ORCID Profile
0000-0001-6560-5594
Current Organisation
Flinders University
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Publisher: Informa UK Limited
Date: 03-12-2010
DOI: 10.3109/13697130903470319
Abstract: To determine the usage of hormone replacement therapy (HRT) and knowledge about HRT among women of Sarawak in Malaysia. A prospective study using a face-to-face interview was conducted on 356 randomly selected Sarawakian women aged between 40 and 65 years. The mean age of respondents was 50.83 ± 6.30 years and the mean age of menopause was 51.28 ± 2.28 years. Twenty-three percent of women were premenopausal, 39.6% perimenopausal and 37.4% postmenopausal. Only 36% of the respondents were aware of the existence of HRT this is especially among those who were younger women, better educated and working. The main sources of information on HRT were friends and relatives (92.2%), newspapers/magazines (89.1%) and television/radio (64.1%). HRT usage among respondents was low (8.1%), mainly for relief of menopausal symptoms such as night sweats (100%), mood swings (93.1%), irritability (93.1%), and hot flushes (86.2%) only 24.1% used it for the prevention of osteoporosis. All women on HRT had taken HRT for less than 3 years. The main reason given for not being on HRT was that it was not recommended by their doctors (56.6%) only 8.3% worried about the side-effects and 4.3% were on other forms of treatment. The use of and knowledge about HRT among women of Sarawak were found to be low in our study. The main sources of information about HRT are from friends/relatives and the mass media. Health-care providers should play an important role in promoting, counseling and health education regarding HRT needs to rectify these problems.
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.SURVOPHTHAL.2016.12.011
Abstract: Advances in the understanding of the genetic, molecular, and cellular biology of retinal diseases have led to the development of new treatments. These expanding treatment options demand appropriate outcome measures for studies of treatment benefit including patient-reported outcomes (PROs). A plethora of PRO instruments assess impacts of retinal diseases from the patients' perspectives. We review all the studies that implemented PRO assessment in retinal diseases and also discuss quality assessment of the PRO instruments. We also include qualitative studies that explored quality of life impact on people with retinal diseases. Most studies used PRO instruments not specifically developed for retinal diseases (non-disease specific), nor have they undergone comprehensive validation in this disease group. A few retina-specific PRO instruments are available, but they suffer from limited content coverage of quality of life. Finally, we discuss the need for a new comprehensive and technologically advanced PRO instrument to assess quality of life impacts in retinal diseases.
Publisher: Informa UK Limited
Date: 20-12-2021
Publisher: Springer Science and Business Media LLC
Date: 23-02-2023
DOI: 10.3758/S13414-023-02670-Z
Abstract: The aim of this report was to analyze reaction times and accuracy in children with a vision impairment performing a feature-based visual search task using a multiverse statistical approach. The search task consisted of set sizes 4, 16, and 24, consisting of distractors (circle) and a target (ellipse) that were presented randomly to school-aged in iduals with or without a vision impairment. Interactions and main effects of key variables relating to reaction times and accuracy were analyzed via a novel statistical method blending GAMLSS (generalized additive models for location, scale, and shape) and distributional regression trees. Reaction times for the target-present and target-absent conditions were significantly slower in the vision impairment group with increasing set sizes ( p .001). Female participants were significantly slower than were males for set sizes 16 and 24 in the target-absent condition ( p .001), with male participants being significantly slower than females in the target-present condition ( p .001). Accuracy was only significantly worse ( p = .03) for participants less than 14 years of age for the target-absent condition with set sizes 16 and 24. There was a positive association between binocular visual acuity and search time ( p .001). The application of GAMLSS with distributional regression trees to the analysis of visual search data may provide further insights into underlying factors affecting search performance in case-control studies where psychological or physical differences may influence visual search outcomes.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 30-03-2022
Publisher: Elsevier BV
Date: 03-2023
DOI: 10.1016/J.SURVOPHTHAL.2022.11.004
Abstract: In this article, we present a review of patient-reported outcome measures (PROMs) used to evaluate the quality of life (QoL) in uveitis and provide a quality assessment of the psychometric properties of the PROMs, making it easier to choose the best questionnaire for uveitis. Our review included 158 articles. A total of 98 PROMs were used to measure QoL in uveitis and the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ 25) was the most frequently used PROM in these studies. There were five uveitis-specific PROMs, but they were meant for either birdshot choroidopathy or cytomegalovirus (CMV) retinitis or paediatric uveitis. There are no PROMs developed explicitly for the more common, anterior uveitis, intermediate uveitis, panuveitis and chronic uveitis. The uveitis specific PROMs performed better in our quality assessment criteria compared to other PROMs. However, these PROMs were constructed using traditional classical test theory and have not been assessed using the modern family of psychometric assessment methods such as Rasch analysis. As new therapeutic modalities for uveitis such as the new biological agents and steroid implants continue to evolve, a comprehensive PROM will be increasingly valued in clinical trial settings to compare the effects of treatments from the patient perspective.
Publisher: ACM
Date: 02-2021
Publisher: Informa UK Limited
Date: 19-09-2022
Publisher: Informa UK Limited
Date: 02-2022
DOI: 10.2147/OPTO.S355091
Publisher: Informa UK Limited
Date: 06-03-2022
DOI: 10.1080/08164622.2022.2033106
Abstract: The aim of this study was to review all the articles that have implemented patient-reported outcome measures (PROMs) to evaluate the quality of life (QoL) in corneal transplantation and discuss quality assessments of the PROMs. An extensive literature review was undertaken to identify all the studies that used PROMs to assess the QoL in corneal transplantation. Non-original or review articles, articles on other subject area and articles on cost-effectiveness/utility without PROM data/results were excluded. Each PROM was assessed against the following criteria: content development (item identification and item selection), psychometric properties, validity, reliability, and responsiveness. 425 articles were identified of which 35 articles were included in the final review. PROMs in corneal transplantation were used to (a) evaluate the QoL after surgery, (b) compare the QoL scores between different surgical techniques and (c) determine the relationship between QoL and objective measures such as visual acuity, visual field and stereoacuity. A total of 17 PROMs were used to assess QoL in corneal transplantation. Whilst this search did not produce any PROMs that were specifically designed to assess corneal transplantation, most studies were found to have employed the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ 25). The Visual Function Index 14 (VF 14) performed better in the present quality assessment criteria compared to other PROMs, however, the NEI VFQ 25 and the VF 14 PROMs were not specifically developed for corneal transplantation and therefore the QoL assessment made using these PROMs may be incomplete. As improvements in various forms of lamellar transplantation surgery techniques such as UT-DSAEK and FT-DSAEK have resulted in better visual outcomes, improved graft survival and reduced complications, a corneal transplantation specific PROM will be useful in clinical settings to compare the outcomes of different surgical techniques from the patient perspective.
Publisher: Informa UK Limited
Date: 11-11-2009
DOI: 10.3109/13697130902919519
Abstract: To document the common menopausal symptoms and quality of life in indigenous women of Sarawak in Malaysia. A face-to-face interview using the Menopause-specific Quality of Life questionnaire was conducted with 276 indigenous Sarawakian women aged 40-65 years to determine the mean age of menopause and common symptoms ( ided into vasomotor, psychosocial, physical and sexual domains) associated with menopause. The mean age at menopause of postmenopausal women was 50.78 +/- 2.47 years (range 47.3-58.2 years). The most common symptoms reported were aching in muscles and joints (82.6%), lack of energy (77.5%) and low backache (77.2%). The typical menopausal symptoms of hot flushes, night sweats, sweating and vaginal dryness were experienced by 42.4%, 34.8%, 29.7% and 49.3%, respectively of the women studied. Perimenopausal women (n = 114) experienced the most physical and psychosocial symptoms, while postmenopausal women (n = 102) experienced most sexual symptoms. Perimenopausal and postmenopausal women were reported to suffer more than premenopausal women (p < 0.001) within the four domains of symptoms (vasomotor, psychosocial, physical and sexual). The menopausal symptoms in this study correspond to those in other studies on Asian women but the prevalence of typical and classical menopausal symptoms was lower compared to studies on Caucasian women. The perimenopausal women had the most significant decrease in quality of life, followed by postmenopausal women and premenopausal women. Vasomotor symptoms had a predominant influence on the quality of life.
Publisher: BMJ
Date: 07-2022
DOI: 10.1136/BMJOPEN-2022-062754
Abstract: Childhood glaucoma is a chronic vision-threatening condition that may significantly impact an in idual’s psychosocial well-being. There is a paucity of literature investigating the quality of life (QoL) in children with glaucoma. The aim of this study was to investigate and report on the QoL issues encountered by children with glaucoma. This is a qualitative interview study. Data were collected through semistructured interviews. NVivo V.12 software (QSR International Pty Ltd, Melbourne, Australia) was used to analyse and code data to identify QoL themes. The prominence of QoL themes was determined by the number of children who raised issues connected to the corresponding theme. Interviews were conducted via telephone or videoconferencing between April 2020 and July 2021. Eighteen children with glaucoma, aged 8–17 years, who resided in Australia, were recruited from the Australian and New Zealand Registry of Advanced Glaucoma. Median child age was 12.1 years (IQR: 9.7–14.5 years) and 33% were female. Seven QoL themes were identified: ‘coping’, ‘inconveniences’ and ‘emotional well-being’ were more prominent themes than ‘symptoms’, ‘ocular health concerns’, ‘social well-being’ and ‘autonomy’. Adaptive coping strategies included resilience throughout clinical examinations and establishing positive relationships with ophthalmologists. These minimised inconveniences related to clinic waiting times and pupillary dilatation. External to the clinical setting, children often dissociated from their glaucoma but struggled with glare symptoms and feeling misunderstood by fellow peers. Older children aged 13–17 years commonly disengaged from their glaucoma care and expressed an unwillingness to attend ophthalmic appointments. Older children further raised issues with career options, obtaining a driver’s licence and family planning under the theme of autonomy. The psychosocial impact of childhood glaucoma extends beyond the clinical environment and was minimised using coping strategies. Older children may require additional social and ophthalmic support as they transition into adulthood.
Publisher: Springer Science and Business Media LLC
Date: 05-05-2018
DOI: 10.1007/S00417-018-3998-5
Abstract: Our understanding of the coping strategies used by people with visual impairment to manage stress related to visual loss is limited. This study aims to develop a sophisticated coping instrument in the form of an item bank implemented via Computerised adaptive testing (CAT) for hereditary retinal diseases. Items on coping were extracted from qualitative interviews with patients which were supplemented by items from a literature review. A systematic multi-stage process of item refinement was carried out followed by expert panel discussion and cognitive interviews. The final coping item bank had 30 items. Rasch analysis was used to assess the psychometric properties. A CAT simulation was carried out to estimate an average number of items required to gain precise measurement of hereditary retinal disease-related coping. One hundred eighty-nine participants answered the coping item bank (median age = 58 years). The coping scale demonstrated good precision and targeting. The standardised residual loadings for items revealed six items grouped together. Removal of the six items reduced the precision of the main coping scale and worsened the variance explained by the measure. Therefore, the six items were retained within the main scale. Our CAT simulation indicated that, on average, less than 10 items are required to gain a precise measurement of coping. This is the first study to develop a psychometrically robust coping instrument for hereditary retinal diseases. CAT simulation indicated that on an average, only four and nine items were required to gain measurement at moderate and high precision, respectively.
Publisher: Informa UK Limited
Date: 25-09-2012
Publisher: Springer Science and Business Media LLC
Date: 13-01-2017
DOI: 10.1038/EYE.2016.315
Publisher: Springer Science and Business Media LLC
Date: 19-04-2013
Abstract: To screen for visual impairment in Malaysian preschool children. Visual screening was conducted in 400 preschool children aged 4 to 6 years. The screening involved two basic procedures the distant visual acuity test using the Sheridan Gardiner chart and the depth perception test using the Langs stereoacuity test. Criteria for referral were a visual acuity of 6/12 or less in the better eye or a fail in the depth perception test. The prevalence of visual impairment was 5% (95% confidence interval [CI] = 3.3, 7.6). Of the 400 preschool children screened, 20 of them failed the distant visual acuity test or the stereopsis test. Refractive errors were the most common cause of visual impairment (95%, 95% CI = 76.2, 98.8) myopic astigmatism was the commonest type of refractive error (63.2%, 95% CI = 40.8, 80.9). The study is a small but important step in the effort to understand the problem of visual impairment among our preschool children. Our study showed that it is feasible to measure distant visual acuity and stereopsis in this age group.
Publisher: Elsevier BV
Date: 05-2021
DOI: 10.1016/J.OGLA.2021.09.007
Abstract: To explore and report on the quality-of-life (QoL) issues encountered by adults with childhood glaucoma. Exploratory qualitative study. Forty-seven participants with childhood glaucoma (defined as disease onset <18 years) recruited from the Australian and New Zealand Registry of Advanced Glaucoma (ANZRAG). A qualitative research methodology (interpretive phenomenology) was applied, and data were collected through semistructured in-depth interviews. NVivo-12 software (QSR International Pty Ltd) was used to inductively analyze and code data to identify QoL themes pertinent to the cohort studied. Quality-of-life themes and subthemes. Mean participant age was 40.0 ± 15.3 years, and 55% of participants were female. We identified 10 QoL themes pertinent to adults living with childhood glaucoma. Coping strategies and emotional well-being were the most prominent themes. Maladaptive coping strategies, including treatment nonadherence, were observed more commonly in in iduals aged <40 years and those without a vision impairment or reviewed less regularly. Emotional well-being was affected by feelings of being misunderstood because of the rarity of the condition, being self-conscious of physical manifestations of the disease, and anxiety related to possible disease progression and vision loss. The effect of childhood glaucoma on family planning formed a novel QoL theme and included worry for their child to inherit the condition and an inability to fulfill parental duties. This often led to genetic counseling-seeking behaviors. Mobility issues were infrequently experienced. Childhood glaucoma poses a substantial impact to the emotional well-being of adults with the condition, which is mediated by the use of coping strategies. Genetic counseling and family planning options may be important. This study supports the development of a childhood glaucoma-specific patient-reported outcome measure for assessment of the psychosocial impact of childhood glaucoma in adults.
Publisher: Informa UK Limited
Date: 15-10-2019
Publisher: Copernicus GmbH
Date: 03-07-2017
Abstract: Abstract. Extratropical cyclones of type Vb, which develop over the western Mediterranean and move northeastward, are major natural hazards that are responsible for heavy precipitation over central Europe. To gain further understanding in the governing processes of these Vb cyclones, the study explores the role of soil moisture and sea surface temperature (SST) and their contribution to the atmospheric moisture content. Thereby, recent Vb events identified in the ERA-Interim reanalysis are dynamically downscaled with the Weather Research and Forecasting (WRF) model. Results indicate that a mean high-impact summer Vb event is mostly sensitive to an increase in the Mediterranean SSTs and rather insensitive to Atlantic SSTs and soil moisture changes. Hence, an increase of +5 K in Mediterranean SSTs leads to an average increase of 24 % in precipitation over central Europe. This increase in precipitation is mainly induced by larger mean upward moisture flux over the Mediterranean with increasing Mediterranean SSTs. This further invokes an increase in latent energy release, which leads to an increase in atmospheric instability, i.e. in convective available potential energy. Both the increased availability of atmospheric moisture and the increased instability of the atmosphere, which is able to remove extra moisture from the atmosphere due to convective processes, are responsible for the strong increase in precipitation over the entire region influenced by Vb events. Precipitation patterns further indicate that a strong increase in precipitation is found at the eastern coast of the Adriatic Sea for increased Mediterranean SSTs. This premature loss in atmospheric moisture leads to a significant decrease in atmospheric moisture transport to central Europe and the northeastern flanks of the Alpine mountain chain. This leads to a reduction in precipitation in this high-impact region of the Vb event for an increase in Mediterranean SSTs of +5 K. Furthermore, the intensity of the Vb cyclones, measured as a gradient in the 850 hPa geopotential height field around the cyclone centre, indicates that an upper bound for intensity might be reached for the most intense Vb event.
Publisher: Springer Science and Business Media LLC
Date: 12-2012
Abstract: To report a case of spontaneous malignant glaucoma in an Asian female. To propose the term “positive vitreous pressure glaucoma” to reflect the pathophysiology, treatment and prognosis of the condition. A 56-year old Chinese female was diagnosed of primary angle closure glaucoma and had bilateral laser peripheral iridotomy one year ago. She presented with spontaneous onset of malignant glaucoma involving the left eye. The condition was treated successfully the final best corrected visual acuity was 0.67 (decimal notation). This case highlights that acute angle closure attack can occur in an eye with patent peripheral iridotomy. Early recognition and treatment is essential for good visual prognosis.
Publisher: Springer Science and Business Media LLC
Date: 21-09-2017
Publisher: Elsevier BV
Date: 09-2022
DOI: 10.1016/J.OGLA.2022.02.005
Abstract: To investigate and report on the quality-of-life (QoL) issues experienced by caregivers of in iduals with childhood glaucoma. Exploratory, qualitative study. Thirty-five caregivers of in iduals with childhood glaucoma (defined as disease onset before 18 years of age) recruited from the Australian and New Zealand Registry of Advanced Glaucoma. A qualitative research methodology (interpretive phenomenology) was applied. Data were collected through semistructured in-depth interviews. NVivo-12 software (QSR International Pty Ltd) was used to analyze, code, and organize data into QoL themes inductively. Quality-of-life themes and their subthemes. The mean caregiver age was 50.2 ± 13.6 years, and 27 of 35 caregivers (77%) were mothers of an in idual with childhood glaucoma. A total of 6 QoL themes were identified. Coping strategies and emotional well-being were the most prominent themes. Caregivers frequently adopted problem-focused adaptive coping strategies including partner or peer support, and normalization. A caregiver's psychosocial well-being was often impacted by feelings of guilt and regret regarding their child's delayed diagnosis, fear and anxiety related to medical and social support, and loss of control as their child developed medical autonomy. The effect of family planning from the perspective of the caregiver formed a novel QoL theme and was associated with normalization and parental confidence in management of the condition. Childhood glaucoma poses a substantial threat to a caregiver's psychosocial well-being. Strategies that promote normalization, peer support, psychotherapeutic intervention, and genetic counseling may be indicated and, indeed, critical to the caregiver as they adapt to supporting their child with glaucoma.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2019
DOI: 10.1097/OPX.0000000000001317
Abstract: This study develops psychometrically valid item banks across 10 areas of quality of life (QoL) specific to people with hereditary retinal diseases, which will enable clinicians and researchers to explore the impact of hereditary retinal diseases across all aspects of QoL. The purpose of this study was to assess the psychometric properties of hereditary retinal disease QoL item banks using Rasch analysis and demonstrate the effectiveness of a computerized adaptive testing (CAT) system in obtaining precise measurement of QoL using only a few items. The hereditary retinal disease item banks were answered by 233 participants (median age, 58 years range, 18 to 94 years female participants, 59%). The hereditary retinal disease item banks cover 10 QoL domains: activity limitation, mobility, emotional, social, convenience, economic, health concerns, visual symptoms, ocular comfort symptoms, and general symptoms. Rasch analysis assessed the psychometric properties of the 10 item banks and provided item calibrations for the development of CAT. Computerized adaptive testing simulations were performed to calculate the average number of items required to gain precise measurement of each QoL domain. The convenience, economic, visual symptoms, and the social domains formed unidimensional scales. However, the activity limitation and health concerns domains demonstrated multidimensionality and required major modifications to resolve this, which resulted in four new QoL domains, namely, reading, driving, lighting, and concerns about the disease progression. In total, 10 item banks underwent CAT simulation testing, which indicated that 8 to 12 items were required to gain precise measurement of each QoL domain. We have developed 10 psychometrically valid item banks to measure the QoL domains relevant to people with hereditary retinal diseases. On average, only 5 and 10 items were required to gain measurement at moderate and high precision, respectively.
Publisher: Informa UK Limited
Date: 07-2019
DOI: 10.1111/CXO.12875
Abstract: Although being the second most common sight-threatening retinal vascular disease after diabetic retinopathy, the patient-centred impact of retinal vein occlusion has not been well studied. This study aims to understand the quality of life issues in people with retinal vein occlusion using a qualitative methodology. In-depth semi-structured interviews were conducted with 17 patients with retinal vein occlusion. All the interviews were digitally recorded and transcribed verbatim. An inductive analytic approach based on the constant comparative method was used for coding, aggregation, and theme development. The qualitative analysis was done using the software NVivo. Participants had a median age of 73 years (range 34-85 years females, 71 per cent). Six quality of life themes were identified: concerns about the disease progression and treatment outcome (health concerns), emotional responses to the disease (emotional), experiencing a range of symptoms (symptoms), inability to do things as before (activity limitation), adapting to the visual loss (coping), and inconveniences due to the eye condition (convenience). Participants often felt that lasers and injections did not improve their vision. They feared that their eye condition may come back, or the other eye may be affected. They experienced a range of visual symptoms that affected their day-to-day performance, particularly reading small print, and driving at night. Having multiple treatments and frequent eye appointments were major sources of inconvenience. Patients adopted several coping strategies to manage the stress associated with visual loss. This study shows that several aspects of quality of life are compromised in people with retinal vein occlusion. The findings of this study will be used to identify the item content for a vitreoretinal disease-specific quality of life item bank.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2009
Publisher: Springer Science and Business Media LLC
Date: 07-09-2012
Publisher: Informa UK Limited
Date: 09-2019
DOI: 10.1111/CXO.12911
Start Date: 2018
End Date: 2018
Funder: Flinders University
View Funded ActivityStart Date: 2010
End Date: 2013
Funder: Universiti Malaysia Sarawak
View Funded Activity