Displaying publications 1 - 20 of 64 in total

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  1. Chiew TK, Khoo S, Ansari P, Kiruthika U
    Disabil Rehabil Assist Technol, 2024 Apr;19(3):994-1002.
    PMID: 36306172 DOI: 10.1080/17483107.2022.2138996
    PURPOSE: This study uses a bibliometric approach to analyse the patterns in research related to mobile and wearable technologies for persons with disabilities to evaluate the current state of relevant research.

    MATERIALS AND METHODS: A systematic search was done using two strings covering "disability" and "mobile and wearable technologies" in the titles of publications in the Web of Science database. Two researchers independently screened the results for relevant publications. During this process, the inclusion and exclusion criteria were deliberated and refined. An independent researcher checked the screening results against the finalized inclusion and exclusion criteria to ensure that the screening was done consistently.

    RESULTS: A total of 2012 out of the 5990 retrieved publications from 2000 to 2022 were included for further analysis. We observed that publications in this area grew exponentially since 2011, almost doubling every 2 years between 2011 and 2015. Universities in the USA were the most active and prominent in relevant publications. Autism is the most researched disability in relation to mobile and wearable technologies. The publications cover both hardware (engineering, electrical and electronic) and software (computer science, theory and methods) technologies used for improving quality of life for persons with disabilities (rehabilitation).

    CONCLUSIONS: The majority of publications were from high income countries, indicating the need to study the digital divide among high-, low- and middle-income countries in adopting mobile and wearable technologies for persons with disabilities, especially ways of making these technologies more affordable and accessible to the under-privileged members of the community.

  2. Aravindhan K, Mat S, Bahyah S, Saedon N, Hasmuk K, Mahadzir H, et al.
    Arch Gerontol Geriatr, 2024 Mar;118:105304.
    PMID: 38056102 DOI: 10.1016/j.archger.2023.105304
    AIM: Several frailty assessment tools are currently used in clinics and research, however, there appears to be a lack of head-to-head comparisons between these tools among older adults in developing countries. This study compared the Cardiovascular Health Study, Study of Osteoporotic Fractures, the Tilburg Frailty Indicator and the Canadian Study of Health and Aging frailty assessment tools and evaluated performance of these individual frailty assessment tools with mortality.

    METHODS: This prospective cohort study utilized stratified simple random sampling to recruit 1614 participants from the Malaysian Elders Longitudinal Research aged above 55 years within the Klang Valley region from 2013 to 2015. Individual items for the frailty tools, alongside baseline physical and cognitive measures were extracted from the initial survey. Mortality data up to 31 December 2020 were obtained through data linkage from the death registry data obtained from the Malaysian National Registration Department.

    RESULTS: Data were available for over 1609 participants, age (68.92 ± 7.52) years and 57 % women, during recruitment. Mortality data revealed 13.4 % had died as of 31 December 2020. Five to 25 % of our study population fulfilled the criteria for frailty using all four frailty tools. This study found an increased risk of mortality with frailty following adjustments for potential factors of falls, total number of illnesses and cognitive impairment, alongside moderate to strong correlation and agreement between frailty tools.

    CONCLUSION: Frailty was associated with increased mortality. All four frailty assessment tools can be used to assess frailty within the Malaysian older adult population. The four available tools, however, may not be interchangeable.

  3. Krishnan G, Mohd Makhatar NH, Ching TH, Khoo S
    PMID: 38290212 DOI: 10.1530/EDM-23-0092
    SUMMARY: Pituitary tuberculoma is extremely rare and may pose as a diagnostic challenge especially when encountered as an isolated lesion without other systemic manifestation of tuberculosis. A 21-year-old female was admitted for diabetic ketoacidosis. On the third day of admission following the resolution of diabetic ketoacidosis she developed a sudden onset of headache and blurring of vision suggestive of pituitary apoplexy. An urgent MRI brain revealed a large sellar mass with erosion into the sphenoid sinus and intracranial vasculitis. Transphenoidal surgery was done for tumour debulking which allowed histopathological examination of the sellar mass. Immunohistochemical examination of the sellar mass was positive for Gene Xpert MTB/Rif suggesting a tuberculoma. Anti-tuberculous therapy was commenced with full recovery of pituitary hormonal profile seen 7 months post-treatment. In regions with a high incidence of tuberculosis, a tuberculoma should be a considered in a diagnostic evaluation of a sellar lesion.

    LEARNING POINTS: In an endemic area of tuberculosis, tuberculoma should be considered as a differential diagnosis when evaluating sellar lesions. Pituitary tuberculoma can present with pituitary apoplexy-like symptoms. Prompt diagnosis and treatment may lead to recovery of pituitary function.

  4. Shahrani S, Gill SS, Sooi CY, Skantha R, Kumar CVC, Limun MF, et al.
    J Gastroenterol Hepatol, 2023 Oct;38(10):1818-1822.
    PMID: 37587719 DOI: 10.1111/jgh.16313
    BACKGROUND: With changes in the epidemiology and treatment of chronic liver disease (CLD), the impact of various etiologies of liver disease on steatosis and advanced fibrosis are uncertain.

    METHODS: A retrospective study was conducted among liver disease patients of various etiologies undergoing transient elastography (TE) over a 9-year duration.

    RESULTS: Data for 2886 patients were analyzed and had the following demographics: The median age was 60 (IQR: 45-69) years, 51% were males, and ethnicity was predominantly Chinese (52.5%), followed by Malays (34%) and Indians (12.3%). The median CAP score was 272 (IQR: 219-319) dB/m and the median liver stiffness measurement (LSM) score was 6.5 (IQR: 4.9-9.7) kPa. Hepatic steatosis occurred across the spectrum of etiologies of CLD. Among patients with steatosis, the most common etiologies were nonalcoholic fatty liver disease (NAFLD) at 62% and chronic hepatitis B (CHB) at 26.3%. TE findings suggestive of cACLD (10.1-15 kPa) and highly suggestive of cACLD (>15 kPa) were observed in 11.3% and 12.4% of patients, respectively. NAFLD was found to be the most common etiology for cases with suggestive of cACLD (47.2%) and highly suggestive of cACLD (41.5%).

    CONCLUSION: Hepatic steatosis is common in CLD, regardless of etiology. Compared with other etiologies, NAFLD is now the leading cause of cACLD.

  5. Backhaus I, Fitri M, Esfahani M, Ngo HT, Lin LJ, Yamanaka A, et al.
    Asia Pac J Public Health, 2023 May;35(4):244-250.
    PMID: 37226778 DOI: 10.1177/10105395231172311
    In this study, we aimed to investigate the prevalence of poor mental health and its association with loneliness and social support among 3531 undergraduate students in nine Asian countries. Mental health was assessed using the Self-Reporting Questionnaire, which was developed by the World Health Organization. Across the entire sample, we detected that nearly half of the students reported poor mental health according to the Self-Reporting Questionnaire and nearly one out of seven students felt lonely. While feeling lonely increased the odds of experiencing poor mental health (odds ratio [OR]), moderate (OR: 0.35) and strong social support (OR: 0.18) decreases the odds of experiencing poor mental health. The high prevalence of poor mental health calls for further in-depth investigations and implementation of mental health support interventions.
  6. Hashim NNA, Mat S, Myint PK, Kioh SH, Delibegovic M, Chin AV, et al.
    Eur J Clin Invest, 2023 Feb;53(2):e13874.
    PMID: 36120810 DOI: 10.1111/eci.13874
  7. Zhao S, Ng SC, Khoo S, Chi A
    PMID: 35162800 DOI: 10.3390/ijerph19031778
    Synchronization of the dynamic processes in structural networks connect the brain across a wide range of temporal and spatial scales, creating a dynamic and complex functional network. Microstate and omega complexity are two reference-free electroencephalography (EEG) measures that can represent the temporal and spatial complexities of EEG data. Few studies have focused on potential brain spatiotemporal dynamics in the early stages of depression to use as an early screening feature for depression. Thus, this study aimed to explore large-scale brain network dynamics of individuals both with and without subclinical depression, from the perspective of temporal and spatial dimensions and to input them as features into a machine learning framework for the automatic diagnosis of early-stage depression. To achieve this, spatio-temporal dynamics of rest-state EEG signals in female college students (n = 40) with and without (n = 38) subclinical depression were analyzed using EEG microstate and omega complexity analysis. Then, based on differential features of EEGs between the two groups, a support vector machine was utilized to compare performances of spatio-temporal features and single features in the classification of early depression. Microstate results showed that the occurrence rate of microstate class B was significantly higher in the group with subclinical depression when compared with the group without. Moreover, the duration and contribution of microstate class C in the subclinical group were both significantly lower than in the group without subclinical depression. Omega complexity results showed that the global omega complexity of β-2 and γ band was significantly lower for the subclinical depression group compared with the other group (p < 0.05). In addition, the anterior and posterior regional omega complexities were lower for the subclinical depression group compared to the comparison group in α-1, β-2 and γ bands. It was found that AUC of 81% for the differential indicators of EEG microstates and omega complexity was deemed better than a single index for predicting subclinical depression. Thus, since temporal and spatial complexity of EEG signals were manifestly altered in female college students with subclinical depression, it is possible that this characteristic could be adopted as an early auxiliary diagnostic indicator of depression.
  8. Luangsukrerk T, Harinwan K, Khoo S, Kongkam P
    Can J Gastroenterol Hepatol, 2022;2022:9250370.
    PMID: 36345379 DOI: 10.1155/2022/9250370
    BACKGROUND: The lumen-apposing metal stent (LAMS) has been increasingly used for EUS-guided drainage of symptomatic walled-off pancreatic fluid collection (WOPFC) in recent years. Nevertheless, some WOPFCs may require additional drainage methods including another LAMS as a result of complexity of the lesions. This current study aimed to compare clinical parameters of patients with complex WOPFC requiring LAMS with additional methods (complex WOPFC: group A) versus single LAMS alone (noncomplex WOPFC; group B).

    METHOD: Medical records of patients with complex (group A) versus noncomplex WOPFCs (group B) were reviewed and compared in three centers in Thailand and Malaysia, between January 2016 to December 2020.

    RESULT: 31 patients with WOPFCs were recruited. 6 of 31 (19%) patients were in group A. Multivariate analysis showed that the maximal diameter of WOPFCs in group A was significantly larger than that of group B (18 ± 6 versus 13 ± 3 cm in diameter, respectively, p = 0.021). Solid component proportion was higher in group A versus B (35.8% versus 17.8%, respectively, p = 0.025). The prevalence of pancreatic duct leakage was significantly higher in group A (67% versus 20%, p = 0.23). The need of direct endoscopic necrosectomy (DEN) and the number of DEN sessions were higher in group A versus B (100% vs. 48%, p = 0.020 and 3.5 vs 0 p = 0.031, respectively).

    CONCLUSIONS: Complex WOPFC had larger diameter of lesions, higher proportion of solid component, higher prevalence of pancreatic duct leakage, and higher number of DEN is required than group noncomplex lesions. Trial Registration. This trial is registered with TCTR20180223004.

  9. Harith S, Backhaus I, Mohbin N, Ngo HT, Khoo S
    PeerJ, 2022;10:e13111.
    PMID: 35382010 DOI: 10.7717/peerj.13111
    BACKGROUND: Poor mental health among university students remains a pressing public health issue. Over the past few years, digital health interventions have been developed and considered promising in increasing psychological wellbeing among university students. Therefore, this umbrella review aims to synthesize evidence on digital health interventions targeting university students and to evaluate their effectiveness.

    METHODS: A systematic literature search was performed in April 2021 searching PubMed, Psychology and Behavioural Science Collection, Web of Science, ERIC, and Scopus for systematic reviews and meta-analyses on digital mental health interventions targeting university students. The review protocol was registered in the International Prospective Register of Systematic Reviews PROSPERO [CRD42021234773].

    RESULTS: The initital literature search resulted in 806 records of which seven remained after duplicates were removed and evaluated against the inclusion criteria. Effectiveness was reported and categorized into the following six delivery types: (a) web-based, online/computer-delivered interventions (b) computer-based Cognitive Behavior Therapy (CBT), (c) mobile applications and short message service (d) virtual reality interventions (e) skills training (f) relaxation and exposure-based therapy. Results indicated web-based online/computer delivered-interventions were effective or at least partially effective at decressing depression, anxiety, stress and eating disorder symptoms. This was similar for skills-training interventions, CBT-based intervention and mobile applications. However, digital mental health interventions using virtual reality and relaxation, exposure-based therapy was inconclusive. Due to the variation in study settings and inconsistencies in reporting, effectiveness was greatly dependent on the delivery format, targeted mental health problem and targeted purpose group.

    CONCLUSION: The findings provide evidence for the beneficial effect of digital mental health interventions for university students. However, this review calls for a more systematic approach in testing and reporting the effectiveness of digital mental health interventions.

  10. Mekaroonkamol P, Tiankanon K, Pittayanon R, Ridtitid W, Shams F, Tayyab GUN, et al.
    Clin Endosc, 2021 Sep 29.
    PMID: 34583452 DOI: 10.5946/ce.2021.051
    Background/Aims: The Thai Association for Gastrointestinal Endoscopy published recommendations on safe endoscopy during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to assess the practicality and applicability of the recommendations and the perceptions of endoscopy personnel on them.

    Methods: A validated questionnaire was sent to 1290 endoscopy personnel globally. Of these, the data of all 330 responders (25.6%) from 15 countries, related to the current recommendations on proper personal protective equipment (PPE), case selection, scope cleaning, and safety perception, were analyzed. Ordinal logistic regression was used to determine the relationships between the variables.

    Results: Despite an overwhelming agreement with the recommendations on PPE (94.5%) and case selection (95.5%), their practicality and applicability on PPE recommendations and case selection were significantly lower (p=0.001, p=0.047, p<0.001, and p=0.032, respectively). Factors that were associated with lower sense of safety in endoscopy units were younger age (p=0.004), less working experience (p=0.008), in-training status (p=0.04), and higher national prevalence of COVID-19 (p=0.003). High prevalent countries also had more difficulty implementing the guidelines (p<0.001) and they considered the PPE recommendations less practical and showed lower agreement with them (p<0.001 and p=0.008, respectively). A higher number of in-hospital COVID-19 patients was associated with less agreement with PPE recommendations (p=0.039).

    Conclusions: Using appropriate PPE and case selection in endoscopic practice during a pandemic remains a challenge. Resource availability and local prevalence are critical factors influencing the adoption of the current guidelines.

  11. Suhaimi SA, Müller AM, Hafiz E, Khoo S
    Health Promot Int, 2021 Sep 13.
    PMID: 34516620 DOI: 10.1093/heapro/daab149
    Adults who accumulate a lot of sedentary time per day are at an increased risk of metabolic syndrome, type 2 diabetes, and hypertension. Prolonged sitting is also associated with depression, anxiety, bipolar disorder and schizophrenia. With the increase in desk-based office work, many office workers spend long hours sitting at the workplace. The aim of this study was to assess occupational sitting time in Malaysian government office workers, and investigate determinants of occupational sitting time and potential strategies to interrupt sitting time. We conducted a mixed-methods study consisting of a survey and focus group discussions (FGDs). A total of 1338 office workers from 24 Malaysian ministries completed the Occupational Sitting and Physical Activity Questionnaire. Twenty-nine office workers who spent at least 7 h per day sitting at work participated in FGDs. We enquired about knowledge, awareness and perceptions related to prolonged sitting time, barriers and facilitators to sitting time at work, and potential intervention strategies. Mean daily sitting time at work was 5.96 h (standard deviation = 1.37 h). FDGs confirmed barriers and facilitators to sitting time in accordance with the social-ecological model for health. Intrapersonal, social and physical environmental factors as well as organizational culture and organizational policy were mentioned to affect occupational sitting time. The results show that Malaysian government office workers spent a significant amount of time sitting at work and we identified multi-level factors influencing sitting time. A smartphone-based intervention to interrupt sitting time at work was suggested and is currently being tested.
  12. Khoo S, Mohbin N, Ansari P, Al-Kitani M, Müller AM
    PMID: 34071342 DOI: 10.3390/ijerph18115798
    This review aimed to identify, evaluate, and synthesize the scientific literature on mobile health (mHealth) interventions to promote physical activity (PA) or reduce sedentary behavior (SB) in cancer survivors. We searched six databases from 2000 to 13 April 2020 for controlled and non-controlled trials published in any language. We conducted best evidence syntheses on controlled trials to assess the strength of the evidence. All 31 interventions included in this review measured PA outcomes, with 10 of them also evaluating SB outcomes. Most study participants were adults/older adults with various cancer types. The majority (n = 25) of studies implemented multicomponent interventions, with activity trackers being the most commonly used mHealth technology. There is strong evidence for mHealth interventions, including personal contact components, in increasing moderate-to-vigorous intensity PA among cancer survivors. However, there is inconclusive evidence to support mHealth interventions in increasing total activity and step counts. There is inconclusive evidence on SB potentially due to the limited number of studies. mHealth interventions that include personal contact components are likely more effective in increasing PA than mHealth interventions without such components. Future research should address social factors in mHealth interventions for PA and SB in cancer survivors.
  13. Ibrahim A, Chong MC, Khoo S, Wong LP, Chung I, Tan MP
    Geriatrics (Basel), 2021 Mar 22;6(1).
    PMID: 33810155 DOI: 10.3390/geriatrics6010031
    Social isolation, magnified by the restriction of movement order during the COVID-19 pandemic, may lead to negative psychosocial health impacts among community-dwelling older adults. We, therefore, aimed to evaluate recruitment rates, data collection, and group exercises conducted through virtual technology among individuals aged 60 years and over in Malaysia. Participants were recruited from the Promoting Independence in Seniors with Arthritis (PISA) pilot cohort through social media messaging. A four-week course of virtual group exercise was offered. Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale (HADS) during the last attended follow-up of the cohort study (pre-pandemic), pre-intervention, and post-intervention. Exercise adherence was recorded using diaries with daily entries and attendance to the virtual group exercise sessions were also captured electronically daily. The outcomes of interest were changes in anxiety and depression scores from baseline to pre-intervention (pandemic-related) and post-intervention (virtual exercise related). Forty-three individuals were recruited. A significant increase in anxiety scores from baseline to pre-intervention was observed. Comparisons using repeated-measures analysis of variance between those who attendance ≥14 and <14 group exercise sessions revealed no between-within subject differences in depression scores. There was a 23% dropout rate in the post intervention survey and 60.5% of diaries were returned. Virtual group exercises could be conducted among older adults residing in a middle-income country, though recruitment would have been limited to those with internet access.
  14. Ramírez Varela A, Cruz GIN, Hallal P, Blumenberg C, da Silva SG, Salvo D, et al.
    Int J Behav Nutr Phys Act, 2021 01 07;18(1):5.
    PMID: 33413479 DOI: 10.1186/s12966-020-01071-x
    BACKGROUND: National, regional and global scientific production and research capacity for physical activity - PA may contribute to improving public health PA policies and programs. There is an uneven distribution of research productivity by region and country income group, where countries with the highest burden of non-communicable diseases attributable to physical inactivity having low research productivity. A first step towards improving global research capacity is to objectively quantify patterns, trends, and gaps in PA research. This study describes national, regional and global trends and patterns of PA research from 1950 to 2019.

    METHODS: A systematic review using searches in PubMed, SCOPUS and ISI Web of Knowledge databases was conducted in August 2017 and updated between January and May 2020. The review was registered at the PROSPERO database number CRD42017070153. PA publications per 100,000 inhabitants per country was the main variable of interest. Descriptive and time-trend analyses were conducted in STATA version 16.0.

    RESULTS: The search retrieved 555,468 articles of which 75,756 were duplicates, leaving 479,712 eligible articles. After reviewing inclusion and exclusion criteria, 23,860 were eligible for data extraction. Eighty-one percent of countries (n = 176) had at least one PA publication. The overall worldwide publication rate in the PA field was 0.46 articles per 100,000 inhabitants. Europe had the highest rate (1.44 articles per 100,000 inhabitants) and South East Asia had the lowest (0.04 articles per 100,000 inhabitants). A more than a 50-fold difference in publications per 100,000 inhabitants was identified between high and low-income countries. The least productive and poorest regions have rates resembling previous decades of the most productive and the richest.

    CONCLUSION: This study showed an increasing number of publications over the last 60 years with a growing number of disciplines and research methods over time. However, striking inequities were revealed and the knowledge gap across geographic regions and by country income groups was substantial over time. The need for regular global surveillance of PA research, particularly in countries with the largest data gaps is clear. A focus on the public health impact and global equity of research will be an important contribution to making the world more active.

  15. Khoo S, Do NDT, Kongkam P
    Endosc Ultrasound, 2020 12 16;9(6):369-379.
    PMID: 33318375 DOI: 10.4103/eus.eus_59_20
    Malignant biliary obstruction (MBO) encompasses a variety of malignancies arising from the pancreaticobiliary system. This can be divided into malignant hilar biliary obstruction (MHBO) or malignant distal biliary obstruction (MDBO) biliary obstruction to which clinical outcomes and technical considerations of various biliary drainage methods may differ. EUS biliary drainage (EUS-BD) has been increasingly influential in the management of MBO together with other familiar biliary drainage methods such as ERCP and percutaneous transhepatic biliary drainage (PTBD). Conventionally, ERCP has always been the primary choice of endoscopic biliary drainage in both MHBO and MDBO and that PTBD or EUS-BD is used as a salvage method when ERCP fails for which current guidelines recommends PTBD, especially for MHBO. This review was able to show that with today's evidence, EUS-BD is equally efficacious and possesses a better safety profile in the management of MBO and should be on the forefront of endoscopic biliary drainage. Therefore, EUS-BD could be used either as a primary or preferred salvage biliary drainage method in these cases.
  16. Li H, Khoo S, Yap HJ
    Sensors (Basel), 2020 Nov 02;20(21).
    PMID: 33147851 DOI: 10.3390/s20216258
    This study aimed to evaluate the motion accuracy of novice and senior students in Baduanjin (a traditional Chinese sport) using an inertial sensor measurement system (IMU). Study participants were nine novice students, 11 senior students, and a teacher. The motion data of all participants were measured three times with the IMU. Using the motions of the teacher as the standard motions, we used dynamic time warping to calculate the distances between the motion data of the students and the teacher to evaluate the motion accuracy of the students. The distances between the motion data of the novice students and the teacher were higher than that between senior students and the teacher (p < 0.05 or p < 0.01). These initial results showed that the IMU and the corresponding mathematical methods could effectively distinguish the differences in motion accuracy between novice and senior students of Baduanjin.
  17. Khoo S, Wong VW, Goh GB, Fan J, Chan WK, Seto WK, et al.
    J Gastroenterol Hepatol, 2020 Feb;35(2):320-325.
    PMID: 31336392 DOI: 10.1111/jgh.14794
    BACKGROUND AND AIM: Nonalcoholic fatty liver disease (NAFLD) patients often have dyslipidemia, and optimal treatment of dyslipidemia lowers the risk of cardiovascular disease and mortality. Our aim was to study the prescription of statin and low-density lipoprotein cholesterol treatment targets in NAFLD patients.

    METHODS: Consecutive NAFLD patients attending five clinics in Asia were included in this study. The 10-year cardiovascular disease risk was calculated based on the Framingham Heart Study, and patients were categorized as moderate, high, or very high risk for cardiovascular disease on the basis of the American Association of Clinical Endocrinologist 2017 Guidelines. The low-density lipoprotein cholesterol treatment goal for each of the risk groups was 2.6, 2.6, and 1.8 mmol/L, respectively.

    RESULTS: The data for 428 patients were analyzed (mean age 54.4 ± 11.1 years, 52.1% male). Dyslipidemia was seen in 60.5% (259/428), but only 43.2% (185/428) were on a statin. The percentage of patients who were at moderate, high, and very high risk for cardiovascular disease was 36.7% (157/428), 27.3% (117/428), and 36.0% (154/428), respectively. Among patients who were on a statin, 58.9% (109/185) did not achieve the treatment target. Among patients who were not on a statin, 74.1% (180/243) should be receiving statin therapy. The percentage of patients who were not treated to target or who should be on statin was highest among patients at very high risk for cardiovascular disease at 79.6% (78/98) or 94.6% (53/56), respectively.

    CONCLUSION: This study highlights the suboptimal treatment of dyslipidemia and calls for action to improve the treatment of dyslipidemia in NAFLD patients.

  18. Khoo S, Poh BK, Suhaimi SA, Chong KH, Ramirez Varela A
    Front Public Health, 2020;8:536239.
    PMID: 33194945 DOI: 10.3389/fpubh.2020.536239
    About three quarters of the Malaysian adult population are physically active. There has been growth in physical activity and health research since 2010, with most studies being observational in design and few included objective measures of physical activity. The Malaysian Ministry of Health has published physical activity guidelines, strategies and action plans aimed at promoting physical activity. Physical activity promotion activities have included national campaigns and programmes which target different populations. Further work that incorporates the WHO Global Action Plans on Physical Activity (GAPPA), as well as a more systemic approach is needed, to promote physical activity and a healthy lifestyle. High-level multi-stakeholder collaboration is required for continuing expansion and strengthening of research capacity, and for bridging the physical activity policy gaps in Malaysia.
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