ORCID Profile
0000-0002-2692-9016
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Kumamoto University
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Publisher: Wiley
Date: 24-02-2017
DOI: 10.1111/JAN.13265
Abstract: To review systematically the psychometric properties of instruments used to measure intention to work with older people. 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. A systematic literature review of evidence and psychometric properties. Eight database searches were conducted between 2006 - 2016. 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. 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. 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.
Publisher: SAGE Publications
Date: 27-04-2016
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 s ling 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 in idual, family, and peer factors in the social-ecological model on adolescents’ behaviors. The findings suggest the need for risk-reduction strategies aimed at the in idual, family, and peer levels as well as the importance of gender-specific focus in assuring better outcomes.
Publisher: Informa UK Limited
Date: 14-11-2016
DOI: 10.1080/08946566.2016.1260083
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 s ling 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.
Publisher: Public Library of Science (PLoS)
Date: 07-07-2017
Publisher: Wiley
Date: 02-06-2015
DOI: 10.1111/JAN.12699
Abstract: 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. Knowledgeable and skilful nurses are crucial amidst the growing numbers of maltreated older patients. This trial is a multi-site, three-armed, community-based cluster randomized controlled trial with 6-months follow-up. 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. 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.
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 30-11-2013
DOI: 10.7314/APJCP.2013.14.11.6769
Abstract: 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. 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 s ling 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 ided into never smokers and susceptible never smokers. Ever-smokers were categorized as experimenters, current smokers or ex-smokers. 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. 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.
Publisher: BMJ
Date: 06-2019
DOI: 10.1136/BMJOPEN-2018-026275
Abstract: To examine the role of dietary intake and physical activity in muscle strength among adolescents. Cross-sectional analysis. The Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study. Fifteen-year-old secondary school children who have given consent and who participated in the MyHeART study in 2014. Muscle strength was measured in relation to dietary intake (energy and macronutrients) and physical activity by using a hand grip dynamometer. 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 .001). Also, males were more active (2.43vs2.12 p .001) and consumed a higher amount of energy (2047 kcal vs 1738 kcal p .001), carbohydrate (280.71 g vs 229.31 g p .001) and protein (1.46 g/kg body weight (BW) vs 1.35 g/kg BW p .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. 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.
Publisher: Oxford University Press (OUP)
Date: 13-10-2017
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.
Publisher: University Library System, University of Pittsburgh
Date: 30-06-2023
Abstract: In response to the COVID-19 pandemic, policies, and treatment guidelines underwent rapid and frequent change. This threatened to disrupt the measured practice of evidence-based medicine (EBM), which relies on tried-and-tested interventions. The uncertainty was compounded by the overwhelming amount of misinformation disseminated via social media. Thus, arose a need for valid information to guide clinical practice. COVID-19 Evidence Retrieval Service (CERS), an evidence retrieval service piloted at a local and then rolled out at a national level, was conceived and developed to address this issue. This article describes the components and implementation of the (CERS), The service’s objective was to review the available medical literature for the best evidence to answer COVID-19-related questions posed by practicing clinicians. Team members providing the service comprised librarians, clinicians, public health specialists, and medical students. Multiple lessons were learned through the development and provision of CERS. Firstly, the rapid nature of the pandemic necessitated adaptations of the current practice of EBM. Secondly, all work processes were conducted online, which proved efficient and sustainable. Thirdly, Lower Middle-Income Country (LMIC) oriented services such as CERS were valid because they provided more relevant questions to resource-limited healthcare systems. Our experience has reinforced that an integrated, evidence-based retrieval service is feasible and valuable to support healthcare workers and policymakers in making informed decisions by performing a systematic appraisal. Crucially, medical students and young healthcare professionals can play a pivotal role in setting up these services.
Publisher: Human Kinetics
Date: 08-2023
Abstract: This study aims to determine the effectiveness of a multicomponent exercise and therapeutic lifestyle (CERgAS) intervention at improving gait speed among older people in an urban poor setting in Malaysia. A total of 249 participants were ided into the intervention ( n = 163) and control ( n = 86) groups. The mean ( SD ) age of participants was 67.83 (6.37) and consisted of 88 (35.3%) males and 161 (64.7%) females. A generalized estimating equation with an intention-to-treat analysis was used to measure gait speed at four time points, baseline (T0), 6 weeks (T1), 3 months postintervention (T2), and 6 months postintervention (T3). The results showed significant changes for time between T0 and T3 (mean difference = 0.0882, p = .001), whereas no significant association were found for group ( p = .650) and interaction ( p = .348) effects. A 6-week intervention is inadequate to improve gait speed. Future efforts should introduce physical activity monitoring and increase exercise duration, frequency, and intensity.
Publisher: Springer Science and Business Media LLC
Date: 05-09-2021
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.YPMED.2012.10.016
Abstract: 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. 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". 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). In a s le 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.
Publisher: Springer Science and Business Media LLC
Date: 29-07-2019
Publisher: Springer Science and Business Media LLC
Date: 27-06-2016
DOI: 10.1007/S11136-016-1348-9
Abstract: 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. 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. 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 ergent 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. The revised 8-item MSPSS-M is a reliable and valid tool for assessment of perceived social support among teachers.
Publisher: Oxford University Press (OUP)
Date: 25-09-2019
DOI: 10.1093/NTR/NTY203
Abstract: 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. 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. 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. 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. 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.
Publisher: Wiley
Date: 22-05-2021
Publisher: BMJ
Date: 07-2018
DOI: 10.1136/BMJOPEN-2017-019579
Abstract: Falls represent major health issues within the older population. In low/middle-income Asian countries, falls in older adults remain an area which has yet to be studied in detail. Using data from the Malaysian Elders Longitudinal Research (MELoR), we have estimated the prevalence of falls among older persons in an urban population, and performed ethnic comparisons in the prevalence of falls. Cross-sectional analysis was carried out using the first wave data from MELoR which is a longitudinal study. Urban community dwellers in a middle-income South East Asian country. 1565 participants aged ≥55 years were selected by simple random s ling from the electoral rolls of three parliamentary constituencies. Consenting participants from the MELoR study were asked the question ‘Have you fallen down in the past 12 months?’ during their computer-assisted home-based interviews. Logistic regression analyses were conducted to compare the prevalence of falls among various ethnic groups. The overall estimated prevalence of falls for in iduals aged 55 years and over adjusted to the population of Kuala Lumpur was 18.9%. The estimated prevalence of falls for the three ethnic populations of Malays, Chinese and Indian aged 55 years and over was 16.2%, 19.4% and 23.8%, respectively. Following adjustment for ethnic discrepancies in age, gender, marital status and education attainment, the Indian ethnicity remained an independent predictor of falls in our population (relative risk=1.45, 95% CI 1.08 to 1.85). The prevalence of falls in this study is comparable to other previous Asian studies, but appears lower than Western studies. The predisposition of the Indian ethnic group to falls has not been previously reported. Further studies may be needed to elucidate the causes for the ethnic differences in fall prevalence.
Publisher: Wiley
Date: 16-02-2021
DOI: 10.1111/AJAG.12919
Abstract: 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. 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. The mean age of the s le 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. Structural social support plays an important role in the QoL of older people in Malaysia.
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1016/J.YPMED.2011.07.020
Abstract: 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. 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. 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). 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.
Publisher: SAGE Publications
Date: 09-06-2015
Abstract: Physical Activity Scale for the Elderly (PASE) is among the frequently used self-reported physical activity assessment for older adults. This study aims to assess the validity and reliability of a Malay version of this scale (PASE-M). A total of 408 community-dwelling older adults were enrolled. Concurrent validity was evaluated by Spearman’s rank correlation coefficients between PASE with physical and psychosocial measures. Test-retest reliability was determined by the intraclass correlation coefficient (ICC). The mean PASE-M scores at baseline and follow-up were 94.96 (SD 62.82) and 92.19 (SD 64.02). Fair to moderate correlation were found between PASE-M and physical function scale, IADL ( r s = 0.429, P .001), walking speed ( r s = 0.270, P .001), grip strength ( r s = 0.313-0.339, P .001), and perceived health status ( r s = −0.124, P = .016). Test-retest reliability was adequate (ICC = 0.493). The Malay version of PASE was shown to have acceptable validity and reliability. This tool is useful for assessing the physical activity level of elderly Malaysians.
Publisher: Public Library of Science (PLoS)
Date: 27-08-2013
Publisher: Wiley
Date: 14-10-2014
DOI: 10.1111/GGI.12369
Abstract: 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. 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. 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). 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.
Publisher: Informa UK Limited
Date: 05-05-2016
DOI: 10.1080/08946566.2016.1185985
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.
Publisher: Wiley
Date: 03-2011
Publisher: Wiley
Date: 30-03-2018
DOI: 10.1111/JGS.15370
Abstract: To examine the cross-sectional and longitudinal relationships between elder abuse and neglect (EAN) and chronic pain in rural older Malaysians. Two-year prospective cohort study. Kuala Pilah, a district in Negeri Sembilan approximately 100 km from the capital city, Kuala Lumpur. Community-dwelling older adults aged 60 and older. Using a multistage cluster s ling strategy, 1,927 respondents were recruited and assessed at baseline, of whom 1,189 were re-assessed 2 years later. EAN was determined using the modified Conflict Tactic Scale, and chronic pain was assessed through self-report using validated questions. The prevalence of chronic pain was 20.4%. Cross-sectional results revealed 8 variables significantly associated with chronic pain-age, education, income, comorbidities, self-rated health, depression, gait speed, and EAN. Abused elderly adults were 1.52 times as likely to have chronic pain (odds ratio=1.52, 95% confidence interval (CI)=1.03-2.27), although longitudinal analyses showed no relationship between EAN and risk of chronic pain (risk ratio=1.14, 95% CI=0.81-1.60). This lack of causal link was consistent when comparing analysis with complete cases with that of imputed data. Our findings indicate no temporal relationship between EAN and chronic pain but indicated cross-sectional associations between the two. This might indicate that, although EAN does not lead to chronic pain, in iduals with greater physical limitations are more vulnerable to abuse. Our study also shows the importance of cohort design in determining causal relationships between EAN and potentially linked health outcomes.
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 30-06-2013
DOI: 10.7314/APJCP.2013.14.6.3483
Abstract: To identify the prevalence of different stages of smoking and differences in associated risk factors. 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. In the s le, 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. 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.
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.YPMED.2013.01.005
Abstract: The objective of this study is to determine the prevalence of metabolic syndrome among schizophrenia patients receiving antipsychotic monotherapy in Malaysia. 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. 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. 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.
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.YPMED.2013.01.006
Abstract: To determine the predictors of death in Malaysian HIV-infected patients undergoing antiretroviral therapy (ART). 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. 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). 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.
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.YPMED.2013.01.007
Abstract: 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. 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 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. 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.
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 18-05-2015
DOI: 10.7314/APJCP.2015.16.9.3659
Abstract: Waterpipe tobacco smoking has becoming popular especially among young people worldwide. Smokers are attracted by its sweeter, smoother smoke, social ambience and the misconception of reduced harm. The objective of this study was to systematically review the effects of waterpipe tobacco policies and practices in reducing its prevalence. A systematic review was conducted electronically using the PubMed, OVID, Science Direct, Proquest and Embase databases. All possible studies from 1980 to 2013 were initially screened based on titles and abstracts. The selected articles were subjected to data extraction and quality rating. Three studies met the inclusion criteria and were eligible for this review. Almost all of the waterpipe tobacco products and its accessories did not comply with the regulations on health warning labelling practices as stipulated under Article 11 of WHO FCTC. In addition, the grisly new warning labels for cigarettes introduced by Food and Drug Administration did not affect hookah tobacco smoking generally. Indoor air quality in smoking lounges was found to be poor and some hookah lounges were operated without smoke shop certification. Our findings revealed the availability of minimal information on the practices in controlling waterpipe smoking in reducing its prevalence. The lack of comprehensive legislations or practices in controlling waterpipe smoking warrants further research and policy initiatives to curb this burgeoning global epidemic, especially among the vulnerable younger population.
Publisher: Elsevier BV
Date: 05-2017
Publisher: Wiley
Date: 03-04-2018
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.MATURITAS.2014.08.014
Abstract: 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. This was a sub-population analysis of the elderly s le 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. 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. 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.
Publisher: Springer Science and Business Media LLC
Date: 11-05-2019
DOI: 10.1007/S10286-019-00610-2
Abstract: 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. The MELoR study recruited community-dwelling adults aged 55 years and over, selected through stratified random s ling 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. 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. Ethnic differences exist for lifetime cumulative incidence of syncope in community-dwelling in iduals 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.
Publisher: Wiley
Date: 16-08-2016
Publisher: Springer Science and Business Media LLC
Date: 23-01-2023
Publisher: John Wiley & Sons, Ltd
Date: 31-01-2013
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.ARCHGER.2018.11.012
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. In iduals 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/ orced, 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.
Publisher: Frontiers Media SA
Date: 03-12-2019
Publisher: Elsevier BV
Date: 05-2013
DOI: 10.1016/J.AMJCARD.2013.01.271
Abstract: Developing countries face challenges in providing the best reperfusion strategy for patients with ST-segment elevation myocardial infarction because of limited resources. This causes wide variation in the provision of cardiac care. The aim of this study was to assess the impact of variation in cardiac care provision and reperfusion strategies on patient outcomes in Malaysia. Data from a prospective national registry of acute coronary syndromes were used. Thirty-day all-cause mortality in 4,562 patients with ST-segment elevation myocardial infarctions was assessed by (1) cardiac care provision (specialist vs nonspecialist centers), and (2) primary reperfusion therapy (thrombolysis or primary percutaneous coronary intervention [P-PCI]). All patients were risk adjusted by Thrombolysis In Myocardial Infarction (TIMI) risk score. Thrombolytic therapy was administered to 75% of patients with ST-segment elevation myocardial infarctions (12% prehospital and 63% in-hospital fibrinolytics), 7.6% underwent P-PCI, and the remainder received conservative management. In-hospital acute reperfusion therapy was administered to 68% and 73% of patients at specialist and nonspecialist cardiac care facilities, respectively. Timely reperfusion was low, at 24% versus 31%, respectively, for in-hospital fibrinolysis and 28% for P-PCI. Specialist centers had statistically significantly higher use of evidence-based treatments. The adjusted 30-day mortality rates for in-hospital fibrinolytics and P-PCI were 7% (95% confidence interval 5% to 9%) and 7% (95% confidence interval 3% to 11%), respectively (p = 0.75). In conclusion, variation in cardiac care provision and reperfusion strategy did not adversely affect patient outcomes. However, to further improve cardiac care, increased use of evidence-based resources, improvement in the quality of P-PCI care, and reduction in door-to-reperfusion times should be achieved.
Publisher: SAGE Publications
Date: 22-02-2017
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.
Publisher: SAGE Publications
Date: 26-03-2008
Abstract: The purpose of this study was to investigate the association between pregnancy-induced hypertension and low birth weight. A population-based case control study was conducted. Antenatal mothers who attended the government health centers in the district of Kuala Muda, Kedah, Malaysia from June 2003 to May 2004 were recruited. Cases were 312 mothers who delivered low birth weight babies, and controls were 312 mothers who delivered normal birth weight babies. Face-to-face interviews using a structured questionnaire and a review of medical records were carried out. After controlling for important confounders such as gestational age at delivery, maternal age, ethnicity, education, parity, and previous history of abortion, pregnancy-induced hypertension was found to be an independent risk factor (adjusted odds ratio = 5.06 95% confidence interval: 2.63, 9.71) for low birth weight. There was a significant association of pregnancy-induced hypertension with low birth weight. Women who delivered low birth weight babies were 5 times more likely to have had pregnancy-induced hypertension.
Publisher: Wiley
Date: 11-2010
DOI: 10.1111/J.1532-5415.2010.03145.X
Abstract: To determine the association between loss of muscle strength, mass, and quality and functional limitation and physical disability in older men. Cross-sectional study of older men participating in the Concord Health and Ageing in Men Project (CHAMP). Elderly men living in a defined geographical region in Sydney, Australia. One thousand seven hundred five community-dwelling men aged 70 and older who participated in the baseline assessments of CHAMP. 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. 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. Muscle strength is the single best measure of age-related muscle change and is associated with physical disability in IADLs and functional limitation.
Publisher: SAGE Publications
Date: 22-07-2013
Abstract: 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. 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. 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. 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.
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.1016/J.PMN.2014.08.012
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.
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.MATURITAS.2012.10.001
Abstract: To establish if there is any gender difference in associations between chronic pain, impact of pain and pain severity with physical disability. 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. 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. 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.
Publisher: Public Library of Science (PLoS)
Date: 21-11-2019
Publisher: Public Library of Science (PLoS)
Date: 05-11-2018
Publisher: American Society of Tropical Medicine and Hygiene
Date: 06-12-2010
Publisher: SAGE Publications
Date: 25-11-2008
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 ≥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.
Publisher: Springer Science and Business Media LLC
Date: 15-01-2016
Publisher: Public Library of Science (PLoS)
Date: 05-11-2015
Publisher: Springer Science and Business Media LLC
Date: 18-08-2010
Publisher: King Faisal Specialist Hospital and Research Centre
Date: 11-2013
Publisher: Springer Science and Business Media LLC
Date: 17-06-2014
Publisher: SAGE Publications
Date: 27-11-2013
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 s ling. 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.
Publisher: Japan Epidemiological Association
Date: 03-2017
Publisher: Wiley
Date: 2015
DOI: 10.1111/JGS.13217
Publisher: Public Library of Science (PLoS)
Date: 30-06-2016
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2018-026667
Abstract: 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. 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. All observational studies investigating the association between social support and depression among community-dwelling older adults in Asia were included. Older adults aged 60 years and more who are living in the community. Social support. Depression. 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. 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. CRD42017074897.
Publisher: Public Library of Science (PLoS)
Date: 02-11-2017
Publisher: Oxford University Press (OUP)
Date: 05-07-2018
Abstract: 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. 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. 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. 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.
Publisher: SAGE Publications
Date: 11-2018
Abstract: Good nutrition for infants, during the first 1000 days from conception, is one of the most important determinants of a healthy long life. Breastfeeding is the most important component of infant nutrition and reduces morbidity and mortality. With the changes to the climate currently occurring, issues of nutrition and food supply are only going to increase in importance. The Sustainable Development Goals of the United Nations, place nutrition at the forefront of world development and a sustainable planet. The vision of Asia-Pacific Academic Consortium for Public Health (APACPH) is to “achieve the highest possible level of health of all the people of the nations of the Asia-Pacific region.” Much of the burden of disease, early deaths, and disability in the Asia Pacific region could be reduced with public health efforts to address the major risk factors, including nutrition-related causes and smoking. The United Nations Decade of Action on Nutrition 2016-2025 has recently been launched with the aim of reducing the global burden of inappropriate nutrition. The goals include increasing rates of exclusive breastfeeding to 6 months, reducing wasting and stunting, and reducing the rates of low birthweight. This is the position endorsed in these guidelines along with the principles of the Baby Friendly Hospital Initiative. These guidelines expand the information on infants that was included in the 2016 APACPH Dietary Guidelines. APACPH covers many different environments, geographical areas, cultures, and socioeconomic groups. These guidelines are generally applicable to all infants in our region, specific local advice may sometimes be needed.
Publisher: Cambridge University Press (CUP)
Date: 18-04-2016
DOI: 10.1017/S1368980016000811
Abstract: To determine the association of vitamin D status with depression and health-related quality of life among women. This was a cross-sectional study conducted among women in Kuala Lumpur, Malaysia. Sociodemographic characteristics, physical activity status, perceived depression and health-related quality of life were assessed via a self-administered questionnaire. Fasting blood s les were taken for the analysis of 25-hydroxyvitamin D, parathyroid hormone, fasting blood glucose and full lipid profile. Complex s les multiple logistic regression analysis was performed. Public secondary schools in Kuala Lumpur, Malaysia. Seven hundred and seventy female teachers were included. The mean age of participants was 41·15 (95 % CI 40·51, 41·78) years and the majority were ethnic Malays. Over 70 % of them had vitamin D deficiency ( ng/ml or nmol/l) and two-thirds were at risk for depression. In the multivariate analysis, ethnic Malays (adjusted OR (aOR)=14·72 95 % CI 2·12, 102·21) and Indians (aOR=14·02 95 % CI 2·27, 86·59), those at risk for depression (aOR=1·88, 95 % CI 1·27, 2·79) and those with higher parathyroid hormone level (aOR=1·13 95 % CI 1·01, 1·26) were associated with vitamin D deficiency, while vitamin D deficiency was negatively associated with mental health-related quality of life (Mental Component Summary) scores (aOR=0·98 95 % CI 0·97, 0·99). Vitamin D deficiency is significantly associated with depression and mental health-related quality of life among women in Kuala Lumpur, Malaysia.
Publisher: Informa UK Limited
Date: 29-03-2017
DOI: 10.1080/07317115.2017.1311978
Abstract: To pilot two new cognitive screening tools for use in an urban Malaysian population and to compare their criterion validity against a gold standard, the well-established Mini-Mental State Examination (MMSE). The IDEA cognitive screen, Picture-based Memory Impairment Scale (PMIS), and MMSE were administered to a convenience s le of elderly (≥ 65 years) from the community and outpatient clinics at an urban teaching hospital. Consensus diagnosis was performed by two geriatricians blinded to PMIS and IDEA cognitive screen scores using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) clinical criteria. The MMSE performance was used as a reference. The study enrolled 66 participants, with a median age of 78.5 years (interquartile range [IQR], 72.5-83.0) years and 11.0 median years of education (IQR, 9.0-13.0). Forty-three (65.2%) were female, and 32 (48.4%) were Chinese. The area under the receiver operating characteristic (AUROC) curve values were .962 (IDEA cognitive screen), .970 (PMIS), and .935 (MMSE). The optimal cutoff values for sensitivity and specificity were: IDEA cognitive screen: ≤ 11, 90.9% and 89.7% PMIS: ≤ 6, 97.3% and 69.0% and MMSE: ≤ 23, 84.6% and 76.0%. Although the s le size was small, multivariable logistic regression modelling suggested that all three screen scores did not appear to be educationally biased. The IDEA and PMIS tools are potentially valid screening tools for dementia in urban Malaysia, and perform at least as well as the MMSE. Further work on larger representative, cohorts is needed to further assess the psychometric properties. Study provides alternative screening tools for dementia for both non-specialists and specialists.
Publisher: Informa UK Limited
Date: 20-10-2021
DOI: 10.1080/08946566.2021.1990815
Abstract: Among the challenges in systematic inquiry into elder abuse and neglect (EAN) is the lack of standardized tool of measurement. Existing literature demonstrates erse 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.
Publisher: Wiley
Date: 25-09-2022
DOI: 10.1111/ECI.13874
Publisher: Public Library of Science (PLoS)
Date: 24-06-2022
DOI: 10.1371/JOURNAL.PONE.0270163
Abstract: Our study aims to describe and determine factors associated with hospitalization among victims of elder abuse and neglect (EAN) in rural Malaysia. A cross sectional study based on the baseline data of the Malaysian Elder Mistreatment Project (MAESTRO) collected from November 2013 until July 2014 involving 1927 older adults in Kuala Pilah, Negeri Sembilan was conducted. EAN was determined using the modified Conflict Tactics Scale (CTS) and hospitalization rates were determined based on self-report. The prevalence of overall EAN was 8.1% (95%CI 6.9–9.3). Among male respondents, 9.5% revealed history of abuse and among female respondents, 7.2% reported experiencing EAN. The annual hospitalization rates per 100 persons within the past one year among EAN victims and non-victims were 18 per 100 persons (SD = 46.1) and 15 per 100 persons (SD = 64.1) respectively. Among respondents with history of EAN, 16.0% (n = 21) had been hospitalized in the past 12 months while among respondents with no EAN experience, 10.2% (n = 153) were hospitalized. Multivariable analyses using Poisson regression did not show any significant association between EAN and hospitalization. This could be due to the complex interactions between medical and social circumstances that play a role in hospital admissions, factors affecting the health care system, and access to health care among EAN victims.
Publisher: International Union Against Tuberculosis and Lung Disease
Date: 08-2012
Abstract: Physicians should play a leading role in combatting smoking information on attitudes of future physicians towards tobacco control measures in a middle-income developing country is limited. Of 310 future physicians surveyed in a medical school in Malaysia, 50% disagreed that it was a doctor's duty to advise smokers to stop smoking 76.8% agreed that physicians should not smoke before advising others not to smoke and 75% agreed to the ideas of restricting the sale of cigarettes to minors, making all public places smoke-free and banning advertising of tobacco-related merchandise. Future physicians had positive attitudes towards tobacco regulations but had not grasped their responsibilities in tobacco control measures.
Publisher: BMJ
Date: 08-2017
DOI: 10.1136/BMJOPEN-2017-017025
Abstract: 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. Cross-sectional study, analysing baseline findings of a cohort of older adults. Kuala Pilah district, Negeri Sembilan state, Malaysia. To determine the prevalence of elder abuse among community dwelling older adults and its associated factors. A total of 2112 community dwelling older adults aged 60 years and above were recruited employing a multistage s ling using the national census. 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. 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. 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.
Publisher: Japan Epidemiological Association
Date: 05-06-2018
Publisher: Elsevier BV
Date: 09-3018
DOI: 10.1016/J.IJNURSTU.2018.05.007
Abstract: Studies have reported that student nurses hold positive attitudes towards older people nevertheless, working with older people has consistently remained one of the least desired career choices among student nurses in most countries. The current study aimed to assess student nurses' intentions to work with older people and to determine the predictors of working intentions among nursing students. The study adopted a cross-sectional design. Multistage s ling was used to recruit nursing students from five states in Malaysia. A total of 1462 nursing students from eleven nursing education institutions participated in this study. A self-administered questionnaire was used to collect data. This study is underpinned by the Theory of Planned Behaviour. The Intent to Work with Older People Scale and Kogan Attitudes Toward Old People Scale were used to assess nursing students' intentions and attitudes towards care of older people respectively. Researcher-developed instruments were used to assess subjective norms and perceived behavioural control among nursing students. The present study found that nursing students in Malaysia demonstrated a moderate level of intention to work with older people, with a mean of 39.72 (±4.38). There were significant differences in effects of gender, ethnic group, academic level, type of nursing institution and setting of older person care clinical experience on intentions to work with older people. There was a moderate and positive relationship between attitudes towards older people and intentions to work with older people, as well as between perceived behavioural control and intentions to work with older people it was found that r = 0.36 for both relationships. Attitudes, subjective norms and perceived behavioural control accounted for 19.7% of the variance in intentions to work with older people. The primary findings of this national study revealed that Malaysian nursing students have a moderate level of intention to work with older people. It is imperative to develop educational interventions to nurture attitudes for caring and promote stronger intentions to work with older people.
Publisher: Informa UK Limited
Date: 03-07-2017
DOI: 10.1080/23288604.2017.1342746
Abstract: An analysis of population coverage of hypertension treatment services can be used to make inferences about the performance of primary care services within health systems. Malaysia, an upper middle-income country, has a well-established primary care system but one that favors rural populations and provision of services for maternal and child health and infectious diseases. Demographic factors including rapid aging, urbanization, as well as lifestyle changes characteristic of a modernizing society have led to an increase in noncommunicable diseases, including hypertension. In this article, we used data from a nationally representative household health survey to develop service coverage indicators for hypertension screening and treatment services. The age-standardized prevalence of hypertension was estimated to be 33.9% (95% confidence interval [CI], 33.9, 33.9). Only 39.0% (95% CI, 37.5, 40.6) of adults with hypertension had been diagnosed by a medical practitioner, 35.7% had been on treatment, and 9.6% had blood pressure controlled under treatment. The diagnosis, treatment, and controlled treatment coverage were higher for older persons compared to younger persons. There were no differences in the diagnosis and treatment coverage between urban and rural areas and between ethnic groups. However, controlled treatment coverage was higher among Chinese and those living in urban areas. Our findings suggest that primary care services in Malaysia may need to intensify health education activities to promote screening services. There is also a need to reprioritize activities to provide regular community health screening of adults and increase access to affordable primary care services, especially in the urban areas.
Publisher: SAGE Publications
Date: 06-2007
DOI: 10.1177/10105395070190020501
Abstract: The objective of this study is to evaluate the relationship between reproductive exposures and age-related cataract among women. This was a hospital based case-control study. The study population included female patients, aged 50 years and above who attended the Eye clinic at the University of Malaya Medical Centre. The outcome measurement was based on ophthalmologic examination by an ophthalmologist. The data on exposure was obtained from face to face interview using a structured questionnaire. In order to reduce the recall bias, patients' medical records were used to substantiate the exposure status. Multiple logistic regression was used to assess the association of age-related cataract with exogenous estrogen usage (HRT and OCP) and duration of menses. Important confounders such as age, history of diabetes, cigarette smoking and steroids usage were controlled for in the analysis. Females with 29 years or less of endogenous estrogen exposure of, have almost three times the risk of developing age related cataract (adjusted OR 3.42: 95% CI: 1.28,9.16), similarly among those with exposure of 30- 32 years (adjusted OR 3.64: 95% CI: 1.08,12.26). Hormone Replacement Therapy used for more than three years was found to be a protective factor of age-related cataract. There is evidence that reproductive exposure may play a role in reducing the occurrence of age-related cataract among Malaysian women. Asia Pac J Public Health 2007 19(2): 23-28.
Publisher: Public Library of Science (PLoS)
Date: 28-02-2019
No related grants have been discovered for Noran Naqiah Hairi.