuantan General Hospital}, author = {Jon Lan Choong}, year = {1979}, date = {1979-01-01}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {This is a study of the characteristics of a sample of inpatients of the Kuantan General Hospital. The main purpose of the study is to see how present resources of the hospital are utilized and whether utilized effectively. The two main criteria for assessing hospital efficiency and output, the bed occupancy rate and the length of stay, have been studied. In addition, some of the characteristics of the inpatients with respect to their age, sex, race, distance of stay, occupations and morbidity patterns have been examined. A sample of 389 inpatients of 1977 was chosen for the study. In the study on the bed occupancy rate, all patients staying in the wards during a two-week period from 7th December 1978 to 20th December 1978 have been included in the study. The ratio of inpatients to outpatients in the Kuantan General Hospital corresponds to the average for the country which is approximately 9%. The sexes of the patients admitted have been found to be proportional to those in the community except for the age group 21 to 30 years where there are more female patients. Patients were divided according to occupational groupings into government employees, private employees (including self-employed), students and unemployed. It has been found that more than 50% of the patients are unemployed, a figure very much higher than the National unemployment figures of 6.9% for Malays, 7.2% for Chinese and 12.2% for Indians. The distance of stay did not appear to affect the decision of patients to seek treatment at the hospital as much as one would expect. Although the majority of patients came from near the hospital, there were 13% of patients who stayed more than 50 miles away. This is probably due to the fact that the Kuantan General Hospital is the only general hospital in the State of Pahang. "Accidents, poisoning and violence" is the main cause of admission to the Kuantan General Hospital. Other major causes include "diseases of the digestive system" and "infective and parasitic diseases" respectively. The average length of stay of patients was found to be 6.8 days, which compares favourably with other hospitals where the length of stay is between seven and ten days. Within three days, nearly half of the patients (49.1%) have been discharged and within a week, as many as 73.3% have been discharged. The longest staying patients have been the orthopaedic patients with an average length of stay of 16.3 days. Patients in the fourth decade of life stay the longest, with an average length of stay of 10.8 days. For the bed occupancy rate, second class wards have the highest rate of 75.8% followed by third class wards with 66.6% and first class wards with 31.6%. The third class occupancy rate was found to be lower due to the inclusion of the chronic wards which have fewer patients. The surgical and paediatric units are found to have the highest bed occupancy rates of 87.5% and 87.4% respectively. More beds are suggested for the paediatric unit while the congestion in the surgical wards may be helped by the introduction of convalescent homes.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN168i, title = {A Study of Immunisation Status of Infants attending the Maternal and Child Health Clinics of the Dewan Bandaraya, 1977}, author = {George Jessie}, year = {1979}, date = {1979-01-01}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {In this dissertation, the immunisation status and factors affecting the immunisation coverage of the infants attending the six Maternal and Child Health Clinics of the Dewan Bandaraya were studied. From the six Maternal and Child Health Clinics of the Dewan Bandaraya, a random sample of 360 infants was selected to form the study sample. Every infant selected in the study was home-visited during a period of about one and a half months to obtain data for the study. It is observed from the study that the clinics serve all the major races in the country. The lower and the lower middle socioeconomic groups are the ones who utilise most of the services provided. The study reveals that 79% of the infants who attend the clinics complete their immunisation. It is found that there is no significant relationship between ethnic groups, sex, age of first visit and education level of the parents and the status of immunisation. Parity and occupation of the parents show a significant association with the immunisation status. Infants whose parents hold jobs requiring lower education levels, earn lower salaries and are of lower social status are less likely to complete their immunisation, and the immunisation status is also lower in those infants who have more than two siblings. Among the immunisations given at the six clinics, triple antigen and poliomyelitis vaccinations have the best coverage, then B.C.G. (95%) and smallpox (83%). The most common reason (53%) given for not completing immunisation is that the child is sick on the due date. Most of the infants (54%) who have completed their immunisation did so because they were advised to do so by the medical staff, thus emphasising the importance of health education. This study shows that completion rates of primary immunisation in the Dewan Bandaraya Maternal and Child Health Clinics during the year 1977 is satisfactory. Immunisation coverage in infants in Malaysia can be improved by better health education of the parents, organising more creches which are visited regularly by health teams, setting up of a central immunisation register and by giving priority to family planning programmes so that every infant's health need can be provided.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @article{RN16150, title = {Food beliefs of rural Malay women of Trengganu}, author = {P C Chen and R A Noordin and L Y Ngor}, url = {https://www.ncbi.nlm.nih.gov/pubmed/548710 http://www.e-mjm.org/1979/v34n2/food-beliefs.pdf}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1979}, date = {1979-01-01}, urldate = {1979-01-01}, journal = {Med J Malaysia}, volume = {34}, number = {2}, pages = {100-7}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16151, title = {Ecological factors influencing the growth of the child}, author = {P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/542155 http://www.e-mjm.org/1979/v34n1/ecological-and-child-growth.pdf}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1979}, date = {1979-01-01}, urldate = {1979-01-01}, journal = {Med J Malaysia}, volume = {34}, number = {1}, pages = {6-12}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16133, title = {Ecological changes and health in the Muda Irrigation Scheme}, author = {P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/522739 http://www.e-mjm.org/1979/v33n4/ecological-changes-and-health.pdf}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1979}, date = {1979-01-01}, urldate = {1979-01-01}, journal = {Med J Malaysia}, volume = {33}, number = {4}, pages = {294-8}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16152, title = {Attendances at an outpatient department of a district hospital}, author = {J T Arokiasamy}, url = {https://pubmed.ncbi.nlm.nih.gov/542143/ http://www.e-mjm.org/1979/v34n1/attendances-at-outpatient-department.pdf}, issn = {0300-5283 (Print) 0300-5283}, year = {1979}, date = {1979-01-01}, urldate = {1979-01-01}, journal = {Med J Malaysia}, volume = {34}, number = {1}, pages = {13-7}, keywords = {}, pubstate = {published}, tppubtype = {article} } @inbook{RN759, title = {Nondietary Factors and Nutrition}, author = {Paul C Y Chen}, editor = {DB Jelliffe and EFP Jelliffe}, url = {https://link.springer.com/chapter/10.1007%2F978-1-4613-2916-9_4}, isbn = {978-1-4613-2916-9}, year = {1979}, date = {1979-01-01}, booktitle = {Human Nutrition (A Comprehensive Treatise): Nutrition and Growth}, volume = {2}, pages = {47-64}, publisher = {Springer}, abstract = {Growth depends on adequate intake of food which must not only be digested and absorbed but also utilized by the body. Several factors influence and interfere in this process of digestion, absorption, and utilization, the chief among which are infection and metabolic disorders. Food intake itself is influenced not only by infection and loss of appetite but also by the availability of foods, which is partly dependent on socioeconomic factors, catastrophies, and the ecological balance that the human being has achieved with the environment. However, not all available and potentially edible materials are recognized or preferred as foods. Each culture views foods according to its own cultural perspective.}, keywords = {}, pubstate = {published}, tppubtype = {inbook} } @article{Chen-PCY-1978-4, title = {Life and Death - Ethical Dilemmas}, author = {P C Y Chen}, url = {http://www.e-mjm.org/1978/v32n4/life-and-death.pdf}, year = {1978}, date = {1978-06-01}, journal = {Medical Journal of Malaysia}, volume = {32}, number = {4}, pages = {266-267}, keywords = {}, pubstate = {published}, tppubtype = {article} } @mastersthesis{RN166_89, title = {Epidemiology of some recent typhoid outbreaks in Peninsular Malaysia}, author = {Karam Singh}, year = {1978}, date = {1978-01-01}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {A study of three typhoid outbreaks, which occurred during the last two years, in the country is presented. The choice of areas had been such that it included both urban and rural parts of the country. In Muar the outbreak in Sagil New Village was purely in a rural area, while in Sentul it is urban in nature. Typhoid outbreak in Kota Bahru district was more widespread and covered both urban and rural areas of the district. The study has been based on available date collected from various sources. It was observed that the overall incidence, based on notification, in West Malaysia range from 9.8/100,000 to 19.4/100,000 during an eleven year period from 1967 to 1977. Although such a long space of time was taken into consideration no definite seasonal variation was actually evident. None of the outbreaks discussed originated from a common source. In each case there had been a gradual increase in the incidence, reaching a peak and then falling more or less abruptly. This sudden fall could be attributed to various preventive measures put into operation during the outbreak. In none of the outbreaks was the real source actually identified. In the case of Kota Bahru, however, there was significant relationship between the outbreak and the poor sanitary conditions prevailing in the district. A high percentage of confirmed cases (77%) consumed raw and untreated water and at least a third did not have any sort of proper latrine for their use. It was observed that the incidence was slightly higher amongst the females than the males. There were 55% confirmed female cases as compared to 45% male cases. This could be due to a more outdoor life and responsible part the female plays in the family. As observed, the maximum number of cases occurred in the ages between 5 and 29 and the main susceptible single group of population was the school children.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN167_43, title = {A Retrospective Study of Medical Failures during Basic Commando Training in Malaysian Special Service Forces from 1970 to 1976}, author = {S Mahesan}, year = {1978}, date = {1978-01-01}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {This study was made to determine the pattern of medical failures experienced by volunteer trainees during Basic Commando Training from 1970 to 1976. It was found that out of 1,767 trainees, 320 trainees failed due to medical reasons giving an overall medical failure rate of 18.1%. The general pattern for medical failures appears to be gradually increasing and the incidence of medical failures also showed an increase for all phases of the training program under the study period. It was found that the overall incidence rate for medical failures was: a) Higher in the older age group (27 - 30 years) and lower in the younger age groups. b) Higher in the group with 7-9 years' military service and lower in the group with 1-3 years of military service. c) Higher in the single trainees and lower in the married trainees. It was found that the three main traumatic causes of medical failures were: a) Fracture of Bones - 48 cases b) HKJ - 41 cases c) Sprain Ankles - 35 cases. The three main non-traumatic causes of medical failures were: a) Exhaustion - 73 cases b) Psychosis - 32 cases c) Malaria - 29 cases. It was found that if the three main causes of traumatic and non-traumatic causes of medical failures were analysed by age, length of service and marital status, the results were: a) For Fracture of Bones the incidence of failures was the least in the trainees in the 23 - 26 years age group with 4 - 6 years of military service and married. b) For HKJ the incidence of failures was least in the trainees in the 27 - 30 years age group with 7 - 9 years of military service and married. c) For Sprain Ankles the incidence of failures was least in the 27 - 30 years age group with 7 - 9 years of military service and married. d) For Exhaustion the incidence of failures was least in the trainees in the 19-22 years age group with 1 - 3 years of military service and single. e) For Psychosis the incidence of failures was least in the trainees in the 27-30 years age group with 7 - 9 years of military service and married. f) For Malaria the incidence of failures was least in the trainees in the 27-30 years age group with 4 - 6 years of military service and married. The conclusion that can be drawn was the incidence of medical failures due to the three main traumatic causes depends on the length of military service which was the most important deciding factor followed by marital status and age. The conclusion that was for the incidence of medical failures due to the three main non-traumatic causes depends on the age and length of military service followed by marital status which were the deciding factors in that order.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @article{RN16135, title = {Reasons underlying the maternal choice of midwives in rural Malaysia}, author = {P C Y Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/683042 http://www.e-mjm.org/1978/v32n3/maternal-choice-of-midwives.pdf}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1978}, date = {1978-01-01}, urldate = {1978-01-01}, journal = {Med J Malaysia}, volume = {32}, number = {3}, pages = {200-5}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16134, title = {Field guide for the study, collection and preservation of medicinal plants}, author = {P C Y Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/750902 http://www.e-mjm.org/1978/v33n1/medicinal-plant.pdf}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1978}, date = {1978-01-01}, urldate = {1978-01-01}, journal = {Med J Malaysia}, volume = {33}, number = {1}, pages = {86-97}, keywords = {}, pubstate = {published}, tppubtype = {article} } @mastersthesis{RN158u, title = {A Study of the National Tuberculosis Control Programme in the State of Negri Sembilan, 1961-1975}, author = {Amar Singh Gill}, year = {1977}, date = {1977-01-01}, urldate = {1977-01-01}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {The National Tuberculosis Control Programme was launched in 1961 and has three components \textendash training, BCG vaccination and Case-finding (including treatment). The three objectives of the programme are: (i) Protection of at 1east 75% of the susceptible population with BCG vaccination. (ii) Identify at least two-thirds of the infectious cases prevalent in the community. (iii) Render 95% of those infections identified non-infectious with effective treatment. The training programme provides the various categories of skilled and trained personnel required for the proper organization and implementation of the programme. By the end of 1975, more than 5,000 people had beam trained in various aspects of the programme. No formal training in done in any of the states but the State Tuberculosis managerial Teams do give technical advice when required. The BCG vaccination programme is undoubtedly the most successful component of the programme. By the end of 1975 more than five million primary vaccinations had been performed in the country while more than 240,000 had been performed in the state of Negri Sembilan. By 1972, the target of vaccinating 75% of the eligible population had been achieved and by 1975, the programme was close to achieving the upper level (70 \textendash 90%) of the suggestion of the 9th W.H.O. expert Committee on Tuberculosis. At the national level 88.3% of the eligible population had been vaccinated as compared to 86% at the state level. Since 1973, the State has also done very well in achieving a BCG vaccination of more than 90% coverage of all newborns. The success of this programme (and its benefits) Is seen by the decline in the number of cases of childhood tuberculosis and of tuberculosis of the meninges and the central nervous system admitted to government hospitals in the country, particularly after 1969. The case-finding programme was launched in 1963 with mass miniature radiography as the main case-finding tool. As this was found to be uneconomical and the yield relatively poor, a change to direct microscopy of sputum from respiratory symptomatics was made in 1969. The National Tuberculosis Centre estimates that only about 40% of the infectious sources prevalent in the country have been discovered. Since 1974 the State of Negri Sembilan has been discovering more sputum positive cases than its estimated annual incidence but the nation as a whole falls short of this target. Unfortunately, cases are still detected in the far advanced stage (about 40% of all cases), resulting in about 10% of all sputum positive cases dying, usually within the first month of diagnosis. It was also seen that most of the cases were diagnosed by urban health facilities indicating relatively poor awareness of the disease among health centre staff. The treatment has been standardised since 1970 and is carried out at every health facility in the country. While all drugs are easily available and treatment is free, there still remains the perennial problem of treatment defaulters. Only 52% of the sputum positive cases registered in Negri Sembilan in 1970 completed treatment. This improved to 70.5% in the 1973 cohort. At the national level, only 69% of the 1973 cohort completed treatment while 17% died or abandoned treatment before their sputum vas converted to direct smear negative. The National Tuberculosis Control Programme has made satisfactory progress since 1961 but there is still room for improvement as not all the objectives set have been achieved. It is in the field of case-finding and treatment that greater efforts will be required to bring about early detection of infectious cases and the rendering of them non-infectious with effective treatment. There will probably be a significant epidemiological impact on the tuberculosis problem only after all the three objectives of the programme are achieved and sustained.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN162_39, title = {A study of Drug Addicts in a Rehabilitation Centre}, author = {Hematram Yadav}, year = {1977}, date = {1977-01-01}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {A study of drug addicts undergoing Therapeutic Community approach at the Help Centre (Pusat Pertolongan) in Batu Gajah was carried out. Keeping in mind the various limitations of the study the following findings were obtained. It was found that majority of the addicts were Chinese, and Malays were next in order with a few Indians and Ceylonese. Majority the addicts in this Centre were between twenty-one to twenty-five years of age. All except one had not been to school and most of them spoke English. Majority of them had been to school till M.C.E. Though most of them had been to school they were poorly employed though there were a few from rich families. 43.3% of them had large families ranging from seven to nine children and 89.8% grew up with their parents till they were sixteen years of age. Yet drug addiction was common in this group. The reasons why they took to drugs were mainly curiosity and experience and some mentioned friends and peer group pressure as a cause. Most of the respondents had started drugs by smoking marihuana and progressed to heroin. Thus the most popular drug amongst them was heroin followed by marihuana, morphine, opium and mandrax. Among this group, smoking was the most popular method of consumption of the drug/ drugs. Majority of them who smoked heroin, smoked it more than five times per day. Those who took other drugs like marihuana and morphine smoked less than five times a day. The addicts enjoyed taking the drugs either late at night, i.e. 9.00 p.m. to midnight or between 4.00 a.m. to 6.00 a.m. Some of them enjoyed taking the drugs at both these times. Cigarette smoking was common amongst them, though they were not heavy smokers. They preferred to smoke cigarettes only when "spiked" with drugs. Majority did not drink alcohol when addicted to drugs. They preferred drugs to alcohol. Those who drank alcohol also preferred to take drugs with alcohol. Since majority of them came from low income groups they had other means to support their drug addiction. Majority of them supported their addiction by resorting to crime such as stealing, gambling, extortion and pushing drugs. Most of them had been arrested by police for various reasons. Some of them had been arrested more than once. The addicts had also tried several other forms of treatment before coming to the Help Centre. Majority of them found that the various forms of treatment available were not satisfactory to them. As a last resort they came to Help Centre (Pusat Pertolongan). Majority of them came for treatment because of family pressure and some replied that they could not afford drugs. Each of the addicts also had several friends who were addicted but not undergoing treatment. An average of fifteen friends was calculated for each addict. Some of the addicts though undergoing this treatment were not sure of themselves whether they could stop drugs after leaving this centre.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN161_68, title = {A study of the Generation, Flow and Utilization of Data in Maternal and Child Health Programme}, author = {Jaswant Singh}, year = {1977}, date = {1977-01-01}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {This study was to find out the routine data generated by the “rural activity centres”, the data flow, the frequency of such data flow and how data were utilized by the “decision centres” as regards the maternal and child health programme.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN157_64, title = {Some Aspects of the Nutritional Status of Temiar in Kemar}, author = {Theam Eng Khoo}, year = {1977}, date = {1977-01-01}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {This study, carried out in November \textendash December 1976, was aimed at assessing the nutritional status of the Temiar in Ulu Perak. The results showed a 2.7% prevalence of protein-calorie malnutrition (PCM) and 24.7% prevalence of anaemia among the below fives. Anthropometry detected presence of acute (prevalence rate 11.4-21.7%) and chronic PCM (28.6% prevalence) in the same age group. Prevalence of anaemia ranged from a low of 33.7% among adult non-pregnant, non-lactating women to a high of 57.1% among pregnant adult females. Most of the households had primary dietary inadequacy of 4 or more nutrients. Food choice was dictated by numerous food taboos and practices.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN159_36, title = {The Impact of an Environmental Sanitation Programme on a Bidayuh Community}, author = {Patau Rubis}, year = {1977}, date = {1977-01-01}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {Bidayuh kampongs. The assessment A two-week's study was carried out to assess the impact of a rural sanitation programme, locally known as RHIS, on two was made on a comparative basis between a kampong with the programme, kampong A, and the other without it, kampong B, on the following indices - worm infection rates, morbidity and mortality statistics and nutritional status. The only significant difference noted was in the worm infection rates. Hookworm infection rate was significantly higher in the kampong A (30.9%) while in kampong B, the rate was only 17.1% (Chi-square = 7.9162Df = 1, 0.01 \> p \> 0. 001). The infection rate f or roundworm was however significantly lower at 74.8% while the other was 85.4% (Chi-square2 = 5.3131}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @article{RN16138, title = {Food habits and malnutrition}, author = {P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/904506}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1977}, date = {1977-01-01}, journal = {Med J Malaysia}, volume = {31}, number = {3}, pages = {170-5}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16137, title = {The human environment--are we committing suicide?}, author = {P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/927230}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1977}, date = {1977-01-01}, journal = {Med J Malaysia}, volume = {31}, number = {4}, pages = {260-1}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16136, title = {Behavioral causes of diseases}, author = {P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/614474}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1977}, date = {1977-01-01}, journal = {Med J Malaysia}, volume = {32}, number = {2}, pages = {100-2}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16231, title = {The traditional birth attendant and neonatal tetanus: the Malaysian experience}, author = {P C Chen}, issn = {0300-9920 (Print) 0300-9920 (Linking)}, year = {1976}, date = {1976-01-01}, journal = {J Trop Pediatr Environ Child Health}, volume = {22}, number = {6}, pages = {263-4}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16132, title = {Have we conquered the communicable diseases?}, author = {P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/1023005}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1976}, date = {1976-01-01}, journal = {Med J Malaysia}, volume = {31}, number = {1}, pages = {1-4}, keywords = {}, pubstate = {published}, tppubtype = {article} } @mastersthesis{RN155_77, title = {A Retrospective Study of the Morbidity Experience among Troops in a Malaysian Infantry Battalion using the Existing Medical Record System from 1973- 1975}, author = {Menjit Singh}, year = {1976}, date = {1976-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {The aim of this study was to study the changes in morbidity patterns in the different climatic settings among members of the Armed forces. The average incidence rate for spells of sickness of all types per month for other ranks was three times greater than that for officers. 1.99 man-days per 1000 available man-days was lost due to hospital and A.F.S.Q. admissions. The author suggested a Central Records Office be established to monitor the health status of Armed Forces personnel with a revised BAT.F.30 form and improved diagnostic procedures.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN156_99, title = {Triple Antigen Immunization in Infants in two Clinics in Penang in 1974}, author = {Swee Keat Ngiam}, year = {1976}, date = {1976-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {The objectives are to determine the percentage of infants who received the full course of triple antigen immunization, to determine the reasons for failure to complete the full course of immunization, and to determine the association between the status of immunization and ethnic group, age of infant, income of parents and level of education of father. 79.2% of selected infants received the full course of immunization. Reasons for failure to complete the course were chronic ill-health, change of residence and adverse reactions to the injection. There is no significant association between immunization status and ethnic group as well as and income of parents. There was significant association between immunization status and age of infant as well as level of education of the father.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @article{Teoh-ST-1975-1, title = {Recommended daily dietary intakes for Peninsular Malaysia}, author = {S T Teoh}, url = {https://pubmed.ncbi.nlm.nih.gov/1207530/ http://www.e-mjm.org/1975/v30n1/recommended-daily-dietary-intakes.pdf}, year = {1975}, date = {1975-09-01}, journal = {Med J Malaysia}, volume = {30}, number = {1}, pages = {38-42}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{Teoh-ST-1975-4, title = {Media selection for education in the allied health sciences}, author = {S T Teoh}, url = {https://pubmed.ncbi.nlm.nih.gov/53778/ http://www.e-mjm.org/1975/v29n4/education-in-allied-health-sciences.pdf}, year = {1975}, date = {1975-06-01}, journal = {Med J Malaysia}, volume = {29}, number = {4}, pages = {240-245}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16161, title = {A synergistic approach to organising educational support services in medical schools--the Malaysian experience}, author = {S T Teoh}, url = {https://www.ncbi.nlm.nih.gov/pubmed/1228345}, issn = {0025-6978 (Print) 0025-6978 (Linking)}, year = {1975}, date = {1975-01-01}, journal = {Med Biol Illus}, volume = {25}, number = {4}, pages = {193-8}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16190, title = {Medical systems in Malaysia: cultural bases and differential use}, author = {P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/1129610}, issn = {0037-7856 (Print) 0037-7856 (Linking)}, year = {1975}, date = {1975-01-01}, journal = {Soc Sci Med}, volume = {9}, number = {3}, pages = {171-80}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16131, title = {Editorial: To serve all the people}, author = {P C Chen}, url = {https://www.ncbi.nlm.nih.gov/pubmed/1196171 http://www.e-mjm.org/1975/v29n4/to-serve-all-the-people.pdf}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1975}, date = {1975-01-01}, urldate = {1975-01-01}, journal = {Med J Malaysia}, volume = {29}, number = {4}, pages = {237-9}, keywords = {}, pubstate = {published}, tppubtype = {article} } @mastersthesis{RN140e, title = {Analysis of Casualty Attendances on Sundays, District Hospital Klang, 1974}, author = {Gurmit Singh}, year = {1975}, date = {1975-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {This study aims to analyse the casualty attendances to study the existence of any behaviour pattern peculiar to an ethnic group and to study the work load of the casualty department in relation to the severity of disorders which reflect proportional abuse in the usage of casualty services. The medical concepts of various ethnic groups are described. Statistics on attendances are presented. Indians used the facility most although they comprised the lowest population of the three major ethnic groups. A quarter of the attendances may be considered as those abusing the casualty service.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN141j, title = {Descriptive Study of Mortality in the Malaysian Armed Forces (1971-1973)}, author = {Jeswant Singh}, year = {1975}, date = {1975-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {The overall mortality experience in the Malaysian Armed Forces over the period of study works out to 1.61 per 1000. Leaving out deaths from enemy action the new rate in 1.42 per 1000. Civilian population of males between the ages of 20 and 44 have a rate of 2.8 per 1000 by 1972 figures. This is 1.97 or roughly 2 times the army rate. Of the deaths in the Armed Forces 49.8% were attributable to service factors. These deaths when broken down by month do not show any convincing peak to correspond with any festive occasion or seasonal pattern. Looking at deaths by age at death and length of service it is seen that there is a greater number of service connected deaths in the younger age. 83.2% of service connected deaths are below 10 years of service. It is however not possible to comment on the mortality risk in the various age groups because we do not have the exact figures for the number of personnel in the various age groups. The mortality rate for service connected deaths is highest for the Army and lowest for the Navy. Air force officers have the highest mortality rate whereas Naval other ranks have the lowest rate. When compared with other major units the Territorial Army seems to have the highest mortality rate. At least 89.5% of all deaths in the Malaysian Armed Forces are medically certified. Breakdown of attributable deaths by cause gives the following figures: - Motor vehicle accidents - 31.9% All other accidents and injuries - 47.6% Infectious and other diseases - 13.0% Symptom and ill defined conditions - 4.3% lschaemic heart disease - 2.2% Malignant neoplasms including neoplasm of lymphatic and hemopoetic tissues - 0.7% Total of attributable deaths - 99.9% Some of the following may be considered preventable to some extent:- Motor vehicle accidents = 31.9% of all attributable deaths Drownings = 8.7% of all attributable deaths Infectious = 7.2% of all attributable deaths Firearm accidents = 5.8% of all attributable death* Cardiovascular diseases contribute 7.9% of all deaths of which 77.3% are deaths due to hypertension and ischaemic heart disease. In the Armed Forces there are about 2.8 times more deaths from motor vehicle accidents compared with the civilian male between age group 20 and 44 and about 2.4 times more deaths from violence.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN143_53, title = {A Study of Infant Mortality from BADIS Records: Pulau Pinang, West Malaysia 1973}, author = {Cheow Pheng Lee}, year = {1975}, date = {1975-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Births and Deaths Intelligence Service (BADIS) compiled records of births and deaths of mothers and children. The author used BADIS to study infant mortality in Pulau Pinang in particular to mortality identify high risk factors of infant and to obtain indices for evaluating the progress of maternal and child health programme in the state.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN144_80, title = {Research Needs and Priorities in Filariasis in Malaysia}, author = {Joon Wah Mak}, year = {1975}, date = {1975-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {The author discussed research projects in filiariasis and prioritized them in the context of present status of the disease and the political and socio-economic position of Malaysia. He started with a review of the history of filiariasis in Malaysia and previous research. He then address the issues of problems in conducting research especially that on transmission of the disease with the rapid socio-economic changes in the country. A comprehensive report of transmission, distribution, survey techniques, control measures, treatment, vectors, immunology and pathology of the infection follows. The author ended by listing the research priorities.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN146_29, title = {Infant Feeding Practices in the ANP Project Area, Telok Datok, Kuala Langat}, author = {Hj Salleh Mohd Omar}, year = {1975}, date = {1975-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {This is a survey of breast-feeding practices and the introduction of supplementary foods among malay infants in the Applied Nutrition Programme pilot scheme in Kuala Langat. After an introduction to the pathology of malnutrition, the author described the nutritional status in Malaysia and the applied nutrition programme. The result of the survey was discussed and suggestions made.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @mastersthesis{RN145_85, title = {Carrier-rates in El Tor Cholera}, author = {M Palanicavadan}, year = {1975}, date = {1975-01-01}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {The carrier-rate among household contacts of cholera patients was found to be 3.8% for the El Tor cholera outbreak in Penang state. This however was found to be lower than the rates for the household contacts observed in other countries, whose studies have been reviewed. The carrier-rates for household contacts in these countries ranged from 6.2% to 19.5%. There are so many factors that could have contributed to the lower carrier-rate in Penang and all these were enumerated. When the Penang outbreak was compared with the carrier studies in other countries, there were many differences observed, for instance, (i) methodology of investigation, (ii) period of investigation, (iii) household size, (iv) water supply, (v) personal hygiene and (vi) method of excreta disposal. Hence a direct comparison of the carrier-rates for the household contacts could not be made. The carrier-rate is not dependent upon the biotype of the organism but it depends upon the community with which one is dealing. If the household is large, personal hygiene is poor, water supply is no safe, and if unsatisfactory excreta disposal system prevails, then the carrier-rate for the household contacts will be higher than in places where all these factors are not present. The case:carrier ratio was found to be 1:0.3 for Penang state. The highest case:carrier ratio reported in the studies reviewed was 1:4.2. But it was postulated in the WHO mimeographed document that for El Tor cholera the ration can be in the range of 1:25 to 1:100 and no reference was given as to where this figure was obtained. This high ratio is possible only if the mildly asymptomatic carriers were included as asymptomatic carriers. Therefore it is a point of definition. Hence the carrier-rate a better index of infection than the case:carrier ratio which can be very misleading}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @article{RN16223, title = {Socio-cultural foundations of Medical Practice in Rural Malay Communities}, author = {CY Paul}, issn = {0300-5283}, year = {1974}, date = {1974-01-01}, journal = {The Medical Journal of Malaysia}, volume = {29}, pages = {1}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16160, title = {Instructional development in medical education}, author = {S T Teoh}, url = {https://www.ncbi.nlm.nih.gov/pubmed/4273775}, issn = {0300-5283 (Print) 0300-5283 (Linking)}, year = {1973}, date = {1973-01-01}, journal = {Med J Malaysia}, volume = {28}, number = {1}, pages = {16-8}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16234, title = {Medical sociology in the undergraduate medical curriculum in Malaysia}, author = {Paul CY Chen}, issn = {1365-2923}, year = {1972}, date = {1972-01-01}, journal = {Medical Education}, volume = {6}, number = {4}, pages = {323-324}, abstract = {A study in Sarawak, Malaysia, revealed diverse opinions, prejudices and degrees of knowledge about leprosy among various ethnic groups. The information gathered was used as the base on which a health education package relating to the disease was established. It is intended that this will lead to the early detection and treatment of a higher propotion of cases than has previously been posible.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16233, title = {Health trends in three Asian countries\textemdashCeylon, Malaysia and Singapore}, author = {P Arumanayagam and Soong Foong San}, issn = {1464-3685}, year = {1972}, date = {1972-01-01}, journal = {International journal of epidemiology}, volume = {1}, number = {2}, pages = {101-109}, abstract = {Three countries which were under British influence, Ceylon, Malaysia and Singapore developed their health services earlier to suit the plantation industry in Ceylon, the plantation and mining industries in Malaysia and the mainly urban population of Singapore. With the attainment of independent status the governments paid more attention to providing total health care, preventive and curative, with special attention being paid to the development of health services in rural areas. Demographic trends, pattern of diseases and other health indicators of the countries are outlined. The health trends seen also reflect the socio-economic development in these countries. The pressures of a rapidly growing population both in Ceylon and Malaysia are complicating the health problems.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{ChenCY1971-1, title = {Focus on Malaysia}, author = {Paul C Y Chen}, year = {1971}, date = {1971-12-31}, journal = {Tropical Doctor}, volume = {1}, pages = {183-186}, abstract = {The problems that face the culturally diverse population of Malaysia are basically related to rural poverty. Since 1957 the government has been implementing national plans including the establishment of rural health services and disease control programmes to raise the standard of living of rural communities. The Medical Centre at the University of Malaya was established in 1963 to meet the serious shortage of professional medical manpower and is oriented to local health needs. With its undergraduate programmes now firmly established, increasing attention is being paid both to research and to postgraduate and continuing medical education.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{ChenCY1971-2, title = {Unlicensed Medical Practice in West Malaysia}, author = {Paul C Y Chen}, year = {1971}, date = {1971-12-31}, journal = {Tropical and Geographical Medicine}, volume = {23}, pages = {173-182}, abstract = {In West Malaysia, the doctor (practitioner of modern scientific medicine) is licensed. However other who desire to practise as healers are not required to do so. These include traditional Malay and Chinese medicine-men, temple-keepers, spirit-mediums, "magicians", drug pedlers and herbal-lists. In addition, so-called "doctors" practise illegally in rural communities. It is noted that where there is a scarcity of doctors, that there is a cultural basis for unlicensed medical practice, and that patients view the various medical systems as complementary and go from one system to another as they search for relief or a cure. Some dangers associated with unlicensed medical practice are mentioned.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16191, title = {Beliefs and practices of Chinese diabetic patients concerning the cause and treatment of their ill-health}, author = {F S Soong}, issn = {0037-5675 (Print) 0037-5675}, year = {1971}, date = {1971-01-01}, journal = {Singapore Med J}, volume = {12}, number = {6}, pages = {309-13}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{Arumayagam1970-2, title = {Typhoid Fever in Ceylon}, author = {P Arumanayagam}, year = {1970}, date = {1970-12-31}, journal = {Ceylon Medical Journal}, volume = {15}, pages = {31-45}, abstract = {Epidemiological data regarding the occurrence of typhoid fever since 1958 is presented in this paper. It is one of the more important public health problems in the country. The only statistical data available are the numbers of patients treated in Government Hospitals. Based on these figures it is estimated that the annual incidence of the disease is in the region of 100-200 per 100,000 population: 70% of the total cases occur between 5-30 years of age. The period of high incidence is during the latter half of the year towards the end of the drought season. The disease is endemic in urban, rural and estate areas. The reason for the high endemicity in certain areas is discussed. The commonest method of transmission is by contact infection and water bourne outbreaks occur occasionally.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{ChenCY1970-1, title = {Ascariasis: Beliefs and Practices of a Rural Malay Community}, author = {Paul C Y Chen}, year = {1970}, date = {1970-12-31}, journal = {The Medical Journal of Malaya}, volume = {24}, pages = {176-182}, abstract = {The beliefs about causation and the practices, with regard to treatment and prevention of ascariasis, of a rural Malay community are reported. The most common belief was that ascariasis is caused by children eating a side dish, lauk, containing fish, the milk of mature coconuts, peanuts and eggs. The vast majority (96.2%) of households used piperazine or santonin preparations for treatment, some (38.5%) combining this with traditional treatments - village herbs and talismans. The use of talismans and food taboos against children constituted the main attempts at prevention. The whole community indiscriminately disposed of human excreta behind bushes close to human dwellings. None of the households encouraged hygienic habits on the part of their children, such as the washing of hands before the handling of food. The implications of the above observations are also discussed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{ChenCY1970-2, title = {Cholera in the Kedah River Area}, author = {Paul C Y Chen}, year = {1970}, date = {1970-12-31}, journal = {The Medical Journal of Malaya}, volume = {24}, pages = {247-256}, abstract = {The cholera outbreak in the Kedah River area of West Malaysia between December 1963 and April 1964 involved 75 cases and 56 carriers. It appears that the outbreak had two phases, an initial carrier-borne phase and a later massive water-borne phase. The aetiological factors of the massive phase of this outbreak include the predisposing factors, namely, river pollution by human excreta via overhung latrines and the use of this river water for drinking, unboiled, by people not aware of the danger involved. The precipitating factors include first the importation of cholera vibrios by a carrier from the neighbouring state of Perlis, and second the pollution of river water in Kedah River area during a drought which diminished the volume of river water, increased the salinity of the estuaries in the area of the outbreak. Analysis of the cased and carriers showed no significant difference in the distribution between the sexes, a preponderance of carriers over frank cased among subjects below the age of 15 years and the reverse in the higher age groups, a preponderance of single cased in households as opposed to multiple case, and the fact that inoculations conferred little if any protection.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{ChenCY1970-3, title = {Effects of the Trained Midwife on Traditional Domicilinary Midwifery in a Rural Malay Community}, author = {Paul C Y Chen}, year = {1970}, date = {1970-12-31}, journal = {Southeast Asian Journal of Tropical Medicine and Public Health}, volume = {1}, pages = {212-224}, abstract = {For domiciliary midwifery, the rural Malay, before the introduction of modern midwifery into rural Malay communities, was dependent upon the traditional bidan kampong (unregistered village midwife). This paper presents the results of a study that examines the effects of the introduction of the trained midwife on traditional domiciliary midwifery in a rural Malay community. With the introduction of modern midwifery into the study community, three established bidan kampong had not only to seek new roles and statuses but also to re-establish for each of themselves a readjusted area and size of practice. One, by virtue of a short course in modern midwifery, established herself as a socially and legally approved bidan kampong; a second, by readjusting as mengurut (massage), complemented and aided the role of the new registered midwife; a third, who tried her best to retain new traditional role, found herself lacking social and legal approval, and consequently restricted to a very limited practice.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{ChenCY1970-4, title = {Indigenous concepts of causation and methods of prevention of childhood diseases in a rural Malay community}, author = {Paul C Y Chen}, year = {1970}, date = {1970-12-31}, journal = {Journal of Tropical Pediatrics}, volume = {16}, pages = {33-42}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{ChenCY1970-5, title = {Socio-cultural aspects of a cholera epidemic in Trengganu, Malaysia}, author = {Paul C Y Chen}, year = {1970}, date = {1970-12-31}, journal = {Tropical Geographical Medicine}, volume = {23}, pages = {296-303}, abstract = {The El Tor cholera epidemic in Trengganu, Malaysia is examined in the context of indigenous rural Malay beliefs and practices. The epidemic was characterised by its magnitude, prolonged duration and a high rate of under-reporting. It seems highly probable that these characteristics were associated with the indigenous practice of contaminating common sources of water with human faeces, to the indigenous concept of cholera causation, treatment, prevention and control, to the customary obligation of the group to render support at times of illness and bereavement, and to their practice of concealing cholera cases and deaths in order that custom may not be stifled by control measures requiring isolation, quarantine, surveillance of cases and carriers, and minimum handling of the dead. The difficulty of control and possible alternatives in the context of such indigenous beliefs and practices is considered.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{ChenCY1970-6, title = {Classification and Concepts of Causation of Mental Illness in a Rural Malay Community}, author = {Paul C Y Chen}, year = {1970}, date = {1970-12-31}, journal = {The International Journal of Social Psychiatry}, volume = {16}, pages = {205-2015}, abstract = {Three broad strategies of mental illness are described: gila - states perceived to be a serious threat and requiring vigorous attention; chronic states perceived to be non-threatening and hence tolerable and requiring no treatment; and acute states perceived to be non-threatening but requiring attention from the bomoh (indigenous Malay medicine-man). Mental illness is thought to be the result of certain physical causes, namely God, spirits and witchcraft. Certain conditions are thought to predispose to mental illness, namely, the loss of semangat (vital force), mental stress and incorrect behaviour. Indigenous Malay psychotherapy is a logical consequence of the above concepts about causation. Exorcism, carried out in illness perceived to be due to spirit possession and witchcraft, is an elaborate ritual during which the bomoh mobilises the elements of shared traditions and incorporates such elements as group participation and support of the emotionally disturbed individual.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @proceedings{Arumayagam1970, title = {Epidemiology of Poliomyelitis in Ceylon}, author = {P Arumanayagam}, year = {1970}, date = {1970-01-01}, booktitle = {Proceedings of the 5th International Scientific Meeting of the International Epidemiological Association 1968}, pages = {43-54}, address = {Primosten, Yugoslavia}, abstract = {The epidemiology of poliomyelitis in Ceylon since 1962 is described. Though immunization with oral poliomyelitis vaccine has been carried out since 1962, cases of poliomyelitis are still being reported. Even in areas where immunization has been adequate, cases are being diagnosed as poliomyelitis. Clinical and laboratory investigations of these cases are essential to establish the diagnosis. Paralytic poliomyelitis was not considered a public health problem in Ceylon until the end of World War II. Following the appearance of poliomyelitis among the British troops stationed in the island, it was made a notifiable disease in 1944. A study of the incidence shows that the disease became endemic and in certain years, as in 1957, a higher endemic level was seen. Following a severe outbreak in 1962, an immunization programme with trivalent oral poliomyelitis vaccine (Sabin) was carried out in the entire country.}, keywords = {}, pubstate = {published}, tppubtype = {proceedings} } @proceedings{Arumayagam1970-3, title = {Experiences in Ceylon of Immunisation Against Poliomyelitis Using Trivalent Oral Poliomyelitis Virus Vaccine (Sabin)}, author = {P Arumanayagam}, year = {1970}, date = {1970-01-01}, booktitle = {Proceedings of the Fifth Malaysia-Singapore Congress of Medicine, Kuala Lumpur, Malaysia}, volume = {5}, pages = {152-156}, abstract = {Poliomyelitis which was endemic in Ceylon broke out in an epidemic form in March 1962. Mass immunization with trivalent oral poliomyelitis vaccine (Sabin) was carried out. This epidemic was a protracted one and the coverage was not adequate on a countrywide scale. An immunization programme was again launched in 1963 when 81% of the susceptible group received one dose and 63% received two doses. Subsequently, in 1968 another outbreak occurred. In tropical countries, other factors too should be considered for the occurrence of cases in addition to inadequate immunization of newborns. These factors could be interference by other enteroviruses, intertypic inhibition and the loss of potency of the vaccine in hot climates.}, keywords = {}, pubstate = {published}, tppubtype = {proceedings} } @techreport{RN764, title = {Third Regional Seminar on Education and Training: Teaching of Preventive Medicine in Medical Schools}, author = {Basil S Hetzel and K P Chen and Francis A Hamel and Winifred Danaraj and Presentacion Peralta and Munehiro Hirayama and R F R Scragg and WK Ng and Doglas Gordon}, year = {1970}, date = {1970-01-01}, institution = {World Health Organization}, keywords = {}, pubstate = {published}, tppubtype = {techreport} } @techreport{RN764b, title = {Third Regional Seminar on Education and Training: Teaching of Preventive Medicine in Medical Schools}, author = {Basil S Hetzel and K P Chen and Francis A Hamel and Winifred Danaraj and Presentacion Peralta and Munehiro Hirayama and R F R Scragg and WK Ng and Doglas Gordon}, year = {1970}, date = {1970-01-01}, institution = {World Health Organization}, keywords = {}, pubstate = {published}, tppubtype = {techreport} } @article{ChenCY1969-1, title = {Health Care for the Developing Countries of Southeast Asia}, author = {Paul CY Chen}, year = {1969}, date = {1969-12-31}, journal = {World Hospitals}, volume = {5}, pages = {93-98}, abstract = {An outline for the planning of medical and health services on a regional basis is presented. Emphasis is placed on integration of curative and preventive services. It is suggested that this may be partially achieved if health units and hospitals share a single administrative secretariat even at local levels. The training of multi-purpose medical and health auxiliaries is discussed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{ChenCY1969-2, title = {Spirits and Medicine-men among Rural Malays}, author = {Paul CY Chen}, year = {1969}, date = {1969-12-31}, journal = {Far East Medical Journal}, volume = {5}, pages = {84-87}, abstract = {Many rural Malays are reluctant to use modern scientific medicine but prefer traditional Malay medicine. The life of the rural Malay is shrouded by a whole body of beliefs and ritual acts pertaining to spirits. Illness is believed to be the consequence of the behaviour of malevolent spirits and healing is achieved by exorcism carried out by the bomoh. The various elements in rural Malay culture form strongly coherent culture patterns, and supply an internally consistent explanation for all that happens, which is reassuring to the rural Malay. Modern scientific medicine, based on materialistic beliefs and knowledge, does not form coherent patterns with rural Malay culture, and the resultant conflict leads to "cultural disorganization" of the rural Malay. The extent to which the crucial culture elements of a group and a system of medicine form the coherent culture patterns is one of the important determinants of acceptance or rejection of that system of medicine by that group of people.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{ChenCY1969-3, title = {The Method of Disposal of Human Excreta used by 177 Rural Malay Households}, author = {Paul CY Chen}, year = {1969}, date = {1969-12-31}, journal = {The Medical Journal of Malaya}, volume = {23}, pages = {159-168}, abstract = {In the more remote rural community all households use the traditional method of "bush" disposal of human faeces. With time, other methods, such as the pit latrine, come to be introduced. In recent years, however, as part of the Rural Health Plan, the water-seal latrine has come to be a satisfies all sanitary and aesthetic criteria, is simple to build and cheap. The water-seal latrine differed significantly from the other methods of disposal, observed in the community studied, in that it was associated with prestige in the community - education, high official village position, wealth and the presence of elders in the household.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{ChenCY1968, title = {The Water-seal Latrine in a Rural Malay Community}, author = {Paul C Y Chen}, year = {1968}, date = {1968-12-31}, journal = {Far East Medical Journal}, volume = {4}, pages = {386-389}, abstract = {A study was carried out in two areas in the State of Kedah, West Malaysia, involving a total of 134 Malay households, in an effort to examine the acceptability of the water-seal latrine to rural Malays. It was found that, as a device, the water-seal latrine is acceptable to rural Malays as it is inexpensive, is easily installed, and is compatible with their traditional practice of using water for anal cleansing and their cultural abhorrence of the handling of human faeces. Furthermore, it is associated with social prestige, is physically safe and is sanitary. However, it was noted that unless modifications are incorporated into the design, it cannot be used in areas subject to a dry season.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{GaleGW1968, title = {The "Great Stink" of London and the Cause of Cholera}, author = {GW Gale}, year = {1968}, date = {1968-12-31}, journal = {Bulletin of the Public Health Society}, volume = {2}, pages = {14-17}, abstract = {The miasmata of central London, 1858, is recounted and the role played by Dr. John Snow in elucidation of the cause of cholera is reviewed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @inbook{Gale1965-2, title = {Working in the Community}, author = {GW Gale}, year = {1965}, date = {1965-12-31}, booktitle = {Medical Education in Malaysia}, pages = {45-56}, publisher = {Andre Publication}, address = {Singapore}, abstract = {A definitive programme of field work for undergraduate students in Social and Preventive Medicine is discussed}, keywords = {}, pubstate = {published}, tppubtype = {inbook} } @inbook{Danaraj1965, title = {The Malaysian Scene}, author = {W Danaraj}, year = {1965}, date = {1965-12-31}, booktitle = {Medical Education in Malaysia}, journal = {Andre Publication}, pages = {15-21}, publisher = {Andre Publication}, address = {Singapore}, abstract = {The land, economy, the people and the pattern of disease are discussed}, keywords = {}, pubstate = {published}, tppubtype = {inbook} } @article{Gale1965, title = {Some factors affecting rural health services in developing countries}, author = {GW Gale}, doi = {https://doi.org/10.1016/S0140-6736(65)91846-5}, year = {1965}, date = {1965-01-01}, journal = {The Lancet}, volume = {285}, number = {7387}, pages = {696-697}, abstract = {The industrial revolution in developing countries differs from that in Europe in various ways. In the latter it was caused by the fiee play of economic factors and private enterprise, and the pace of scientific discovery and technological progress was slow. In developing countries now the revolution results from political and governmental pressure, and this has resulted in a fear of neo-colonialism and the rejection of help from the former colonial power. A policy of non-alignment tends to produce a multiplicity of advisers and conflicting advice, with dissipation of limited resources. In Europe rapid urbanization was associated with epidemic disease, but in the tropics now, better hygiene and public health measures prevent this. Better communications make medical facilities available to rural areas and reduce isolation. In towns the clash of a variety of cultures causes much psychogenic illness. An agricultural revolution coincided with the British industrial revolution, so that food production and population growth matched until exports paid for imported food, but in developing countries food production is being outstripped, and emigration is no longer a practicable solution. In these countries provision of further medical facilities without sufficient forethought can do little for the total good of the rural areas. It is recommended that dispersed rural populations should be concentrated into villages, each with its health centre. Subjects for health education are proposed, some involving changes in traditional customs and beliefs}, keywords = {}, pubstate = {published}, tppubtype = {article} } @phdthesis{RN767, title = {A Study of the Effect of Physical Disablement on Adolescents Living in Singapore, 1956-1958}, author = {Rosemary Stabb Mills}, year = {1962}, date = {1962-01-01}, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @article{RN16170, title = {Survey of sickness in Singapore with notes on births, deaths, handicapped persons, puberty, menopause, immunisation, incidence of cough and adoption}, author = {T A Lloyd Davies and R Mills}, url = {https://www.ncbi.nlm.nih.gov/pubmed/14466048}, issn = {0025-7303 (Print) 0025-7303 (Linking)}, year = {1961}, date = {1961-01-01}, journal = {Med J Malaya}, volume = {15}, pages = {117-56}, abstract = {A medical survey was carried out in three districts in Singapore, a large village consisting of shop-houses and houses with palm-leaf roofs, a densely inhabited part of China-town composed entirely of shop-houses and a Malay-pattern village with some " high class houses " on the periphery. The population of the whole area was about 7, 000. In May, June and August 1958 all the houses were visited by three female investigators who made a census and took details of water supply and latrines. Monthly visits started in September 1958 and continued until July 1960. Questions were asked about sickness in the previous month, the type of treatment received and absence from work due to sickness. The results are given in 20 tables and 4 figures. A comparison is made between the survey area and Singapore as a whole. Demographic and occupational details are given. Over half the population is under 18 years of age. The causes of death in Singapore in 1958 are very similar to those in England and Wales in 1906. The sickness survey revealed that men between 25 and 54 years of age lost from 5 to 9 days' work a year owing to sickness; the figure for European countries is 14. The causes of sickness and the type of treatment received are given in considerable detail. The number of questions that could be asked at the time of the survey was obviously limited but the opportunity was taken to obtain information about a variety of subjects. The use of facilities for vaccination and prophylactic inoculation was disappointing. Details are given of the age of puberty and the onset of menopause, of the number of handicapped persons, of the ages at which children became " dry " at night and of persistent cough in persons of 45 years of age and over. A section is devoted to family structure and adoption; it seems that the habit of adoption in Singapore is not changing.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @phdthesis{RN765, title = {The Collection and Disposal of Refuse in the City of Singapore}, author = {Thong Kah Leong}, year = {1961}, date = {1961-01-01}, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @article{RN16169, title = {Flies in aeroplanes as vectors of faecal-borne disease}, author = {J H Hale and T A Lloyd Davies and W K Hin}, issn = {0035-9203 (Print) 0035-9203}, year = {1960}, date = {1960-01-01}, journal = {Trans R Soc Trop Med Hyg}, volume = {54}, pages = {261-2}, abstract = {Cholera occurred in Bangkok in May 1958 and spread to 31 of the 7, 1 provinces of Thailand, all in the south. During the epidemic two of the authors, during an air flight from Bangkok to Singapore, noticed flies in the passenger cabin and, later, in the restaurant and waiting rooms at Bangkok airport: 12 flies were counted on a piece of fruit provided as refreshment in the airport. During June-July, 43 aeroplanes arriving in Singapore from Bangkok were examined for flies in passenger and crew cabins after disembarkation and flies were found in all. The flies (Musca domestica) were trapped either alive or after pyrethrum spraying. In the first 4-day collections (9 aeroplanes) the flies were cultured individually for the presence of (1) Vibrio cholerae, (2) Shigella, (3) Salmonella, (4) faecal Escherichia cali, (5) Streptococcus faecalis. The subsequent 16 collections were grouped in daily collections and examined for (1), (2) and (3) only. The flies were incubated in peptone water and subcultures were made thereafter on appropriate selective media. Flies were recovered from the flight deck, crew and passenger cabins, kitchen and pantry and closets. Faecal organisms were recovered from 9 of 34 flies in the first 4 collections, but cultures for (1), (2) and (3) were negative. In the second period 94 flies were recovered from 32 aeroplanes but no pathogenic organisms were isolated. Thereafter, airline companies were asked to spray aircraft between Bangkok and Singapore and this was done during flight within 24 hours of reaching Singapore by means of pressure aerosol bombs containing pyrethrum and DDT. In the 3 following weeks, 48 aircraft were searched. 20 did not contain flies and 64 flies were caught in the remainder. Evidently the flies had been in contact with faeces, but contamination in aeroplanes is unlikely as all employed well-designed chemical closets. The risk of flies carrying pathogenic organisms is clearly increased during an epidemic, but " whether flies become contaminated with V. cholerae is a numerical function ". The fact that all the aircraft contained flies increases the risk of flies acting as aeroplane-borne vectors across international boundaries. The risk was not abolished by special spraying during the flight from Bangkok to Singapore. Flies are difficult to kill, except by knock-down sprays, but as these are not suitable for aircraft when passengers are present, the authors suggest that strict control of flies should be enforced at all international airports.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @inproceedings{RN768, title = {Genetic Variations in Small Human Populations}, author = {Ivan Polunin}, editor = {R D Purchon}, year = {1960}, date = {1960-01-01}, booktitle = {Centenary and Bicentenary Congress of Biology}, pages = {208-211}, publisher = {University of Malaya Press}, keywords = {}, pubstate = {published}, tppubtype = {inproceedings} } @article{RN16246, title = {Muruts of North Borneo}, author = {Ivan Polunin}, url = {http://www.sciencedirect.com/science/article/pii/S014067365990529X}, doi = {https://doi.org/10.1016/S0140-6736(59)90529-X}, issn = {0140-6736}, year = {1959}, date = {1959-01-01}, journal = {The Lancet}, volume = {274}, number = {7091}, pages = {65}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16241, title = {A Note on Visual Non-Literary Methods of Communication Among the Muruts of North Borneo}, author = {Ivan Polunin}, issn = {0025-1496}, year = {1959}, date = {1959-01-01}, journal = {Man}, volume = {59}, pages = {97-99}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16168, title = {An investigation of absenteeism in selected groups of employees of H. M. Dockyard, Singapore}, author = {J Glass and T A Lloyd Davies}, url = {https://www.ncbi.nlm.nih.gov/pubmed/13828363}, issn = {0025-7303 (Print) 0025-7303 (Linking)}, year = {1959}, date = {1959-01-01}, journal = {Med J Malaya}, volume = {13}, pages = {331-4}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16216, title = {Work preferences of adolescent boys and girls in Penang}, author = {T A Davies and R Mills}, url = {https://www.ncbi.nlm.nih.gov/pubmed/13666190}, issn = {0025-7303 (Print) 0025-7303 (Linking)}, year = {1959}, date = {1959-01-01}, journal = {Med J Malaya}, volume = {13}, number = {3}, pages = {222-36}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16163, title = {Ethnic group differences in coronary heart disease in Singapore: an analysis of necropsy records}, author = {T J Danaraj and M S Acker and W Danaraj and H O Wong and B Y Tan}, url = {https://www.ncbi.nlm.nih.gov/pubmed/13813926}, issn = {0002-8703 (Print) 0002-8703 (Linking)}, year = {1959}, date = {1959-01-01}, journal = {Am Heart J}, volume = {58}, pages = {516-26}, abstract = {Coronary disease formed about 50 per cent. of all heart disease in Indian, but only from 10 to 20 per cent. in Chinese, men over 20 years of age. There was little difference in percentage incidence of non-coronary forms. Differences in coronary atheroma were small and thus the higher prevalence of coronary disease among Indians was attributable to coronary heart disease. Data for women also are presented but the number of Indians was considered too small for study. Further investigation is advised, particularly since the Chinese and Indians are culturally distinct groups living in the same physical environment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16238, title = {The influence of maternal age and birth order on the outcome of pregnancy in poor Chinese women}, author = {Jean Millis}, url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1469-1809.1958.tb01430.x/abstract}, issn = {1469-1809}, year = {1958}, date = {1958-01-01}, journal = {Annals of human genetics}, volume = {22}, number = {4}, pages = {362-369}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16167, title = {Young mothers in Singapore}, author = {T A Lloyd Davies and R Mills}, url = {https://www.ncbi.nlm.nih.gov/pubmed/13577151}, issn = {0025-7303 (Print) 0025-7303 (Linking)}, year = {1958}, date = {1958-01-01}, journal = {Med J Malaya}, volume = {12}, number = {4}, pages = {585-601}, abstract = {The annual report of the Singapore medical department drew attention to the fact that the babies of mothers under the age of 21 years were at greater risk than those of older women. This article is the result of an investigation of all mothers under the age of 16 years who gave birth to a live baby in Singapore in 1955. Of 228 mothers registered, 50 could not be traced and 72 were actually over 16 years of age at the time of delivery. Of the remaining 106 mothers all but 2 were in good health but 15 of the babies had died. (This gives an infant mortality rate of about double that of the Singapore average.) There is an interesting account of the reasons and the varying traditions behind these early marriages. The racial distribution was as follows: [img 1T348.tif] The large number of Malaysians in this group reflects the conservatism of this group. [The small infant mortality among the Tamils probably indicates not only their willingness to use hospitals and clinics, but also their superior ability in breast feeding.]}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16166, title = {Comparative health. Industrial medicine in changing societies}, author = {T A Lloyd Davies}, url = {https://www.ncbi.nlm.nih.gov/pubmed/13554721}, issn = {0033-3506 (Print) 0033-3506 (Linking)}, year = {1958}, date = {1958-01-01}, journal = {Public Health}, volume = {72}, number = {2}, pages = {61-9}, abstract = {This is an unusual essay. The author is Professor of Social Medicine and Public Health in Singapore, and he writes with primitive and developing societies in mind, pointing out that religious and traditional beliefs affect attitudes towards illness. Early industrial development of a country has usually meant removal of work people from their accustomed haunts to places where the whole form, and content of life are different, and has resulted in detribalization and loss of old standards and security. It has also meant conflict between government and employers on the subject of responsibility for the health of employees. Industrialization usually results in a raised standard of living, but in the period of transition, which may last for several generations, there are in the industrial field certain needs which should be borne in mind. Established procedures to secure the health, safety and welfare of workers should be introduced, on the basis of what is possible rather that what is ideal. Efficiency should be increased by improving health and by substituting machine power for muscle power. Social security schemes should be developed, along with a properly directed trade union movement, but this is not easy since education, which leads to high office in a trade union, may seriously separate the official from the worker in a developing community, and the developing trade union leader may chase " out-dated shibboleths" (of which colonialism is the most convenient to hand) at the expense of the true needs of his people. Finally, none of these industrial needs can be secured, or even approached, without universal education. The author ends by remarking that where aid is given to these countries it should be in a form which acts as an incentive to self help, and it should be given for need, not for political advantage.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @phdthesis{RN766, title = {The Problem of Nightsoil Disposal in Singapore Rural Settlements}, author = {Tan Kah Hong}, year = {1958}, date = {1958-01-01}, keywords = {}, pubstate = {published}, tppubtype = {phdthesis} } @article{RN16244, title = {The relation between birth weight and weight gain throughout the first year}, author = {JEAN MILLIS and TYE CHO‐YOOK}, url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1469-1809.1972.tb00289.x/abstract}, issn = {1469-1809}, year = {1957}, date = {1957-01-01}, journal = {Annals of human genetics}, volume = {21}, number = {3}, pages = {289-292}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{Danaraj1956, title = {Lead Encephalopathy}, author = {W. Danaraj}, year = {1956}, date = {1956-07-01}, journal = {Proceedings of the Alumni Association}, volume = {9}, number = {2}, pages = {107-20}, abstract = {A series of 4 cases of lead encephalopathy is reported here with clinical particulars, the results of blood, urine and X-ray examinations and the investigations which were carried out to discover the source of the lead poisoning. In 2 of these cases the investigations were unsuccessful, but in the other 2 cases lead storage batteries were discovered to be the cause of the poisoning. One of the patients had supplemented his earnings as a farmer by taking part in the recovery of lead from accumulator plates which were broken up and melted down in a kuali over an open wood fire. Evidence of lead intoxication was also found in the 3 other individuals who had worked in the same place. The other patient, an 11-year-old Chinese boy, lived with his parents, a brother and a baby sister in the ground floor of a shop-house where his father had been engaged for years in storage battery repair. This repair, which consisted in scraping, repasting and soldering the leaden plates, was carried out under very insanitary conditions in the room that was used for eating, sleeping and living. X-ray photographs of the brother and baby sister are reproduced to show the lead lines in the bones which were demonstrated. Of interest is the mention of sources of lead other than occupational, which have caused plumbism in reported cases in Malaya, viz. : -(1) Chinese face powders which were found to contain up to 50 per cent. of lead carbonate [this Bulletin, 1930, v. 5, 891] and in one instance 70 per cent. of red lead oxide, and (2) a sample of chu sha, a Chinese medicine powder adulterated with up to 34 per cent. of lead. Reference is made to the possibility that black market chandu (opium prepared for smoking) and chandu dross may cause lead poisoning through adulteration with lead to increase the weight.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16210, title = {A study of the medico-social needs of old people living in Singapore}, author = {T A Lloyd Davies}, year = {1956}, date = {1956-01-01}, journal = {Medical Journal of Malaya}, volume = {11}, number = {1}, pages = {1-19}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16208, title = {The Employment of Elderly Persons}, author = {T A Lloyd Davies}, year = {1955}, date = {1955-01-01}, journal = {Bulletin of the World Health Organization}, volume = {13}, pages = {595-603}, abstract = {Not every old person is fit for employment, and consequently employment agencies must reserve the right of selection. Retirement at the customary age with, if desired, re-employment for defined periods seems to offer the best method of employing old people, avoiding damaging loss of dignity and the blocking of promotion of younger people. Under suitable conditions, old persons are capable of a high level of employment. The possibilities of employment, however, vary very much with different types of industries and industrial regions. The elderly usually have a higher sickness absenteeism than young people, but have fewer absences for other reasons than sickness. Elderly workers seem to be able to carry out manual labour with efficiency if they are put into jobs without time-stress. If retraining is necessary, the utmost possible use should be made of already established skills. Heavy work does not seem to be necessarily harmful for old people. Little knowledge is yet available on the health problems of professional workers or executives at increasing age. Lack of decisiveness, failure of critical judgement, and increasing irritability -resulting from difficulty in organizing new information-will call for transfer to less responsible positions. Many more studies of old age are needed before the circumstances under which they may best be employed in present-day industry can be determined. Full employment and the need for production make this problem still more urgent.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16240, title = {Extreme Anaemia with Recovery}, author = {Peter Tasker and Ivan Polunin}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2079910/pdf/brmedj03629-0043.pdf}, year = {1954}, date = {1954-01-01}, journal = {British Medical Journal}, volume = {2}, number = {4902}, pages = {1465}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16236, title = {Extreme anaemia with recovery, associated with pigmentary changes in the hair}, author = {P Tasker and I Polunin}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2079910/pdf/brmedj03629-0043.pdf}, issn = {0007-1447 (Print) 0007-1447 (Linking)}, year = {1954}, date = {1954-01-01}, journal = {Br Med J}, volume = {2}, number = {4902}, pages = {1465}, abstract = {This case shows that a haemoglobin level of 0.7g% (5% Sahli) is compatible with life and moderate activity.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16247, title = {A study of growth in the first year of life of southern Indian infants born in Singapore}, author = {Jean Millis}, issn = {0022-3476}, year = {1954}, date = {1954-01-01}, journal = {The Journal of pediatrics}, volume = {45}, number = {6}, pages = {692-696}, abstract = {Sixty-four male and sixty-threefemale Southern Indian infants were selected from the “normal full-term” infants born in the Kandang Kerbau Maternity Hospital, Singapore, in 1951. They belonged to the lower income sections of the community. Home visits were made to collect 1,980 measurements of weight and 456 measurements of length at regular intervals in the first year. A geometrically progressive increase in weight was observed; the rate of increase was less than that of Chinese infants in Singapore and of infants of Northern European stock in America and Australia, but the increase in length was comparable.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16209, title = {Medicine, society and health}, author = {T A Lloyd Davies}, year = {1954}, date = {1954-01-01}, journal = {Medical Journal of Malaya}, volume = {8}, number = {3}, pages = {207-216}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16164, title = {Studies on the chemotherapy of malaria. II. The treatment of acute malaria with proguanil (paludrine)}, author = {J W Field and J H Strahan and J F Edeson and T Wilson}, url = {https://www.ncbi.nlm.nih.gov/pubmed/13193268}, issn = {0025-7303 (Print) 0025-7303 (Linking)}, year = {1954}, date = {1954-01-01}, journal = {Med J Malaya}, volume = {8}, number = {4}, pages = {303-17}, abstract = {During the period 1947-53, 709 Asian patients suffering from acute malarial attacks (538 P. falciparum, 150 P. vivax, 21 P. malariae) were treated with proguanil in Kuala Lumpur. All were of Malay, Chinese or Indian race and were classed as semi-immunes. Two hundred and forty-seven patients were given single-dose treatment with 100 mgm., 250 mgm. or 300 mgm. proguanil; 436 received a full course of 300 mgm. daily for 5 to 7 days; 26 patients suffering from severe P. falciparum malaria were given proguanil by intramuscular or intravenous injection. In P. falciparum malaria the clinical response was often slow, but for the first 2 years clearance of asexual parasites was satisfactory, even with a single dose of 100 mgm. Late in 1948 the first failure with single-dose treatment was noted, and early in 1949 the first failure with a full course of 300 mgm. daily for 5 to 7 days. [The criterion of failure was persistence of asexual parasitaemia 7 days after beginning treatment, or where therapeutic intervention with another drug was found necessary before the 7th day.] By 1950 about half the patients treated with a full course of the drug failed to respond and this continued to be the case during the remainder of the period under review. In P. vivax malaria clinical response and clearance of parasites were slow, but no actual failures were noted till early in 1951; the proportion of failures continued to remain at a low level. P. malariae infection has become increasingly rare in Malaya in recent years. In the few cases treated the response was slow with the single-dose treatment used; no failures were noted. Artificial feeding experiments with Anopheles maculatus indicated that sporogony in the mosquito is arrested at an early stage. In a discussion on the problems associated with proguanil resistance, it is noted that resistant strains are not confined to any one part of Malaya but can be found in various parts of the country if looked for; their natural transmission despite regular prophylactic doses of proguanil is now known to be possible. Chloroquine, amodiaquine, mepacrine and quinine all proved effective in the treatment of proguanil-resistant infections. It is noted that quinine is a poor suppressive drug, but that any of the others named above can be relied upon should a serious decline in the efficacy of suppressive proguanil occur.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16248, title = {Studies of blood groups in South-East Asia}, author = {Ivan Polunin and PHA Sneah}, issn = {0307-3114}, year = {1953}, date = {1953-01-01}, journal = {The Journal of the Royal Anthropological Institute of Great Britain and Ireland}, volume = {83}, number = {2}, pages = {215-251}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16239, title = {Tinea imbricata in Malaya}, author = {Ivan Polunin}, url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2133.1952.tb15801.x/abstract}, issn = {1365-2133}, year = {1952}, date = {1952-01-01}, journal = {British Journal of Dermatology}, volume = {64}, number = {10}, pages = {378-384}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16243, title = {Pineapple Dermatosis}, author = {Ivan Polunin}, url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2133.1951.tb13682.x/abstract}, issn = {1365-2133}, year = {1951}, date = {1951-01-01}, journal = {British Journal of Dermatology}, volume = {63}, number = {12}, pages = {441-455}, abstract = {Workers in Malayan pineapple canning factories who cut up raw pineapples suffer from skin lesions of unusual type on those parts of the body exposed to the fruit. A preliminary note on this condition has already been published (Polunin, 1951). The pineapple is remarkable among fruits, for, as it well known, it can be used in cooking to soften tough meat. Over-indulgence in the raw fruit would appear to have a similiar effect on the buccal mucosa, for it may be followed by a most unplesant sensation in the mouth and lips, which feel as if they had been burned with hot liquid, or as if a new pipe were being broken in. In Malaya, the existence of a labour force which works with hands always wet with pineapple juice provides a situation for the study of the response of the skin to noxious agents of a special type.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16242, title = {An Industrial Dermatosis due to Enzyme Action}, author = {Ivan Polunin}, issn = {1476-4687}, year = {1951}, date = {1951-01-01}, journal = {Nature}, volume = {167}, number = {4246}, pages = {442}, abstract = {LABOURERS in factories in South Malaya who cut up pineapples by hand for canning invariably show an abnormality of those parts of the body which are exposed to slight pressure and pineapple juice, notably the palmar surfaces of the fingertips and the periphery of the palms. At the beginning of the canning season, the left hand, which comes more into contact with the fruit than the knife-holding hand, becomes sore and small superficial raw areas on the fingertips are often seen. Within several days, however, these heal, and the skin ceases to be sore. The labourers state that this tolerance to the pineapple juice is due to the development of an abnormality of the skin, which in the affected area becomes bluish-white and so smooth that fingerprints may be completely lost. Deep cracks are sometimes seen in the region of the skin creases. These often stay raw and bleeding for a long time, and show no clinical signs of infection, presumably because of removal of dead tissues by enzymatic action.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16220, title = {Reflections on the Course of Preventive Medicine in Malaysia}, author = {J H Strahan}, year = {1948}, date = {1948-01-01}, journal = {Medical Journal of Malaya}, volume = {2}, number = {4}, pages = {221-238}, abstract = {This presidential address delivered at the Annual Meeting of the Malaya Branch of the British Medical Association deals with the history of the impact of western medicine on Malaya. In the early years curative medicine monopolized attention. A Port Quarantine Service was established in 1900 but serious attention to preventive medicine had to wait till 1911 When the Health Service of the then Federated Malay States was founded. Rubber had brought amazing prosperity and disease prevention yielded increased dividends. The address provides much interesting information about Malaya, its peoples and their diseases, and the efforts made by research workers and health departments to control disease prevalence during the last 28 years: this does not lend itself to summary. For the future, outstanding tasks include the application of recently acquired knowledge and techniques to the control of malaria; an allout attack on tuberculosis; much more attention to nutrition and deficiency diseases, and an orientation of the work of the Health Services towards social medicine. Norman White.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16165, title = {Quinine by continuous intravenous drip in the treatment of acute falciparum malaria}, author = {J H Strahan}, url = {https://www.ncbi.nlm.nih.gov/pubmed/18912196}, issn = {0035-9203 (Print) 0035-9203 (Linking)}, year = {1948}, date = {1948-01-01}, journal = {Trans R Soc Trop Med Hyg}, volume = {41}, number = {5}, pages = {669-76}, abstract = {During the Japanese occupation of Malaya, the author was able to observe the records of nearly 2, 000 cases of acute Plasmodium falciparum malaria in malnourished British, Australian and Dutch prisoners near Singapore. Treatment was based on quinine followed, so long as stocks lasted, by mepacrine and plasmoquine; severe infections were treated with quinine by intramuscular or intravenous injection-the latter almost entirely by standard methods. This paper records clinical and parasitological details of 15 patients treated by a continuous intravenous drip technique. Approximately 1, 000 cases were seen between February 1942 and September 1944; the majority were in 1942, one of the worst periods of malnutrition. No record of the number of intravenous injections is available, but it is small. Solution for injection contained 1 grain of the bihydrochloride in 2 cc. of saline, the rate of injection being 2 ce. a minute and the usual single dose 0.5 to 0.66 gramme. Four fatalities which were apparently due to this method, are recorded, namely: - 1. Heavy infection with P. falciparum: intravenous injection, 0.5 gm. ; immediate epileptiform convulsions and death. 2. Very heavy infection with P. falciparum: intramuscular quinine, 0. 66 gm. followed in 1 hour by 0.2 gm. intravenously 20 minutes later, collapse and death. 3. Moderate P. falciparum infection: died during an intravenous injection (dose not given). 4. Heavy P. falciparum infection: 1 .0 gm. quinine intravenously in 5 cc. water. Immediate epileptiform convulsions and death [a large and concentrated dose]. In addition, there was a case of P. vivax malaria in which during mepacrine treatment a convulsion occurred and death followed immediately after 0.25 gm. quinine intravenously. Approximately 1, 000 other cases were admitted between October 1944 and September 1945. Usually all these with over 100 parasites per thick field (Field's method) were given a preliminary intramuscular injection of 0.5 gm. quinine. When the thick film showed considerably more than this number, a parasite count was made. Where this was over 300, 000 parasites per cmm. (estimated by total red cell counts and the number of trophoZoites per 100 red cells) intravenous drip quinine was given regardless of the clinical condition and also where cerebral or other pernicious signs were present. A Soluvac or Vacolite gravity flask, with drip regulator and tied-in cannula was used. The vehicle was sterile normal saline, sometimes with an intravenous preparation of thiamin added. In each case, 2 gm. of quinine bihydrochloride were given in 24 hours, 0.5 to 0.66 gm. per litre. The rate of flow was 30 to 40 drops per minute. The long saphenous vein at the ankle was chosen for injection, to allow use of the arms. The leg was placed on a back splint with a footpiece. The drip was continued for 12 to 96 hours, according to the severity of the case: 15 cases so treated are described in detail. The advantages of this method were: (a) ease of combination with other treatment; thus 2 patients received 600 cc. of blood for gross anaemia; (b) certainty of complete absorption; (c) certainty of a constant safe concentration of quinine without degeneration products producing inefficiency; (d) absence of unpleasant after-effects. The disadvantage was some mild phlebitis of the vein when the cannula was in situ for 2 or 3 days, with risk of severe septic phlebitis. Of the 15 patients so treated two died, one on the 3rd day from tonic spasm, 3 hours after starting the drip, the second from pyaemia due to sepsis at the site of the drip on the 28th day. This patient on admission had 1, 240, 000 parasites per cmm. of blood, while four had over 500, 000 and all were in very poor condition. FIELD and NIVEN [this Bulletin, 1937, v. 34, 615] in an analysis of 750 cases of P. falciparum malaria on the 1st day of treatment concluded that 750, 000 parasites per cmm. in the peripheral blood was about the extreme limit of tolerance in Asian adults for the Malayan strain and FIELD in a series of 2, 000 cases records no recoveries where the count exceeded this figurer (unpublished). A combination of starvation with a heavy malarial infection is, very dangerous; FERNANDO and SANDARASAGARA in Colombo [ibid., 1936, v. 33, 687] found that intravenous quinine was contraindicated when the systolic blood pressure was below 90. The author considers that the drip method of using intravenous quinine in a dilute form sufficient to secure administration of 2 gm. in 24 hours is a safe and efficient one. Recovery is recorded of 3 cases with a peripheral intensity of infection higher than has been hitherto recorded in Malaya (871, 000, 925, 000 and 662, 000 parasites per cmm. respectively).}, keywords = {}, pubstate = {published}, tppubtype = {article} }