Displaying publications 1 - 20 of 97 in total

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  1. Stop smoking clinics in Malaysia: characteristics of attendees and predictors of success
    Wee LH, Shahab L, Bulgiba A, West R
    Addict Behav, 2011 Apr;36(4):400-3.
    PMID: 21195553 DOI: 10.1016/j.addbeh.2010.11.011
    INTRODUCTION: As Stop Smoking Clinics (SSCs) become more common across the globe, it is important to know how far one can make broad generalisations concerning characteristics of smokers who attend these clinics and factors that predict their success. This involves accumulation of data from different countries.
    OBJECTIVE: The aim of this study was to identify characteristics of smokers and factors leading up to quitting with clinics in Malaysia.
    METHOD: Records from 629 smokers who had sought help from five selected SSCs in Malaysia from January 2006 to June 2007 were analysed.
    RESULTS: The characteristics of smokers attending Malaysian smoking clinics were broadly similar to those in Western countries. Consistent with the findings from other countries, older age and longest duration of previous quit attempts were associated with successful smoking cessation. Greater baseline carbon-monoxide readings (OR 0.96, 95% CI 0.93-0.99; p=0.013), but not Fagerstrom Test for Nicotine Dependence (FTND), predicted failure to quit at six-month in multivariate analysis. Success rates varied greatly between clinics even after adjusting for all other predictors.
    CONCLUSION: In these rare data from a non-Western culture some predictors of successful smoking cessation appeared to generalise from Western smokers but the universal validity of the FTND in particular needs to be examined further.
  2. Should the threshold for expired-air carbon monoxide concentration as a means of verifying self-reported smoking abstinence be reduced in clinical treatment programmes? Evidence from a Malaysian smokers' clinic
    Wee LH, West R, Mariapun J, Chan CM, Bulgiba A, Peramalah D, et al.
    Addict Behav, 2015 Aug;47:74-9.
    PMID: 25889913 DOI: 10.1016/j.addbeh.2015.03.021
    BACKGROUND: It has been proposed that the expired-air carbon monoxide (CO) threshold for confirming smoking abstinence in clinical practice be reduced below 10 ppm. Optimal thresholds may vary across regions. Data are needed to assess the impact of such a change on claimed success.
    METHODS: A total of 253 smokers who attended the Tanglin quit smoking clinic in Malaysia were followed-up 1, 3 and 6 months after the target quit date. All participants received a standard behavioural support programme and were prescribed either varenicline or nicotine replacement therapy. Expired-air CO was measured at every visit. Respondents' smoking status was assessed using a range of different CO thresholds (3, 5 and 10 ppm) and the impact on quit rates was calculated. Predictors of success as defined using the different thresholds were assessed.
    RESULTS: The 6-month abstinence rates were: 1 month - 54.9% at 10 ppm, 54.9% at 5 ppm and 48.6% at 3 ppm; 3 months - 36.0% at 10 ppm, 35.2% at 5 ppm and 30.4% at 3 ppm; 6 months - 24.1% at 10 ppm, 24.1% at 5 ppm and 20.6% at 3 ppm. Older smokers were more likely to be recorded as abstinent at 6 months regardless of the threshold used.
    CONCLUSIONS: Reducing the threshold for expired-air carbon monoxide concentrations to verify claimed smoking abstinence from 10 ppm to 5 ppm makes minimal difference to documented success rates in Malaysian smoker's clinic patients. Reducing to 3 ppm decreases success rates slightly. Predictors of success at stopping appear to be unaffected by the threshold used.
    KEYWORDS: Carbon monoxide; Predictors for abstinence; Smoking cessation; Success rates
  3. Association of melanocortin-4 receptor gene polymorphisms with obesity-related parameters in Malaysian Malays
    Apalasamy YD, Ming MF, Rampal S, Bulgiba A, Mohamed Z
    Ann Hum Biol, 2013 Jan;40(1):102-6.
    PMID: 22989167 DOI: 10.3109/03014460.2012.720709
    Melanocortin-4 receptor (MC4R) is an important regulator of body weight and energy intake. Genetic polymorphisms of the MC4R gene have been found to be linked to obesity in many recent studies across the globe.
  4. "Feeling unsafe": a photovoice analysis of factors influencing physical activity behavior among Malaysian adolescents
    Saimon R, Choo WY, Bulgiba A
    Asia Pac J Public Health, 2015 Mar;27(2):NP2079-92.
    PMID: 23513006 DOI: 10.1177/1010539513480229
    Understanding the factors influencing physical activity (PA) in the Asia-Pacific region is critical, given the high prevalence of inactivity in this area. The photovoice technique explores the types of PA and factors influencing PA among adolescents in Kuching, Sarawak. A total of 160 photographs were collected from participants (adolescents, n = 22, mean age = 14.27 ± 0.7 years, and parents, n = 8, mean age = 48 ± 6.8 years). Data analysis used constant comparison methods of a grounded theory. The Analysis Grid for Environments Linked to Obesity was used to categorize PA factors. Study findings were centered on the concept of safety, facilities, parental restriction, friends, cultural traits, media, community cohesiveness, and weather. The central theme was "feeling unsafe" when being outdoors. To promote PA behavior, provision of PA facilities needs to be supported by other programs that build on peer support, crime prevention, and traffic safety, together with other educational campaigns.
  5. Gender-dependent association of a β(2)-adrenergic gene variant with obesity parameters in Malaysian Malays
    Apalasamy YD, Ming MF, Rampal S, Bulgiba A, Mohamed Z
    Asia Pac J Public Health, 2015 Mar;27(2):NP154-65.
    PMID: 22199155 DOI: 10.1177/1010539511430250
    Recent findings have shown that the rs1042714 (Gln27Glu) single-nucleotide polymorphism (SNP) on the β2-adrenoceptor gene may predispose to obesity. The findings from other studies carried on different populations, however, have been inconsistent. The authors investigated the association between the rs1042714 SNP with obesity-related parameters. DNA of 672 Malaysian Malays was analyzed using real-time polymerase chain reaction. Univariate and multivariate linear regression analyses revealed significant associations between rs1042714 and diastolic blood pressure in the pooled Malaysian Malay subjects under additive and recessive models. After gender stratification, however, a significant association was found between the rs1042714 and triglyceride and the rs1042714 and log-transformed high-density lipoprotein cholesterol levels in Malaysian Malay men. No significant association was found between the SNP and log-transformed body mass index. This polymorphism may have an important role in the development of obesity-related traits in Malaysian Malays. Gender is an effect modifier for the effect of the rs1042714 polymorphism on obesity-related traits in Malaysian Malays.
  6. Information technology in health care--what the future holds
    Bulgiba AM
    Asia Pac J Public Health, 2004;16(1):64-71.
    PMID: 18839870 DOI: 10.1177/101053950401600111
    In 1998, Malaysia opened its first hospital based on the "paperless and filmless" concept. Two are now in operation, with more to follow. Telemedicine is now being used in some hospitals and is slated to be the technology to watch. Future use of technology in health care will centre on the use of centralised patient databases and more effective use of artificial intelligence. Stumbling blocks include the enormous capital costs involved and difficulty in getting sufficient bandwidth to support applications on a national scale. Problems with the use of information technology in developing countries still remain; mainly inadequate skilled resources to operate and maintain the technology, lack of home-grown technology, insufficient experience in the use of information technology in health care and the attitudes of some health staff. The challenge for those involved in this field will not be in building new "paperless and filmless" institutions but in transforming current "paper and film-based" institutions to "paperless and filmless" ones and changing the mindset of health staff. Universities and medical schools must be prepared to respond to this new wave by incorporating elements of medical/health informatics in their curriculum and assisting governments in the planning and implementation of these projects. The experience of the UMMC is highlighted as an example of the difficulty of transforming a paper-based hospital to a "paperless and filmless" hospital.
  7. The Physical Activity Scale for the Elderly (PASE): Validity and Reliability Among Community-Dwelling Older Adults in Malaysia
    Ismail N, Hairi F, Choo WY, Hairi NN, Peramalah D, Bulgiba A
    Asia Pac J Public Health, 2015 Nov;27(8 Suppl):62S-72S.
    PMID: 26058900 DOI: 10.1177/1010539515590179
    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 (rs = 0.429, P < .001), walking speed (rs = 0.270, P < .001), grip strength (rs = 0.313-0.339, P < .001), and perceived health status (rs = -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.
  8. Physical Activity Among Adolescents in an East Malaysian Rural Indigenous Community: Exploring the Influence of Neighborhood Environmental Factors
    Saimon R, Choo WY, Chang KH, Ng CJ, Bulgiba A
    Asia Pac J Public Health, 2015 Nov;27(8 Suppl):33S-40S.
    PMID: 25900978 DOI: 10.1177/1010539515582220
    This study explores the rural environmental factors that influence adolescents' participation in physical activities (PA). Thirty-six indigenous adolescents, aged 13 to 17 years from rural communities of East Malaysia were involved in the photovoice procedures: photo-taking, selecting, contextualizing, and codifying themes. Despite being endowed with natural resources such as river, forest, hills, and so on, the adolescents and the community did not capitalize on these rich resources to promote and engage in PA. Poor maintenance of natural resources, the lack of pedestrian infrastructures and road safety, the lack of PA facilities, and negative perception of ancestors' agricultural activities were among factors that constrained adolescents' PA. Although basic amenities such as play spaces and pedestrian infrastructures are necessary to increase adolescents' PA, any intervention should make the most of the natural resources, which are cheaper, environment friendly, and sustainable.
  9. IT usage, perceptions and literacy of medical students
    Bulgiba AM, Noran MH
    Asia Pac J Public Health, 2003;15(2):127-34.
    PMID: 15038688
    A cross-sectional study of medical students using a self-administered questionnaire was carried out in the Faculty of Medicine, University of Malaya, Malaysia from December 2000 to January 2001 to determine IT usage, perceptions and literacy of medical students. 366 of 653 (56.0%) students reported owning some type of personal computer. Students mainly used the computer to get onto the Internet, do word-processing and make presentations. Junior (Year One and Two) students and those who had used computers before entering university were more likely to use the Internet. Those who own computers were more likely to feel comfortable with software (OR 1.61, 95% CI: 1.09, 2.38). Students who use the Internet were more likely to perceive that IT facilitated their studies (OR 4.61, 95% CI: 2.35, 9.05). The highest self-reported IT skill was e-mailing followed by surfing the World Wide Web and word-processing. Male students and junior students had significantly higher self-reported IT literacy scores compared to female students and senior students. Significant predictors for an IT identifier score after adjusting for other variables were self-reported rating of computer knowledge, number of siblings, parents' income and gender.
  10. Guidelines for Complementary Feeding of Infants in the Asia Pacific Region: APACPH Public Health Nutrition Group
    Binns C, Lee MK, Yun Low W, Baker P, Bulgiba A, Dahlui M, et al.
    Asia Pac J Public Health, 2020 05;32(4):179-187.
    PMID: 32475150 DOI: 10.1177/1010539520931328
    Good nutrition in the first "1000 days," including breastfeeding and appropriate complementary foods, prepares for a healthy childhood and adult life, also contributes to the prevention of the double burden of malnutrition. Exclusive breastfeeding provides all required nutrients until an infant is around 6 months of age when complementary foods are needed. A literature review was undertaken of complementary foods in the Asia Pacific region. The foods being used at present are often of low nutrient density may provide insufficient amounts of some critical nutrients, and generally the variety is limited. Guidelines for complementary feeding are provided to assist in education and in public health planning.
  11. Adaptive Leadership and Independent Opinions: Lessons From the National COVID-19 Immunisation Programme
    Bulgiba A
    Asia Pac J Public Health, 2021 Dec 15.
    PMID: 34911369 DOI: 10.1177/10105395211065309
    Malaysia was slow to begin its COVID-19 immunization program for various reasons. However, it is one of the fastest developing countries to vaccinate 80% of its adult population. Nontraditional health leadership played a large role in the implementation of the National COVID-19 Immunisation Programme (NCIP). Independent opinions from academia also helped the NCIP and may be useful as a way of pushing forward recommendations that may otherwise be difficult to make.
  12. Depression, Anxiety, and Stress Among Frontline Primary Health Care Workers During the COVID-19 Pandemic
    Salaton NF, Bulgiba A
    Asia Pac J Public Health, 2022 Feb 07.
    PMID: 35130753 DOI: 10.1177/10105395221077064
  13. Internet-Based Research in Public Health: Can It Ever Be Reliable?
    Binns C, Yun Low W, Shunnmugam B, Minh Pham N, Lee A, Bulgiba A, et al.
    Asia Pac J Public Health, 2023 Mar 16.
    PMID: 36924228 DOI: 10.1177/10105395231162470
  14. Infant Feeding Guidelines for the Asia Pacific Region
    Binns C, Lee MK, Kagawa M, Low WY, Scott J, Lee A, et al.
    Asia Pac J Public Health, 2018 Nov 23.
    PMID: 30466298 DOI: 10.1177/1010539518809823
    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.
  15. Commuting Accidents and Its Associated Factors Among Public Hospital Nurses in Selangor, Malaysia
    Fadzil SS, Bulgiba A
    Asia Pac J Public Health, 2024 Jan;36(1):119-122.
    PMID: 37864305 DOI: 10.1177/10105395231207234
    Commuting accidents account for 48% of work-related accidents in Malaysia. However, commuting accidents among health care workers are understudied and formally reported commuting accident numbers among nurses are likely to be an underestimate of actual numbers. This is the first study in Malaysia to attempt to establish the true incidence and associated factors for commuting accidents among nurses in Malaysia. A cross-sectional study was conducted to determine the true incidence of commuting accidents and its associated factors among public hospital nurses in Selangor, Malaysia. A validated and pilot-tested self-reported questionnaires were distributed to all nurses via an online-based platform. This study found a significant difference between the incidence of formally reported and self-reported commuting accidents from 2018 to 2022, with incidence rates ranging between 0.3 and 8.6 per 1000 nurses. Multivariable logistic regression showed that nurses working in district hospitals had lower odds to be involved in commuting accidents, while nurses working in clinical departments and traveling longer distances between home and workplaces had increased odds of commuting accidents.
  16. Prevalence of Co-Occurrence of Physical Frailty and Malnutrition and Its Associated Factors Among Community-Dwelling Older Adults in a Rural District, Malaysia
    Mustaffa M, Hairi NN, Majid HA, Choo WY, Hairi FM, Peramalah D, et al.
    Asia Pac J Public Health, 2024 Mar;36(2-3):210-218.
    PMID: 38482611 DOI: 10.1177/10105395241238092
    Frailty and malnutrition commonly co-occur but remains undetected and untreated in community settings. This study aimed to determine the prevalence of co-occurring frailty and malnutrition, and its associated factors among community-dwelling older adults in a rural setting in Malaysia. A cross-sectional study was conducted among adults aged ≥ 60 residing in Kuala Pilah district, Negeri Sembilan, Malaysia. Physical frailty and nutritional status were assessed using the Fried phenotype and the Mini Nutritional Assessment (MNA), respectively. Among 1855 participants, 6.4% had co-occurring frailty and at-risk/malnutrition and 11.3% had co-occurring prefrailty and at-risk/malnutrition. Older age, fair-to-poor self-rated health, long-term disease, polypharmacy, activities of daily living (ADLs) and instrumental ADLs' disabilities, cognitive impairment, and poor social support were associated with higher odds of co-occurring frailty and malnutrition. Therefore, beside early identification, targeted intervention is crucial to prevent or delay the progression of frailty and malnutrition in this population.
  17. Sarcopenia and All-Cause Mortality Risk in Community-Dwelling Rural Malaysian Older Adults
    Ramoo K, Hairi NN, Yahya A, Choo WY, Hairi FM, Ismail N, et al.
    Asia Pac J Public Health, 2024 Mar;36(2-3):225-231.
    PMID: 38482589 DOI: 10.1177/10105395241237811
    Sarcopenia is associated with numerous adverse health outcomes, including frailty, disability, and mortality. Since the Asian Working Group for Sarcopenia 2019 guidelines, which were published in 2020, are relatively new, studies on the association between sarcopenia as defined by these guidelines and mortality are limited in the Asian region. Accordingly, this study aimed to examine the all-cause mortality risk associated with sarcopenia among community-dwelling older adults in rural Malaysia. This cohort study included 2404 older adults residing in Kuala Pilah District, Negeri Sembilan, Malaysia who were followed up for 83 months. The prevalence rates of sarcopenia and severe sarcopenia were 5.0% and 3.60%, respectively. Older adults with sarcopenia and severe sarcopenia had a 114% (hazard ratio [HR]: 2.14) and 146% (HR: 2.46) increased mortality risk compared with those without sarcopenia (HR: 2.14). Our findings indicate that early intervention is recommended to prevent sarcopenia in older adults.
  18. Is breast self examination (BSE) still relevant? A study on BSE performance among female staff of University of Malaya
    Dahlui M, Ng C, Al-Sadat N, Ismail S, Bulgiba A
    Asian Pac J Cancer Prev, 2011;12(2):369-72.
    PMID: 21545196
    OBJECTIVES: This study aimed to determine the rate of breast self examination (BSE) among the female staff of University of Malaya and to determine the role of BSE in detecting breast abnormalities.

    METHODS: A total of 1598 questionnaires were posted to all female staff, aged 35 years and above. Their knowledge on breast cancer, practice of BSE and detection rate of breast abnormality as confirmed by CBE was determined.

    RESULTS: The response rate for this study was 45 percent (714 respondents). The rate of respondents having awareness on breast cancer was 98.7 percent. Eighty four percent (598) of the respondents had performed BSE in their lifetime. However, in only 41% was it regular at the recommended time. Forty seven percent (334) had undergone CBE at least once in a lifetime but only 26% (185) had CBE at least once in the past 3 years, while 23% (165) had had a mammogram. There was a significant relationship between CBE and BSE whereby those who had CBE were twice more likely to do BSE. Nineteen percent (84 respondents) of those who did BSE claimed they had detected a breast lump. Of these, 87% (73) had gone for CBE and all were confirmed as such.

    CONCLUSION: BSE is still relevant as a screening tool of breast cancer since those who detect breast lump by BSE will most probably go for further check up. CBE should be done to all women, especially those at highest risk of breast cancer, to encourage and train for BSE.

  19. Fulltext Systematic review on international practices in controlling waterpipe tobacco smoking
    Tee GH, Hairi NN, Nordin F, Choo WY, Chan YY, Kaur G, et al.
    Asian Pac J Cancer Prev, 2015;16(9):3659-65.
    PMID: 25987018
    BACKGROUND: 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.

    MATERIALS AND METHODS: 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.

    RESULTS: 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.

    CONCLUSIONS: 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.
  20. Fulltext MultiComponent Exercise and theRApeutic lifeStyle (CERgAS) intervention to improve physical performance and maintain independent living among urban poor older people--a cluster randomised controlled trial
    Loh DA, Hairi NN, Choo WY, Mohd Hairi F, Peramalah D, Kandiben S, et al.
    BMC Geriatr, 2015;15:8.
    PMID: 25887235 DOI: 10.1186/s12877-015-0002-7
    The ability of older people to function independently is crucial as physical disability and functional limitation have profound impacts on health. Interventions that either delay the onset of frailty or attenuate its severity potentially have cascading benefits for older people, their families and society. This study aims to develop and evaluate the effectiveness of a multiComponent Exercise and theRApeutic lifeStyle (CERgAS) intervention program targeted at improving physical performance and maintaining independent living as compared to general health education among older people in an urban poor setting in Malaysia.
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