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Fulltext Oh I remember the beauty and aesthetics of guilin!: Exploring the implications of memorability on tourist loyalty through a two-wave panel data

Cao EY, Chong KM, Pan L, Ning L, Pan FD, Li KK

Heliyon, 2024 Jan 15;10(1):e23365.
PMID: 38169803 DOI: 10.1016/j.heliyon.2023.e23365

The travel and tourism industry is among most severely impacted by natural disasters, terrorism, financial crises, and pandemics. Scholars are currently paying attention to how to revive tourism and establish tourist loyalty in the post-pandemic era. Aesthetics is a fundamental component of the tourist experience, and significantly affects tourist loyalty, intention, and behavior. However, research on destination aesthetics is limited, with most studies neglecting the role of memorability in the outcomes of aesthetics, particularly after the pandemic. Therefore, this study explores the mediating role of memorability in the effects of the aesthetic experiential qualities (scenery, cleanliness, harmony, art/architecture, and genuineness) of a nature-based tourism destination on tourist loyalty. Based on a two-wave panel data approach, 509 survey responses were collected and analyzed using Smarts. The findings indicate that the aesthetic experiential qualities positively affect tourists' memorability. Although three of the five aesthetic qualities (scenery, harmony, art/architecture) demonstrated no direct impact on loyalty, all the qualities had significant indirect effects on loyalty through the mediation of memorability. This study provides insights and new perspectives for promoting tourist loyalty in the context of post-pandemic tourism recovery.
Fulltext Management of Medicines Wastage, Returned Medicines and Safe Disposal in Malaysian Community Pharmacies: A Qualitative Study

Chong KM, Rajiah K, Chong D, Maharajan MK

Front Med (Lausanne), 2022;9:884482.
PMID: 35665362 DOI: 10.3389/fmed.2022.884482

INTRODUCTION: In supplying medicines to patients and consumers waste can occur in prescribing, dispensing, and leftover stages. Pharmacists in community pharmacies play a crucial role in dispensing and should share information on appropriate medicines disposal with consumers. This qualitative study explored how Malaysian community pharmacists manage medication wastage, returned medicines, and medicines disposal by eliciting their opinions on medicines wastage, the challenges faced, and feasibility of medicine return and safe medicine disposal in the setting of Malaysian community pharmacy.
METHODS: Telephonic interviews were conducted using a pre-validated interview guide among community pharmacists. Purposive sampling was used to ensure heterogeneity of participants in terms of gender, age, and position in the pharmacy. The interview was conducted until a point where no new information was obtained. Interview data were thematically analyzed.
RESULTS: The analysis identified nine themes organized into four domains. The results revealed that pharmacists have positive perceptions of the safe disposal of medicines. Pharmacists mentioned that medicine returns to service in community pharmacies are not common due to a lack of facilities in the management of unwanted, expired, and returned medicines. As such pharmacists have suggested a few ways to minimize medicinal wastage.
CONCLUSIONS: Respondents aimed to minimize medicines wastage (unused medicines) in order to minimize loss of revenue. Respondents did not usually accept returned medicines due to the operational costs of safe disposal. Disposal of unused medicines was undertaken by centralizing the stocks at an organization facility before being disposed of by outsourced waste management companies.
Fulltext Can a mathematical model be used to estimate the contribution of acute gastroenteritis to the overall prevalence of irritable bowel syndrome?

Chong KM, Chua AS

J Neurogastroenterol Motil, 2012 Apr;18(2):120-2.
PMID: 22523720 DOI: 10.5056/jnm.2012.18.2.120
Fulltext Development, Translation and Validation of Enhanced Asian Rome III Questionnaires for Diagnosis of Functional Bowel Diseases in Major Asian Languages: A Rome Foundation-Asian Neurogastroenterology and Motility Association Working Team Report

Ghoshal UC, Gwee KA, Chen M, Gong XR, Pratap N, Hou X, et al.

J Neurogastroenterol Motil, 2015 Jan 1;21(1):83-92.
PMID: 25537673 DOI: 10.5056/jnm14045

The development-processes by regional socio-cultural adaptation of an Enhanced Asian Rome III questionnaire (EAR3Q), a cultural adaptation of the Rome III diagnostic questionnaire (R3DQ), and its translation-validation in Asian languages are presented. As English is not the first language for most Asians, translation-validation of EAR3Q is essential. Hence, we aimed to culturally adapt the R3DQ to develop EAR3Q and linguistically validate it to show that the EAR3Q is able to allocate diagnosis according to Rome III criteria.
Consensus and contentious statements on the use of probiotics in clinical practice: A south east Asian gastro-neuro motility association working team report

Gwee KA, Lee WW, Ling KL, Ooi CJ, Quak SH, Dan YY, et al.

J Gastroenterol Hepatol, 2018 Oct;33(10):1707-1716.
PMID: 29697855 DOI: 10.1111/jgh.14268

The concept of consuming microorganisms in the treatment of a medical condition and in health maintenance has gained much attraction, giving rise to an abundance of medical claims and of health supplements. This study identified relevant clinical questions on the therapeutic use of probiotics and reviewed the literature in irritable bowel syndrome, inflammatory bowel disease, impaired intestinal immunity, liver disease, intestinal infections, and common childhood digestive disorders. Statements were developed to address these clinical questions. A panel of experienced clinicians was tasked to critically evaluate and debate the available data. Both consensus and contentious statements are presented to provide to clinicians a perspective on the potential of probiotics and importantly their limitations.
Fulltext Initiating or Switching to Insulin Degludec/Insulin Aspart in Adults with Type 2 Diabetes in Malaysia: Results from a Prospective, Non-interventional Real-World Study

Mohamed M, Lim SC, Mumtaz M, Uppal S, Mukherjee D, Kassim MSM, et al.

J ASEAN Fed Endocr Soc, 2023;38(1):37-44.
PMID: 37252419 DOI: 10.15605/jafes.038.01.12

OBJECTIVES: Insulin degludec (IDeg)/insulin aspart (IAsp; IDegAsp) is a co-formulation of 70% IDeg and 30% IAsp. According to several randomized controlled trials, IDegAsp is effective and safe for patients with type 2 diabetes mellitus (T2DM). A subgroup analysis of the ARISE study was conducted to explore the safety and efficacy of IDegAsp among Malaysian patients with T2DM in real-world settings.
METHODOLOGY: ARISE, an open-label, multicenter, non-interventional, prospective study was conducted between August 2019 and December 2020. Adult Malaysian patients with T2DM who were enrolled from 14 sites received IDegAsp as per the local label for 26 weeks. The primary endpoint was change in glycated hemoglobin (HbA1c) levels from baseline to end of study (EOS).
RESULTS: Of the 182 patients included in the full analysis set, 159 (87.4%) completed the study. From baseline to EOS, HbA1c (estimated difference [ED]: -1.3% [95% CI: -1.61 to -0.90]) and fasting plasma glucose levels (ED: -1.8 mmol/L [95% CI: -2.49 to -1.13]) were significantly reduced (p<0.0001). The patient-reported reduced hypoglycemic episodes (overall and nocturnal) during treatment. Overall, 37 adverse events were observed in 23 (12.6%) patients.
CONCLUSION: Switching or initiating IDegAsp treatment resulted in significant improvements in glycemic control and a reduction in hypoglycemic episodes.
Rome foundation Asian working team report: Real world treatment experience of Asian patients with functional bowel disorders

Xiong L, Gong X, Siah KT, Pratap N, Ghoshal UC, Abdullah M, et al.

J Gastroenterol Hepatol, 2017 Aug;32(8):1450-1456.
PMID: 28084664 DOI: 10.1111/jgh.13730

BACKGROUND AND AIM: Information on real world treatment experiences of patients with functional bowel disorders is lacking from Asia. This study aimed to describe the medication exposure and treatment satisfaction of patients presenting to gastroenterology clinics across a sampling of Asian cities.

METHODS: From March 2011 to October 2013, adult patients presenting to hospital-based gastroenterology outpatient clinics in 11 cities across Asia, who fulfilled screening criteria for any functional gastrointestinal disorder, were asked to complete a validated culturally adapted translation of the Rome III diagnostic questionnaire, a checklist of medications received in the preceding 3 months and questions on treatment satisfaction.

RESULTS: A total of 1376 patients (female 755, male 621, 41.36 ± 13.25 years) comprising irritable bowel (621, 45.1%), unspecified functional bowel disorder (372, 27.8%), functional constipation (202, 14.7%), functional bloating (144, 10.5%), and functional diarrhea (56, 4.1%) completed the study. Of 1105 patients with a previous consultation, 509 (46.1%) were dissatisfied with their treatment, with ineffective treatment being the commonest reason. Satisfaction with previous consultation was lowest by diagnosis for functional constipation (29.2%), and the most bothersome symptom was straining (37.5%). Of 1046 patients who had taken medications for their gastrointestinal symptoms in the last 3 months, 793 (75.8%) had received two or more drugs. For irritable bowel syndrome patients, treatment with proton pump inhibitors and antispasmodics was recorded in 57% and 31%, with overlapping epigastric pain and heartburn predicting proton pump inhibitors use.

CONCLUSIONS: More attention should be given to treatment gaps with regards to possible under-treatment with antispasmodics in irritable bowel syndrome and to critically evaluating the efficacy of constipation management.
Fulltext Synthetic-type control charts for time-between-events monitoring

Yen FY, Chong KM, Ha LM

PLoS One, 2013;8(6):e65440.
PMID: 23755231 DOI: 10.1371/journal.pone.0065440

This paper proposes three synthetic-type control charts to monitor the mean time-between-events of a homogenous Poisson process. The first proposed chart combines an Erlang (cumulative time between events, Tr ) chart and a conforming run length (CRL) chart, denoted as Synth-Tr chart. The second proposed chart combines an exponential (or T) chart and a group conforming run length (GCRL) chart, denoted as GR-T chart. The third proposed chart combines an Erlang chart and a GCRL chart, denoted as GR-Tr chart. By using a Markov chain approach, the zero- and steady-state average number of observations to signal (ANOS) of the proposed charts are obtained, in order to evaluate the performance of the three charts. The optimal design of the proposed charts is shown in this paper. The proposed charts are superior to the existing T chart, Tr chart, and Synth-T chart. As compared to the EWMA-T chart, the GR-T chart performs better in detecting large shifts, in terms of the zero- and steady-state performances. The zero-state Synth-T4 and GR-Tr (r = 3 or 4) charts outperform the EWMA-T chart for all shifts, whereas the Synth-Tr (r = 2 or 3) and GR-T 2 charts perform better for moderate to large shifts. For the steady-state process, the Synth-Tr and GR-Tr charts are more efficient than the EWMA-T chart in detecting small to moderate shifts.