Displaying publications 1 - 20 of 117 in total

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  1. Lolekha S, Cooksley G, Chan V, Isahak I, Ismael S, John J, et al.
    PMID: 11414406
    Meningitis due to an invasive Haemophilus influenzae type b (Hib) infection, has been previously perceived to be relatively uncommon in Asia. However, the incidence of disease and its impact may have been underestimated. In addition to a lack of microbiological facilities in some hospitals, difficulties in culturing the organism and the widespread use of antibiotics may have hidden the true incidence of the disease in some countries. Furthermore, the reported disease burden probably underestimates the incidence of Hib pneumonia. The epidemiology of invasive Hib disease for various Asian nations is reviewed in this paper. Hospital-based studies show that Hib is a major cause of bacterial meningitis and/or pneumonia in the Philippines, India, Thailand, Malaysia, Indonesia and Vietnam. Singapore and Hong Kong have a low incidence of infection compared with Western and other Asian nations. This low incidence is not due to a higher level of natural protective antibodies, but may be related to an interaction between environmental and genetic factors. Therefore the widespread belief that Hib infection is unimportant in Asia does not refer to Asia as a whole and possibly to Chinese patients only, and failure to recognize this has serious implications. The inclusion of Hib vaccine in the routine infant immunization schedule in many industrialized nations has significantly reduced the incidence of invasive disease. Recent studies have shown Hib vaccination is also effective in preventing invasive disease in children in developing countries. While population-based data may be required to confirm the need for public-funded infant Hib immunization in Asia, its introduction in countries with a high incidence of Hib meningitis and/or pneumonia has the potential to significantly improve pediatric health and survival.
  2. Jin H, Earnshaw VA, Wickersham JA, Kamarulzaman A, Desai MM, John J, et al.
    AIDS Care, 2014;26(10):1223-8.
    PMID: 24625279 DOI: 10.1080/09540121.2014.894616
    Stigma perpetuated by health-care providers has been found to be a barrier to care for vulnerable populations, including HIV-infected, people who inject drugs (PWIDs), and men who have sex with men (MSM) in multiple clinical contexts and remains unexamined among professional health-care students in Malaysia. This cross-sectional, anonymous, and Internet-based survey assessed the attitudes of medical and dental students toward HIV-infected, PWID, and MSM patients. Survey invitation was emailed to 3191 students at 8 professional schools; 1296 (40.6%) responded and scored their attitudes toward these patient groups using a feeling thermometer, indicating their attitudes on a sliding scale from 0 (most negative) to 100 (most positive). Compared to general patients (mean = 76.50), the mean scores for HIV-infected (mean = 54.04; p < 0.001), PWID (mean = 37.50; p < 0.001), and MSM (mean = 32.13; p < 0.001) patients were significantly lower and significantly different between each group comparison. Within group differences, most notably religion, ethnicity, and personally knowing someone from these populations were associated with significant differences in attitudes. No differences were noted between pre-clinical and clinical year of training. Health-care students represent the next generation of clinicians who will be responsible for future HIV prevention and treatment efforts. Our findings suggest alarmingly negative attitudes toward these patients, especially MSM, necessitating prompt and effective interventions designed to ameliorate the negative attitudes of health-care students toward vulnerable populations, specifically HIV-infected, PWID, and MSM patients in Malaysia.
    Site site: online surveys at seven universities: University of Malaya, National University of Malaysia, International Islamic University Malaysia, Universiti Malaysia Sarawak, Penang International Dental College, Universiti Teknologi MARA Malaysia, and Universiti Sains Malaysia.
  3. Rozali M.N., Wahid F.H., John J., Purmal K.
    Ann Dent, 2017;24(1):27-32.
    MyJurnal
    The objectives of the study were to determine the normal dental arch width of Malays, their correlation with
    the facial framework and the ideal size of orthodontic impression trays that fit the dental arch. Eighteen adult
    Malays with normal Class I occlusion were evaluated. Arch width was measured on each subject’s dental
    cast. Direct anthropometric measurements were taken for 8 facial landmarks. Orthodontic impression trays
    were tried on each subject’s dental cast to determine the best fitting tray. Correlations analysis was made
    between the arch widths and the best fitting impression trays used and also with various craniofacial
    anthropometric measurements. The eight measurements from the craniofacial region were compared
    with the maxillary and mandibular intercanine, interpremolar and intermolar widths. In the maxillary arch,
    there were significant correlation between the face width and the interpremolar and intermolar widths
    respectively, while in the mandibular arch, significant correlations were noted between the mandible depth
    and the interpremolar and intermolar widths respectively. The most common fitting impression tray was size
    6 for the upper jaw and size 5 for the lower jaw. There was a significant correlation between the maxillary
    intercanine width and the size of the impression trays. The significant correlation between upper and lower
    interpremolar and intermolar widths and the anthropometric measurements of this Malay population may
    assist in predicting arch expansion to achieve Class 1 occlusion during orthodontic or maxillofacial surgical
    treatment. The significant correlation between the upper intercanine width and the size of impression tray
    can be a useful parameter when determining the size of impression tray.
  4. Md Bohari NF, Kruger E, John J, Tennant M
    Int Dent J, 2019 Jun;69(3):223-229.
    PMID: 30565655 DOI: 10.1111/idj.12454
    OBJECTIVE: The aim of this study was to analyse, in detail, the distribution of primary dental clinics in relation to the Malaysian population and relative population wealth, to test the hypothesis that an uneven distribution of dental services exists in Malaysia.

    METHOD: This 2016 study located every dental practice in Malaysia (private and public) and mapped these practices against population, using Geographic Information Systems (GIS) tools. Population clusters within 5, 10 and 20 km of a dental clinic were identified, and clinic-to-population ratios were ascertained. Population data were obtained from the Population and Housing Census of Malaysia 2010. Population relative wealth was obtained from the 2014 Report on Household Income and Basic Amenities Survey for Malaysia. The physical address for each dental practice in Malaysia was gathered from the Official Portal of Ministry of Health Malaysia. All data for analysis were extracted from the integrated database in Quantum GIS (QGIS) into Microsoft Excel.

    RESULT: The population of Malaysia (24.9 million) was distributed across 127 districts, with 119 (94%) having at least one dental clinic. Sixty-four districts had fewer than 10 dental clinics, and 11.3% of Malaysians did not reside in the catchment of 20 km from any dental clinic. The total dental clinic-to-population ratio was 1:9,000: for public dental clinics it was 1:38,000 and for private clinics it was 1:13,000.

    CONCLUSION: Dental services were distributed relative to high population density, were unevenly distributed across Malaysia and the majority of people with the highest inaccessibility to a dental service resided in Malaysian Borneo.

  5. Heo CC, Mohamad AR, Rosli H, Nurul Ashikin A, Chen CD, John J, et al.
    Trop Biomed, 2009 Apr;26(1):106-9.
    PMID: 19696735
    An observational study was conducted in an oil palm plantation in Tanjung Sepat, Selangor, Malaysia on August until September 2007 to note the decomposition process of pigs and their related faunal succession. We collected six species of ants (Formicidae) from 3 subfamilies: Formicinae (Oecophylla smaragdina and Anoplolepis gracilipes), Myrmicinae (Tetramorium sp. and Pheidologeton sp.) and Ponerinae (Odontoponera sp. and Diacamma sp.) that were associated with pig carcasses placed on the ground. Oecophylla smaragdina, Pheidologeton sp. and Tetramorium sp. were found on a partially burnt pig carcass whereas the other species were recovered from unburned pig carcass. These ants predated on fly eggs, larvae, pupae and adults. Ants could be found at all stages of decomposition starting from fresh until dry stage. Predatory ants can reduce fly population and thus may affect the rate of carcass decomposition but this was not seen in our study. Even though O. smaragdina was seen at all stages of decomposition of the burnt pig, this did not alter much the decomposition process by fly larvae.
  6. Al-koshab M, Nambiar P, John J
    PLoS One, 2015;10(3):e0121682.
    PMID: 25803868 DOI: 10.1371/journal.pone.0121682
    INTRODUCTION: Proper imaging allows practitioners to evaluate an asymptomatic tempormandibular joint (TMJ) for potential degenerative changes prior to surgical and orthodontic treatment. The recently developed cone-beam computed tomography (CBCT) allows measurement of TMJ bony structures with high accuracy. A study was undertaken to determine the morphology, and its variations, of the mandibular condyle and glenoid fossa among Malay and Chinese Malaysians.

    METHODS: CBCT was used to assess 200 joints in 100 subjects (mean age, 30.5 years). i-CAT CBCT software and The Mimics 16.0 software were employed to measure the volume, metrical size, position of each condyle sample and the thickness of the roof of the glenoid fossa (RGF).

    RESULTS: No significant gender differences were noted in thickness of the RGF and condylar length; however condylar volume, width, height and the joint spaces were significantly greater among males. With regards to comparison of both TMJs, the means of condylar volume, width and length of the right TMJ were significantly higher, while the means of the left condylar height and thickness of RGF were higher. When comparing the condylar measurements and the thickness of RGF between the two ethnic groups, we found no significant difference for all measurements with exception of condylar height, which is higher among Chinese.

    CONCLUSION: The similarity in measurements for Malays and Chinese may be due to their common origin. This information can be clinically useful in establishing the diagnostic criteria for condylar volume, metrical size, and position in the Malaysian East Asians population.

  7. Michailidou K, Lindström S, Dennis J, Beesley J, Hui S, Kar S, et al.
    Nature, 2017 Nov 02;551(7678):92-94.
    PMID: 29059683 DOI: 10.1038/nature24284
    Breast cancer risk is influenced by rare coding variants in susceptibility genes, such as BRCA1, and many common, mostly non-coding variants. However, much of the genetic contribution to breast cancer risk remains unknown. Here we report the results of a genome-wide association study of breast cancer in 122,977 cases and 105,974 controls of European ancestry and 14,068 cases and 13,104 controls of East Asian ancestry. We identified 65 new loci that are associated with overall breast cancer risk at P 
  8. Lewiecki EM, Binkley N, Morgan SL, Shuhart CR, Camargos BM, Carey JJ, et al.
    J Clin Densitom, 2016 Apr-Jun;19(2):127-40.
    PMID: 27020004 DOI: 10.1016/j.jocd.2016.03.003
    Dual-energy X-ray absorptiometry (DXA) is a technology that is widely used to diagnose osteoporosis, assess fracture risk, and monitor changes in bone mineral density (BMD). The clinical utility of DXA is highly dependent on the quality of the scan acquisition, analysis, and interpretation. Clinicians are best equipped to manage patients when BMD measurements are correct and interpretation follows well-established standards. Poor-quality acquisition, analysis, or interpretation of DXA data may mislead referring clinicians, resulting in unnecessary diagnostic evaluations, failure to evaluate when needed, inappropriate treatment, or failure to provide medical treatment, with potentially ineffective, harmful, or costly consequences. Misallocation of limited healthcare resources and poor treatment decisions can be minimized, and patient care optimized, through meticulous attention to DXA instrument calibration, data acquisition and analysis, interpretation, and reporting. This document from the International Society for Clinical Densitometry describes quality standards for BMD testing at DXA facilities worldwide to provide guidance for DXA supervisors, technologists, interpreters, and clinicians. High-quality DXA testing is necessary for correct diagnostic classification and optimal fracture risk assessment, and is essential for BMD monitoring.
  9. Kramer I, Hooning MJ, Mavaddat N, Hauptmann M, Keeman R, Steyerberg EW, et al.
    Am J Hum Genet, 2020 11 05;107(5):837-848.
    PMID: 33022221 DOI: 10.1016/j.ajhg.2020.09.001
    Previous research has shown that polygenic risk scores (PRSs) can be used to stratify women according to their risk of developing primary invasive breast cancer. This study aimed to evaluate the association between a recently validated PRS of 313 germline variants (PRS313) and contralateral breast cancer (CBC) risk. We included 56,068 women of European ancestry diagnosed with first invasive breast cancer from 1990 onward with follow-up from the Breast Cancer Association Consortium. Metachronous CBC risk (N = 1,027) according to the distribution of PRS313 was quantified using Cox regression analyses. We assessed PRS313 interaction with age at first diagnosis, family history, morphology, ER status, PR status, and HER2 status, and (neo)adjuvant therapy. In studies of Asian women, with limited follow-up, CBC risk associated with PRS313 was assessed using logistic regression for 340 women with CBC compared with 12,133 women with unilateral breast cancer. Higher PRS313 was associated with increased CBC risk: hazard ratio per standard deviation (SD) = 1.25 (95%CI = 1.18-1.33) for Europeans, and an OR per SD = 1.15 (95%CI = 1.02-1.29) for Asians. The absolute lifetime risks of CBC, accounting for death as competing risk, were 12.4% for European women at the 10th percentile and 20.5% at the 90th percentile of PRS313. We found no evidence of confounding by or interaction with individual characteristics, characteristics of the primary tumor, or treatment. The C-index for the PRS313 alone was 0.563 (95%CI = 0.547-0.586). In conclusion, PRS313 is an independent factor associated with CBC risk and can be incorporated into CBC risk prediction models to help improve stratification and optimize surveillance and treatment strategies.
  10. May LW, John J, Seong LG, Abidin ZZ, Ibrahim N, Danaee M, et al.
    J Indian Prosthodont Soc, 2021 5 4;21(2):198-203.
    PMID: 33938871 DOI: 10.4103/jips.jips_41_21
    Aim: To investigate the effect of different cooling methods on denture base adaptation of rapid heat-cured acrylic resin using 3D superimposition technique.

    Setting and Design: In vitro - Comparative study.

    Materials and Methods: Denture base adaptation of two different rapid heat-cured polymethyl methacrylate acrylic resins using five different cooling methods were compared. Forty maxillary edentulous stone cast were prepared to produce the denture bases with standardized thickness. The specimens were divided into five groups (n = 8) according to type of materials and cooling methods. The master stone cast and all forty denture bases were scanned with 3Shape E1 laboratory scanner. The scanned images of each of the denture bases were superimposed over the scanned image of the master cast using Materialize 3-matic software. Three dimensional differences between the two surfaces were calculated and color surface maps were generated for visual qualitative assessment.

    Statistical Analysis Used: Generalized Linear Model Test, Bonferroni Post Hoc Analysis.

    Results: All bench-cooled specimens showed wide green-colored area in the overall palatal surface, while the rapid cooled specimens presented with increased red color areas especially at the palate and post dam area. Generalized Linear Model test followed by Bonferroni post hoc analysis showed significant difference in the root mean square values among the specimen groups.

    Conclusion: Samples that were bench cooled, demonstrated better overall accuracy compared to the rapid cooling groups. Regardless of need for shorter denture processing time, bench cooling of rapid heat-cured PMMA is essential for acceptable denture base adaptation.

  11. Mani SA, Naing L, John J, Samsudin AR
    Int J Paediatr Dent, 2008 Sep;18(5):380-8.
    PMID: 18284472 DOI: 10.1111/j.1365-263X.2007.00890.x
    BACKGROUND: Numerous methods of age estimation have been proposed. The Demirjian method is the most frequently used, which was first applied in a French Canadian population in 1973. The Willems method is a modification of the above and was applied in a Belgian population in 2002.
    OBJECTIVES: The objectives of this study were to test the applicability of the two methods, namely Demirjian and Willems, for age estimation in a Malay population, and to find the correlation between body mass index and the difference between the dental age and the chronological age.
    MATERIALS AND METHODS: A cross-sectional study involving 214 boys and 214 girls, selected by a simple stratified random sampling method was carried out. The orthopantomograph was used to score the seven left mandibular teeth, and the calculated maturity score was used to obtain the Demirjian dental age. Willems dental age was estimated using the tables proposed in the Willems method. Results. The Demirjian method overestimated the age by 0.75 and 0.61 years, while the Willems method overestimated the age by 0.55 and 0.41 years among boys and girls, respectively. In boys, the body mass index was significantly correlated to the difference in age using the Willems method.
    CONCLUSION: Further modification of either method is indicated for dental age estimation among the Malay population.
  12. Al-Amery SM, Nambiar P, Jamaludin M, John J, Ngeow WC
    PLoS One, 2015;10(2):e0117251.
    PMID: 25679505 DOI: 10.1371/journal.pone.0117251
    The maxillary incisive canal connects the roof of the oral cavity with the floor of nasal cavity and has the incisive and nasal foramina respectively at its two opposite ends. Its close proximity with the anterior incisors affects one's ability to place immediate implants in ideal position.
  13. Khachatryan V, Sirunyan AM, Tumasyan A, Adam W, Bergauer T, Dragicevic M, et al.
    Eur Phys J C Part Fields, 2015 06 26;75(6):288.
    PMID: 26146483
    The inclusive jet cross section for proton-proton collisions at a centre-of-mass energy of 7[Formula: see text] was measured by the CMS Collaboration at the LHC with data corresponding to an integrated luminosity of 5.0[Formula: see text]. The measurement covers a phase space up to 2[Formula: see text] in jet transverse momentum and 2.5 in absolute jet rapidity. The statistical precision of these data leads to stringent constraints on the parton distribution functions of the proton. The data provide important input for the gluon density at high fractions of the proton momentum and for the strong coupling constant at large energy scales. Using predictions from perturbative quantum chromodynamics at next-to-leading order, complemented with electroweak corrections, the constraining power of these data is investigated and the strong coupling constant at the Z boson mass [Formula: see text] is determined to be [Formula: see text], which is in agreement with the world average.
  14. Khachatryan V, Sirunyan AM, Tumasyan A, Adam W, Bergauer T, Dragicevic M, et al.
    Eur Phys J C Part Fields, 2015 07 17;75(7):325.
    PMID: 26213486
    Stringent limits are set on the long-lived lepton-like sector of the phenomenological minimal supersymmetric standard model (pMSSM) and the anomaly-mediated supersymmetry breaking (AMSB) model. The limits are derived from the results presented in a recent search for long-lived charged particles in proton-proton collisions, based on data collected by the CMS detector at a centre-of-mass energy of 8 TeV at the Large Hadron Collider. In the pMSSM parameter sub-space considered, 95.9 % of the points predicting charginos with a lifetime of at least 10 ns are excluded. These constraints on the pMSSM are the first obtained at the LHC. Charginos with a lifetime greater than 100 ns and masses up to about 800 GeV in the AMSB model are also excluded. The method described can also be used to set constraints on other models.
  15. Clavadetscher J, Hoffmann S, Lilienkampf A, Mackay L, Yusop RM, Rider SA, et al.
    Angew Chem Int Ed Engl, 2016 12 12;55(50):15662-15666.
    PMID: 27860120 DOI: 10.1002/anie.201609837
    The copper-catalyzed azide-alkyne cycloaddition (CuAAC) reaction has proven to be a pivotal advance in chemical ligation strategies with applications ranging from polymer fabrication to bioconjugation. However, application in vivo has been limited by the inherent toxicity of the copper catalyst. Herein, we report the application of heterogeneous copper catalysts in azide-alkyne cycloaddition processes in biological systems ranging from cells to zebrafish, with reactions spanning from fluorophore activation to the first reported in situ generation of a triazole-containing anticancer agent from two benign components, opening up many new avenues of exploration for CuAAC chemistry.
  16. Rashid RM, Ramli S, John J, Dahlui M
    Asian Pac J Cancer Prev, 2014;15(13):5143-7.
    PMID: 25040965
    Cervical cancer screening in Malaysia is by opportunistic Pap smear which contributes to the low uptake rate. To overcome this, a pilot project called the SIPPS program (translated as information system of Pap smear program) had been introduced whereby women aged 20-65 years old are invited for Pap smear and receive recall to repeat the test. This study aimed at determining which recall method is most cost-effective in getting women to repeat Pap smear. A randomised control trial was conducted where one thousand women were recalled for repeat smear either by registered letter, phone messages, phone call or the usual postal letter. The total cost applied for cost-effectiveness analysis includes the cost of sending letter for first invitation, cost of the recall method and cost of two Pap smears. Cost-effective analysis (CEA) of Pap smear uptake by each recall method was then performed. The uptake of Pap smear by postal letter, registered letters, SMS and phone calls were 18.8%, 20.0%, 21.6% and 34.4%, respectively (p<0.05). The CER for the recall method was lowest by phone call compared to other interventions; RM 69.18 (SD RM 0.14) compared to RM 106.53 (SD RM 0.13), RM 134.02 (SD RM 0.15) and RM 136.38 (SD RM 0.11) for SMS, registered letter and letter, respectively. ICER showed that it is most cost saving if the usual method of recall by postal letter be changed to recall by phone call. The possibility of letter as a recall for repeat Pap smear to reach the women is higher compared to sending SMS or making phone call. However, getting women to do repeat Pap smear is better with phone call which allows direct communication. Despite the high cost of the phone call as a recall method for repeat Pap smear, it is the most cost-effective method compared to others.
  17. Okely T, Reilly JJ, Tremblay MS, Kariippanon KE, Draper CE, El Hamdouchi A, et al.
    BMJ Open, 2021 10 25;11(10):e049267.
    PMID: 34697112 DOI: 10.1136/bmjopen-2021-049267
    INTRODUCTION: 24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviours is lacking, particularly in low-income and middle-income countries (LMICs). This paper describes the development of the SUNRISE International Study of Movement Behaviours in the Early Years protocol, designed to address this gap.

    METHODS AND ANALYSIS: SUNRISE is the first international cross-sectional study that aims to determine the proportion of 3- and 4-year-old children who meet the WHO Global guidelines. The study will assess if proportions differ by gender, urban/rural location and/or socioeconomic status. Executive function, motor skills and adiposity will be assessed and potential correlates of 24-hour movement behaviours examined. Pilot research from 24 countries (14 LMICs) informed the study design and protocol. Data are collected locally by research staff from partnering institutions who are trained throughout the research process. Piloting of all measures to determine protocol acceptability and feasibility was interrupted by COVID-19 but is nearing completion. At the time of publication 41 countries are participating in the SUNRISE study.

    ETHICS AND DISSEMINATION: The SUNRISE protocol has received ethics approved from the University of Wollongong, Australia, and in each country by the applicable ethics committees. Approval is also sought from any relevant government departments or organisations. The results will inform global efforts to prevent childhood obesity and ensure young children reach their health and developmental potential. Findings on the correlates of movement behaviours can guide future interventions to improve the movement behaviours in culturally specific ways. Study findings will be disseminated via publications, conference presentations and may contribute to the development of local guidelines and public health interventions.

  18. Amanat MA, John J, Pin TM, Danaee M, Malhotra V, Abbas SA, et al.
    J Public Health (Oxf), 2020 May 26;42(2):304-311.
    PMID: 30796789 DOI: 10.1093/pubmed/fdz014
    BACKGROUND: Poor oral health affects not only dietary choices but overall well-being. This study explores the influence of lifestyle, socio-demographics and utilization of dental services on the dentition status of an older urban Malaysian population.

    METHODS: A total of 1210 participants 60 years and above, representing the three main ethnic groups were recruited from a larger cohort study. Weighted factors valued for comparison included socio demographics and health status. Knowledge of and attitude and behaviour towards personal oral health were also assessed. Dentition status, adapted from WHO oral health guidelines, was the dependent variable investigated. Data were analysed using descriptive chi square test and multivariate binary logistic regression.

    RESULTS: Overall, 1187 respondents completed the study. The dentition status and oral health related knowledge, attitude and behaviour varied between the three ethnic groups. The Chinese were significantly less likely to have ≥13 missing teeth (OR = 0.698, 95% CI: 0.521-0.937) and ≥1 decayed teeth (0.653; 0.519-0.932) compared to the Malays, while the Indians were significantly less likely than the Malays to have ≥1 decayed teeth (0.695; 0.519-0.932) and ≥2 filled teeth (0.781; 0.540-1.128).

    CONCLUSION: Ethnic differences in dentition outcome are related to oral health utilization highlighting the influence of cultural differences and the need for culturally sensitivity interventions.

  19. Faulks D, Dougall A, Ting G, Ari T, Nunn J, Friedman C, et al.
    Eur J Dent Educ, 2018 May;22(2):e278-e290.
    PMID: 28940883 DOI: 10.1111/eje.12292
    INTRODUCTION: Recommended curricula in Special Care Dentistry (SCD) outline learning objectives that include the domain of attitudes and behaviours, but these are notoriously difficult to measure. The aims of this study were (i) to develop a test battery comprising adapted and new scales to evaluate values, attitudes and intentions of dental students towards people with disability and people in marginalised groups and (ii) to determine reliability (interitem consistency) and validity of the scales within the test battery.

    MATERIALS AND METHODS: A literature search identified pre-existing measures and models for the assessment of attitudes in healthcare students. Adaptation of three pre-existing scales was undertaken, and a new scale was developed based upon the Theory of Planned Behaviour (TPB) using an elicitation survey. These scales underwent a process of content validation. The three adapted scales and the TPB scale were piloted by 130 students at 5 different professional stages, from 4 different countries.

    RESULTS: The scales were adjusted to ensure good internal reliability, variance, distribution, and face and content validity. In addition, the different scales showed good divergent validity.

    DISCUSSION: These results are positive, and the scales now need to be validated in the field.

    CONCLUSIONS: It is hoped that these tools will be useful to educators in SCD to evaluate the impact of teaching and clinical exposure on their students.

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