Displaying publications 1 - 20 of 30 in total

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  1. Al-Sadat N, Majid HA, Sim PY, Su TT, Dahlui M, Abu Bakar MF, et al.
    BMJ Open, 2016 08 18;6(8):e010689.
    PMID: 27540095 DOI: 10.1136/bmjopen-2015-010689
    OBJECTIVE: To determine the prevalence of vitamin D deficiency (<37.5 nmol/L) among young adolescents in Malaysia and its association with demographic characteristics, anthropometric measures and physical activity.

    DESIGN: This is a cross-sectional study among Form 1 (year 7) students from 15 schools selected using a stratified random sampling design. Information regarding sociodemographic characteristics, clinical data and environmental factors was collected and blood samples were taken for total vitamin D. Descriptive and multivariable logistic regression was performed on the data.

    SETTING: National secondary schools in Peninsular Malaysia.

    PARTICIPANTS: 1361 students (mean age 12.9±0.3 years) (61.4% girls) completed the consent forms and participated in this study. Students with a chronic health condition and/or who could not understand the questionnaires due to lack of literacy were excluded.

    MAIN OUTCOME MEASURES: Vitamin D status was determined through measurement of sera 25-hydroxyvitamin D (25(OH)D). Body mass index (BMI) was classified according to International Obesity Task Force (IOTF) criteria. Self-reported physical activity levels were assessed using the validated Malay version of the Physical Activity Questionnaire for Older Children (PAQ-C).

    RESULTS: Deficiency in vitamin D was seen in 78.9% of the participants. The deficiency was significantly higher in girls (92.6%, p<0.001), Indian adolescents (88.6%, p<0.001) and urban-living adolescents (88.8%, p<0.001). Females (OR=8.98; 95% CI 6.48 to 12.45), adolescents with wider waist circumference (OR=2.64; 95% CI 1.65 to 4.25) and in urban areas had higher risks (OR=3.57; 95% CI 2.54 to 5.02) of being vitamin D deficient.

    CONCLUSIONS: The study shows a high prevalence of vitamin D deficiency among young adolescents. Main risk factors are gender, ethnicity, place of residence and obesity.

  2. Fadzlina AA, Harun F, Nurul Haniza MY, Al Sadat N, Murray L, Cantwell MM, et al.
    BMC Public Health, 2014;14 Suppl 3:S7.
    PMID: 25437226 DOI: 10.1186/1471-2458-14-S3-S7
    BACKGROUND: Obesity and metabolic syndrome is prevalent among Malaysian adolescents and has been associated with certain behavioural factors such as duration of sleep, screen time and physical activity. The aim of the study is to report the prevalence of overweight/obesity, metabolic syndrome and its risk factors among adolescents.
    METHODS: A multi-staged cluster sampling method was used to select participants from urban and rural schools in Selangor, Perak and Wilayah Persekutuan Kuala Lumpur. Participants underwent anthropometric measurement and physical examination including blood pressure measurement. Blood samples were taken for fasting glucose and lipids and participants answered a self-administered questionnaire. Overweight and obesity was defined using the extrapolated adult body mass index (BMI) cut-offs of >25 kg/m2 and >30 kg/m2, according to the International Obesity Task Force (IOTF) criteria. Metabolic syndrome was defined based on International Diabetes Federation (IDF) 2007 criteria.
    RESULTS: Data were collected from 1361 participants. After excluding incomplete data and missing values for the variables, we analysed a sample of 1014 participants. Prevalence of overweight and obesity in this population was 25.4% (N = 258). The prevalence of metabolic syndrome was 2.6% in the population and 10% among the overweight and obese adolescents. Participants who slept between 7 and 9 hours a day has a lower risk of developing metabolic syndrome OR 0.38(0.15-0.94).
    CONCLUSION: Our results provide the prevalence of metabolic syndrome in Malaysian adolescents. Adequate sleep between 7 and 9 hours per day reduces the risk of developing metabolic syndrome.
    MESH: screen time
  3. Hazreen MA, Su TT, Jalaludin MY, Dahlui M, Chinna K, Ismail M, et al.
    BMC Public Health, 2014;14 Suppl 3:S6.
    PMID: 25437068 DOI: 10.1186/1471-2458-14-S3-S6
    BACKGROUND: The National Health & Morbidity Survey (NHMS) IV (2011) observed that the prevalence of obese children aged less than 18 years in Malaysia is 6.1% compared to 5.4% overweight and obese in NHMS III (2006). As such, this observation is of public health importance as obesity is a forewarning risk factor for chronic diseases such as type-2 diabetes, cardiovascular diseases (CVD) and certain types of cancers. This MyHeART (Malaysian Health and Adolescents longitudinal Research Team) study aims to examine risk factors of non-communicable diseases (NCD) among adolescents.
    METHODS/DESIGN: The MyHeART study is longitudinal cohort study of 1361 schoolchildren (13-years old) attending 15 public secondary schools from the central (Kuala Lumpur and Selangor) and northern (Perak) regions of Peninsular Malaysia. The study used a stratified sampling design to select the study participants. Data collected at baseline included socio-economic, lifestyle (e.g. smoking, physical activity assessment, fitness assessment, seven-day diet history), and environmental information, anthropometric measurements, blood pressure, handgrip strength and bone mineral density. Blood samples for fasting blood glucose and lipid profiles, full blood count, renal profile, as well as bone profile and serum vitamin D were taken. This study cohort will be followed up again when participants turn 15, 17 and lastly, after a period of ten years (around the age of 27).
    RESULTS: Nine percent of the adolescents from this study were obese. More male participants smoked compared to female participants (15.4% vs. 4.7%). Adolescent males had higher fasting blood glucose but the female participants had lower high density lipoprotein (HDL-cholesterol) and higher low density lipoprotein (LDL-cholesterol). In addition, adolescents from the rural area had higher fasting blood glucose, diastolic blood pressure, total cholesterol and LDL-cholesterol.
    DISCUSSION: Our results demonstrated that adolescents from the rural area are at higher risk of NCDs compared to their urban counterpart. Tailor made public health interventions are highly recommended for adolescents as this may minimise the dreadful NCD burden in adulthood and health disparity between the rural and urban in the near future.
    Study name: Malaysian Health and Adolescents Longitudinal Research Team study (The MyHeART study)
  4. Hanifah RA, Majid HA, Jalaludin MY, Al-Sadat N, Murray LJ, Cantwell M, et al.
    BMC Public Health, 2014;14 Suppl 3:S5.
    PMID: 25436933 DOI: 10.1186/1471-2458-14-S3-S5
    The importance of fitness level on the well-being of children and adolescent has long been recognised. The aim of this study was to investigate the fitness level of school-going Malaysian adolescent, and its association with body composition indices.
  5. Su TT, Sim PY, Nahar AM, Majid HA, Murray LJ, Cantwell MM, et al.
    Prev Med, 2014 Oct;67:100-5.
    PMID: 25016043 DOI: 10.1016/j.ypmed.2014.07.001
    BACKGROUND: Obesity and lack of physical activity are fast becoming a concern among Malaysian adolescents.

    OBJECTIVE: This study aims to assess physical activity levels among Malaysian adolescents and investigate the association between physical activity levels and body composition such as body mass index (BMI), waist circumference (WC) and percentage of body fat.

    SUBJECTS AND METHODS: 1361 school-going 13 year old multi-ethnic adolescents from population representative samples in Malaysia were involved in our study. Self-reported physical activity levels were assessed using the validated Malay version of the Physical Activity Questionnaire for Older Children (PAQ-C). Height, weight, body fat composition and waist circumference (WC) were measured. Data collection period was from March to May 2012.

    RESULTS: 10.8% of the males and 7.4% of the females were obese according to the International Obesity Task Force standards. A majority of the adolescents (63.9%) were physically inactive. There is a weak but significant correlation between physical activity scores and the indicators of obesity. The adjusted coefficient for body fatness was relatively more closely correlated to physical activity scores followed by waist circumference and lastly BMI.

    CONCLUSION: This study demonstrates that high physical activity scores were associated with the decreased precursor risk factors of obesity.

  6. Zulkipli AF, Islam T, Mohd Taib NA, Dahlui M, Bhoo-Pathy N, Al-Sadat N, et al.
    Integr Cancer Ther, 2018 06;17(2):312-321.
    PMID: 29218996 DOI: 10.1177/1534735417745248
    BACKGROUND: The use of complementary and alternative medicine (CAM) has increased and little is known on CAM use during the initial period. Therefore, the aim was to determine prevalence of CAM use among newly diagnosed breast cancer patients prior to seeking conventional treatment.

    METHODS: This is a cross-sectional study involved interviewing newly diagnosed breast cancer patients in the University Malaya Medical Centre (UMMC) using a structured questionnaire. Eligible respondents were interviewedduring a routine clinical visit.

    RESULTS: A total of 400 patients were interviewed, of whom 139 (34.8%) were CAM users. Dietary supplementation (n = 107, 77.0%) was the most frequently used type of CAM, followed by spiritual healing (n = 40, 28.8%) and traditional Chinese medicine (n = 32, 23.0%). Malay ethnic group (n = 61, 43.9%) was the largest group of CAM users, followed by Chinese (n = 57, 41.0%) and Indian (n = 20, 14.4%). Majority of these CAM users (n = 87, 73.1%) did not disclose the use of CAM to their doctors. Most of them used remedies based on the recommendation of family and friends. Malay ethnicity and patients with 3 or more comorbidities were more likely to use CAM.

    CONCLUSION: There is substantial use of CAM among breast cancer patients in UMMC prior to seeking hospital treatment, and the most popular CAM modality is dietary supplements. Since, the majority of CAM users do not disclose the use of CAM to their physicians, therefore health care providers should ensure that those patients who are likely to use CAM are appropriately counseled and advised.

  7. Farid ND, Aziz NA, Al-Sadat N, Jamaludin M, Dahlui M
    PLoS One, 2014;9(9):e106469.
    PMID: 25188003 DOI: 10.1371/journal.pone.0106469
    Breast cancer is the most common cause of deaths and the most frequently diagnosed cancer among women worldwide. This study aimed to determine the prevalence of breast cancer screening, specifically on clinical breast examination, and the predictors of its uptake among women in Malaysia. A cross-sectional study was carried out in five selected districts whereby women aged between 20 to 64 years old, from a total of 1000 households were interviewed. A total of 1192 women responded to the survey of which 53.3% reported had ever done clinical breast examination. Significant associations with clinical breast examination were noted for income and distance from the hospital. These factors should be considered in developing interventions aimed at promoting clinical breast examination. In particular, healthcare providers should be proactive in raising awareness about clinical breast examination among women in Malaysia.
  8. Su TT, Sallehuddin BA, Murniati HH, Swinder J, Al Sadat N, Saimy I
    Asian Pac J Cancer Prev, 2012;13(1):175-9.
    PMID: 22502663
    The objective of the study is to investigate the success rate of quit attempts and identify factors associated with success or failure of quit attempts in a quit smoking clinic. A cohort study was conducted with 495 smokers who enrolled in a quit smoking clinic from 2005 to 2008. The factors leading to quit smoking successfully were "being Malay", "having high blood pressure" "type of Nicotine Replacement Therapy" and "duration of follow up". In contrast, clerical staff had negative association to quit smoking. People who started smoking in their teenage years had a high risk of relapse. Integration of active follow up and tailor-made support programmes for quitters appear necessary in order to maintain their non-smoking status and encourage them to be permanent quitters. Integration of quit smoking clinics and primary care clinics could be another potential step for the success of quit smoking programmes.
  9. Dahlui M, Jahan NK, Majid HA, Jalaludin MY, Murray L, Cantwell M, et al.
    PLoS One, 2015;10(6):e0129628.
    PMID: 26068668 DOI: 10.1371/journal.pone.0129628
    Smoking among Malaysian adolescents remains a public health concern despite concerted efforts in tobacco control. The aims of this study were to examine the prevalence and determinants of current-smoking status in young adolescents. This cross sectional study used the first round of the Malaysian Health and Adolescents Research Team's prospective cohort study. It was conducted in three States of the Central and Northern regions of Peninsular Malaysia between March and May 2012. The study used the multistage stratified sampling design. A total of 1,342 adolescents of both sexes, aged 12-13 years, were sampled from randomly selected urban and rural national schools. Information on current smoking status and associated factors were collected by a self-administered, pre-tested, validated, structured questionnaire. Seven percent of the samples were current-smokers; the majority (62%) of them started smoking at the age of 11 years or below. The prevalence of current smoking was significantly higher in males (odds ratio [OR] = 2.37; 95% CI: 1.46, 3.84), those who were influenced by smoker friends (OR = 8.35; 95% CI: 4.90, 14.25), who were unaware of the health risks of smoking (OR =1.85; 95% CI: 1.02, 3.36) and who reported a lack of satisfaction about their overall life (OR =3.26; 95% CI: 1.73, 6.12). The study findings provide valuable information to strengthen the existing school-based smoking prevention program through integration of social competence and social influence curricula. The program should empower the young adolescents to refuse tobacco offers, to overcome social influences and to resist peer pressure to avoid starting smoking. Particular focuses to include mental health service to prevent both emotional and behavioural problems are needed.
  10. Marzuki N, Ismail S, Al-Sadat N, Ehsan FZ, Chan CK, Ng CW
    Asia Pac J Public Health, 2015 Nov;27(8 Suppl):86S-93S.
    PMID: 26085477 DOI: 10.1177/1010539515590180
    Despite the high costs involved and the lack of definitive evidence of sustained effectiveness, many low- and middle-income countries had begun to strengthen their health information system using information and communication technology in the past few decades. Following this international trend, the Malaysian Ministry of Health had been incorporating Telehealth (National Telehealth initiatives) into national health policies since the 1990s. Employing qualitative approaches, including key informant interviews and document review, this study examines the agenda-setting processes of the Telehealth policy using Kingdon's framework. The findings suggested that Telehealth policies emerged through actions of policy entrepreneurs within the Ministry of Health, who took advantage of several simultaneously occurring opportunities--official recognition of problems within the existing health information system, availability of information and communication technology to strengthen health information system and political interests surrounding the national Multimedia Super Corridor initiative being developed at the time. The last was achieved by the inclusion of Telehealth as a component of the Multimedia Super Corridor.
  11. Thangiah N, Chinna K, Su TT, Jalaludin MY, Al-Sadat N, Majid HA
    PMID: 32257989 DOI: 10.3389/fpubh.2020.00069
    Background: Cardiovascular disease (CVD) risk factors tend to cluster and progress from adolescence to young adulthood. Reliable and meaningful clustering of CVD risk factors is essential to circumvent loss of information. Tracking adverse and high-risk profiles of adolescents is hoped to curb CVD progression later in life. The study aims to investigate the clustering of biological CVD risk factor among adolescents in Malaysia and the transitions between clusters over time. Method: The Malaysian Health and Adolescents Longitudinal Research Team study (MyHeARTs) examined school students aged 13 in 2012 and re-examined them in 2014 and 2016. In a two-stage stratified cluster sampling, 1,361 students were recruited, of which, 1,320 had complete data. In the follow-up, there were 881 and 637 students in 2014 and in 2016, respectively. Pearson's correlation coefficients were used to identify and remove highly correlated CVD risk factors. All risk factors were standardized into z-scores. The hierarchical and non-hierarchical (k-means) cluster analyses were used to classify students into high, medium and low risk clusters in each screening year. The tracking and stability of cluster transitions through cross-classification were enumerated with Pearson's inter-age correlations and percentages. Results: Three significant clusters of high, medium and low risk groups were derived from the clustering of eight biological CVD risk factors. The transitions between risk clusters from one screening year to the other were categorized as either stagnant, improved or adverse. The number of students who had adverse transitions increased from 15.5% (13-15 year) to 19.5% (15-17 year), 13.8 to 18.2% among the girls and 19.9 to 22.8% among the boys. For girls, the number of them who remained at high risk over the two transition periods were about the same (13.6 vs. 13.8%) whereas for boys, the percentage reduced from 14.6 to 12.3%. Conclusion: Over time, more than 12% of adolescents remained in the high risk cluster. There were sizable adverse transitions over time as more adolescents appear to be shifting toward an increased risk of having CVD. Collaborative and constant measures should be taken by parents, school, health promotion boards and policy makers to curb the multiplicative effect of clustering CVD risk factors among adolescents.
  12. Majid HA, Amiri M, Mohd Azmi N, Su TT, Jalaludin MY, Al-Sadat N
    Sci Rep, 2016 07 28;6:30544.
    PMID: 27465116 DOI: 10.1038/srep30544
    Insufficient physical activity and growing obesity levels among Malaysian adolescents are becoming a public health concern. Our study is to identify the trends of self-reported physical activity (PA) levels, blood lipid profiles, and body composition (BC) indices from a cohort of 820 adolescents. The self-reported PA was assessed using a validated Malay version of the PA Questionnaire for Older Children (PAQ-C). Fasting blood samples were collected to investigate their lipid profiles. Height, weight, waist and hip circumferences as well as body fat percentage were measured. The baseline and the first follow-up were conducted in 2012 and 2014, respectively. A downward trend in the PA level was seen in all categories with a significant reduction among all rural adolescents (P = 0.013) and more specifically, PA among girls residing in rural areas dropped significantly (P = 0.006). Either a significant reduction in high-density lipoprotein (HDL) or a significant increment in BC indices (i.e., body mass index [BMI], waist circumference [WC], hip circumference, and body fat percentage [BF %]) were seen in this group. Female adolescents experienced more body fat increment with the reduction of physical activity. If not intervened early, adolescents from rural areas may increase their risk of developing cardiovascular diseases earlier.
  13. Suriawati AA, Majid HA, Al-Sadat N, Mohamed MN, Jalaludin MY
    Nutrients, 2016 Oct 24;8(10).
    PMID: 27783041
    BACKGROUND: Dietary calcium and vitamin D are essential for bone development. Apart from diet, physical activity may potentially improve and sustain bone health.

    OBJECTIVE: To investigate the relationship between the dietary intake of calcium and vitamin D, physical activity, and bone mineral content (BMC) in 13-year-old Malaysian adolescents.

    DESIGN: Cross-sectional.

    SETTING: Selected public secondary schools from the central and northern regions of Peninsular Malaysia.

    PARTICIPANTS: The subjects were from the Malaysian Health and Adolescents Longitudinal Research Team Cohort study (MyHeARTs).

    METHODS: The data included seven-day diet histories, anthropometric measurements, and the BMC of calcaneal bone using a portable broadband ultrasound bone densitometer. Nutritionist Pro software was used to calculate the dietary calcium and vitamin D intakes from the diet histories, based on the Nutrient Composition of Malaysian Food Database guidance for the dietary calcium intake and the Singapore Energy and Nutrient Composition of Food Database for vitamin D intake.

    RESULTS: A total of 289 adolescents (65.7% females) were recruited. The average dietary intakes of calcium and vitamin D were 377 ± 12 mg/day and 2.51 ± 0.12 µg/day, respectively, with the majority of subjects failing to meet the Recommended Nutrient Intake (RNI) of Malaysia for dietary calcium and vitamin D. All the subjects had a normal Z-score for the BMC (-2.00 or higher) with a mean of 0.55 ± 0.01. From the statistical analysis of the factors contributing to BMC, it was found that for those subjects with a higher intake of vitamin D, a higher combination of the intake of vitamin D and calcium resulted in significantly higher BMC quartiles. The regression analysis showed that the BMC might have been influenced by the vitamin D intake.

    CONCLUSIONS: A combination of the intake of vitamin D and calcium is positively associated with the BMC.

  14. Mohamed K, Tin TS, Jalaludin MY, Al-Sadat N, Majid HA
    Asia Pac J Clin Nutr, 2018 7 27;27(4):898-907.
    PMID: 30045437 DOI: 10.6133/apjcn.022018.03
    BACKGROUND AND OBJECTIVES: The food frequency questionnaire (FFQ) is a dietary tool used to assess the habitual intake of the population. The goal of this study is to examine the reproducibility and validity of the FFQ that was developed for a multi-ethnic population in Malaysia.

    METHODS AND STUDY DESIGN: Collective food data from MyHeARTs 2012 database were used to construct the MyUM Adolescent FFQ. Seventy-eight participants between 13 and 15 years old in 2014 were selected through convenient sampling for test-retest study. They completed the MyUM Adolescent FFQ twice, with an interval period of one week. One hundred and fifty-six MyHeARTs study participants who were 15 years old in 2014 were randomly selected for this comparative valid-ity study. They completed a 7-day diet history (7DDH) and subsequently completed the self-administered MyUM Adolescent FFQ.

    RESULTS: Pearson's correlations between the FFQ and 7DDH for all macronutrients were statistically significant. Energy-adjusted correlations for protein, carbohydrate, and fat were 0.54, 0.63 and 0.49 respectively. Most of the micronutrients and minerals, were statistically correlated ranging from 0.31 to 0.49 after energy adjustment. Cross-classification analyses revealed that more than 70 percent of adolescents were classified into either the same or adjacent quartile of nutrient intake when comparing data of 7DDH and FFQ. No serious systematic bias was evident in the Bland-Altman plots.

    CONCLUSION: The 200-item FFQ developed for Malaysian adolescents has moderate to good comparative validity for assessment of macronutrient and micronutrient intake.

  15. Quah SW, Abdul Majid H, Al-Sadat N, Yahya A, Su TT, Jalaludin MY
    PLoS One, 2018;13(7):e0200736.
    PMID: 30024934 DOI: 10.1371/journal.pone.0200736
    BACKGROUND: This study is to determine the prevalence and risk factors of vitamin D deficiency (vitamin D ≤ 50 nmol/L) among 15-year-old Malaysian adolescents. By identifying potential risk factors, prevention strategies and interventions can be carried out to improve the vitamin D status in adolescents.

    METHODS AND FINDINGS: Stratified random sampling design was used to select adolescents from 15 urban and rural secondary schools in Selangor, Perak and Kuala Lumpur, Malaysia. Data collection was carried out from 1st April 2014 to 30th June 2014. Information regarding socio-demographic characteristics, sun exposure and sun protective behaviours, clinical data and environmental factors were collected. Blood for total vitamin D was sampled. Descriptive and multivariate logistic regressions were performed. Total 1061 participants were analyzed (62% were female; mean age 15.1 ± 0.4 years). The prevalence of vitamin D deficiency was 33%. Mean vitamin D was lower in female (53 ± 15 nmol), obese (body fat percentage (≥25%m; ≥33.8%f) (56 ± 16 nmol/L), Malays (58 ± 18 nmol/L) and Indians (58 ± 15 nmol/L). In multivariate analysis, female (OR = 5.5; 95% CI: 3.4-7.5), Malay (OR = 3.2; 95% CI: 1.3-8.0), Indian (OR = 4.3; 95% CI: 1.6-12.0) and those always wearing long sleeve (OR = 2.4; 95% CI: 1.1-5.4) were more likely to have vitamin D deficiency. For female participants, ethnicity {Malays (OR = 6.7; 95% CI: 2.0-18.5), Indian (OR = 4.5; 95% CI: 1.8-19.3)} was an important risk factors. Cloud cover, school residence, skin pigmentation, sun-exposure and sun-protective behaviours were not significant risk factors. The limitation of this study was recall bias as it relied on self-reported on the sun exposure and protective behaviours. The diet factors were not included in this analysis.

    CONCLUSIONS: The prevalence of Vitamin D deficiency among Malaysian adolescents was considerable. Gender, ethnicity and clothing style were important risk factors.

  16. Reidpath DD, Ling ML, Wellington E, Al-Sadat N, Yasin S
    Nicotine Tob Res, 2013 Mar;15(3):729-33.
    PMID: 22990215 DOI: 10.1093/ntr/nts177
    INTRODUCTION: It is held that younger smoking initiates are more likely to become regular smokers. The definitions of smoking initiation (a puff, part of a cigarette, a whole cigarette) are inconsistent and raise questions about the robustness of the view. We sought to re-examine the relationship using adolescent smoking data from 3 European countries.
    METHODS: A stratified secondary, logistic regression analysis of Global Youth Tobacco Survey data was conducted using a design-based analysis. Subgroup analyses were conducted of 13- to 15-year olds from Latvia (high smoking prevalence), Slovenia (moderate prevalence), and Montenegro (low prevalence) who had initiated smoking. The outcome was current smoking--smoking everyday for the past 30 days, or smoking 10 or more days in the past 30 days. Smoking initiation was operationalized as a single puff of a cigarette, and age of smoking initiation was a derived continuous measure.
    RESULTS: In Latvia, there was a significant association between age of smoking initiation and current smoking for males (p < .05) and females (p < .001) when smoking was operationalized as smoking every day. It was only significant in female adolescents (p < .001) for smoking 10 or more days. In Slovenia and Montenegro, there was no significant relationship between age of smoking initiation and current smoking for either males or females.
    CONCLUSIONS: The evidence about the relationship between age of smoking initiation and current smoking is not clear. Explanations for the findings may relate to a lack of power, the specificity of the measure, or problems with the theory.
  17. Farid ND, Rus SC, Dahlui M, Al-Sadat N, Aziz NA
    BMC Public Health, 2014;14 Suppl 3(Suppl 3):S9.
    PMID: 25437631 DOI: 10.1186/1471-2458-14-S3-S9
    BACKGROUND: In welfare institutions, it is essential to address the health-related needs of adolescent populations who often engage in sexual activities. This study examines the association between individual and interpersonal factors concerning sexual risk behaviour (SRB) among adolescents in welfare institutions in Malaysia.

    METHODS: Data were derived from a cross-sectional study of 1082 adolescents in 22 welfare institutions located across Peninsular Malaysia in 2009. Using supervised self-administered questionnaires, adolescents were asked to assess their self-esteem and to complete questions on pubertal onset, substance use, family structure, family connectedness, parental monitoring, and peer pressure. SRB was measured through scoring of five items: sexual initiation, age of sexual debut, number of sexual partners, condom use, and sex with high-risk partners. Multivariate logistic regression analysis was used to examine the various predictors of sexual risk behaviour.

    RESULTS: The study showed that 55.1% (95%CI = 52.0-58.2) of the total sample was observed to practice sexual risk behaviours. Smoking was the strongest predictor of SRB among male adolescents (OR = 10.3, 95%CI = 1.25-83.9). Among females, high family connectedness (OR = 3.13, 95%CI = 1.64-5.95) seemed to predict the behaviour.

    CONCLUSION: There were clear gender differences in predicting SRB. Thus, a gender-specific sexual and reproductive health intervention for institutionalised adolescents is recommended.

  18. Mohammad AH, Al-Sadat N, Siew Yim L, Chinna K
    Biomed Res Int, 2014;2014:302097.
    PMID: 25276774 DOI: 10.1155/2014/302097
    This study aims to test the translated Hausa version of the stroke impact scale SIS (3.0) and further evaluate its psychometric properties. The SIS 3.0 was translated from English into Hausa and was tested for its reliability and validity on a stratified random sample adult stroke survivors attending rehabilitation services at stroke referral hospitals in Kano, Nigeria. Psychometric analysis of the Hausa-SIS 3.0 involved face, content, criterion, and construct validity tests as well as internal and test-retest reliability. In reliability analyses, the Cronbach's alpha values for the items in Strength, Hand function, Mobility, ADL/IADL, Memory and thinking, Communication, Emotion, and Social participation domains were 0.80, 0.92, 0.90, 0.78, 0.84, 0.89, 0.58, and 0.74, respectively. There are 8 domains in stroke impact scale 3.0 in confirmatory factory analysis; some of the items in the Hausa-SIS questionnaire have to be dropped due to lack of discriminate validity. In the final analysis, a parsimonious model was obtained with two items per construct for the 8 constructs (Chi-square/df < 3, TLI and CFI > 0.9, and RMSEA < 0.08). Cross validation with 1000 bootstrap samples gave a satisfactory result (P = 0.011). In conclusion, the shorter 16-item Hausa-SIS seems to measure adequately the QOL outcomes in the 8 domains.
  19. Hamza AM, Al-Sadat N, Loh SY, Jahan NK
    Biomed Res Int, 2014;2014:350281.
    PMID: 24982864 DOI: 10.1155/2014/350281
    This study aims to identify the predictors in the different aspects of the health-related quality of life (HRQoL) and to measure the changes of functional status over time in a cohort of Nigerian stroke survivors. A prospective observational study was conducted in three hospitals of Kano state of Nigeria where stroke survivors receive rehabilitation. The linguistic-validated Hausa versions of the stroke impact scale 3.0, modified Rankin scale, Barthel index and Beck depression inventory scales were used. Paired samples t-test was used to calculate the amount of changes that occur over time and the forward stepwise linear regression model was used to identify the predictors. A total of 233 stroke survivors were surveyed at 6 months, and 93% (217/233) were followed at 1 year after stroke. Functional disabilities were significantly reduced during the recovery phase. Motor impairment, disability, and level of depression were independent predictors of HRQoL in the multivariate regression analysis. The involvement of family members as caregivers is the key factor for those survivors with improved functional status. Thus, to enhance the quality of poststroke life, it is proposed that a holistic stroke rehabilitation service and an active involvement of family members are established at every possible level.
  20. Jeganathan PD, Hairi NN, Al Sadat N, Chinna K
    Asian Pac J Cancer Prev, 2013;14(6):3483-9.
    PMID: 23886133
    BACKGROUND: To identify the prevalence of different stages of smoking and differences in associated risk factors.

    MATERIALS AND METHODS: Thos longitudinal study started in February 2011 and the subjects were 2552 form one students aged between twelve to thirteen years of from 15 government secondary schools of Kinta, Perak. Data on demographic, parental, school and peer factors were collected using a self-administered questionnaire. We examined the effects of peer, school and parental factors on the five stages of smoking; never smokers, susceptible never smokers, experimenters, current smokers and ex-smokers, at baseline.

    RESULTS: In the sample, 19.3% were susceptible never smokers, 5.5% were current smokers 6% were experimenters and 3.1% were ex-smokers. Gender, ethnicity, best friends' smoking status, high peer pressure, higher number of relatives who smoked and parental monitoring were found to be associated with smoking stages. Presence of parent-teen conflict was only associated with susceptible never smokers and experimenters whereas absence of home discussion on smoking hazards was associated with susceptible never smokers and current smokers.

    CONCLUSIONS: We identified variations in the factors associated with the different stages of smoking. Our results highlight that anti-smoking strategies should be tailored according to the different smoking stages.

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