Displaying publications 1 - 20 of 180 in total

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  1. Wong LP, Lee HY, Alias H, Zimet G, Liu T, Lin Y, et al.
    Hum Vaccin Immunother, 2024 Dec 31;20(1):2313860.
    PMID: 38359815 DOI: 10.1080/21645515.2024.2313860
    The primary objective of this paper is to serve as a valuable resource for policymakers who are confronted with the evolving landscape of the coronavirus disease 2019 (COVID-19), considering both free and cost-based vaccination approaches. The potential consequences of shifting from free to cost-based vaccination are explored, encompassing its impact on global vaccine equity and prioritization, economic well-being, healthcare systems and delivery, public health policies, and vaccine distribution strategies. Examining past studies on willingness to pay for the initial COVID-19 vaccine dose and booster shots provides insights into how individuals value COVID-19 vaccinations and underscores the significance of addressing issues related to affordability. If COVID-19 vaccinations incur expenses, using effective communication strategies that emphasize the importance of vaccination and personal health benefits can increase willingness to pay. Making COVID-19 vaccines accessible through public health programs or health insurance can help alleviate financial barriers and increase vaccination rates.
  2. Wei D, Wong LP, He X, Loganathan T
    J Headache Pain, 2024 Apr 19;25(1):60.
    PMID: 38641794 DOI: 10.1186/s10194-024-01763-w
    BACKGROUND: Despite the recognised high prevalence of migraines among bank employees, yet their healthcare utilisation patterns and the economic burden of migraines remain underexplored.

    AIM: To examine migraine-related healthcare utilisation among bank employees in China, and to estimate the economic burden of migraines.

    METHODS: A cross-sectional survey was conducted in Guizhou province, China between May and October 2022. The HARDSHIP questionnaire was used to identify migraine-positive individuals and enquire about their healthcare utilisation and productivity losses. A probabilistic decision-analytic model with a micro-costing approach was used to estimate the economic burden from the perspectives of the healthcare system, employers, and society. All costs were expressed in 2022 United States dollars. One-way and probabilistic sensitivity analyses were performed.

    RESULTS: Nearly half of individuals with migraines reported not seeking medical care. Only 21.8% reported seeking outpatient consultations, 52.5% reported taking medicines, and 27.1% reported using complementary therapies. Chronic migraine patients had significantly higher healthcare utilisation than episodic migraine patients. Among individuals with a monthly migraine frequency of 15 days or more, 63.6% took inappropriate treatments by excessively using acute medications. Migraines in the banking sector in Guizhou cost the healthcare system a median of $7,578.0 thousand (25th to 75th percentile $4,509.2-$16,434.9 thousand) per year, employers $89,750.3 thousand (25th to 75th percentile $53,211.6-$151,162.2 thousand), and society $108,850.3 thousand (25th to 75th percentile $67,370.1-$181,048.6 thousand). The median societal cost per patient-year is $3,078.1. Migraine prevalence and productivity losses were identified as key cost drivers.

    CONCLUSIONS: The study points to the need to raise awareness of migraines across all stakeholders and to improve the organisation of the migraine care system. A substantial economic burden of migraines on the healthcare system, employers, and society at large was highlighted. These cost estimates offer evidence-based benchmarks for assessing economic savings from improved migraine management, and can also draw the attention of Chinese policymakers to prioritise migraine policies within the banking and other office-based occupations.

  3. Wong LP, Alias H, Lee HY, AbuBakar S, Lin Y, Hu Z
    BMC Womens Health, 2024 Mar 21;24(1):190.
    PMID: 38515067 DOI: 10.1186/s12905-024-02999-z
    BACKGROUND: Although Zika virus infection is rarely reported now, continuous prevention is needed to achieve sustained eradication. This study aimed to explore the knowledge gaps, risk perception and preventive measures against Zika virus infection (ZIKV) in pregnant women in Malaysia.

    METHODS: We conducted in-depth virtual interviews with pregnant women between February and April 2022. The interviews were recorded and transcribed, and data were analyzed by content analysis.

    RESULTS: The majority of the participants demonstrated a commendable level of awareness regarding the signs and symptoms associated with ZIKV infection. They also exhibited a clear understanding of preventive measures, particularly emphasizing the importance of avoiding mosquito bites to minimize the risk of ZIKV transmission. However, a noteworthy gap in knowledge surfaced as a subset of participants remained uninformed about the potential for sexual transmission of ZIKV, which could lead to congenital ZIKV in pregnant women. Even among women who were cognizant of ZIKV and its potential negative health outcomes, associated with the infection, many of them did not perceive themselves to be at risk, mainly because ZIKV infection is infrequently discussed or heard of, leading to a sense of infections' rarity. While the adoption of preventive measures such as mosquito bite prevention during pregnancy was a common practice, however, prevention of sexually transmitted infections (STIs) including mosquito-borne diseases such as Zika is low. A minority of women express concerns about the sensitivity surrounding discussions and prevention of STIs within the context of marriage. Most of the participants were supportive of the provision of awareness of ZIKV infection in women during pregnancy and the involvement of men, especially in initiatives aimed at preventing transmission through sexual contact.

    CONCLUSION: This study uncovered gaps in both knowledge and practices pertaining ZIKV infection among pregnant women in the aftermath of the ZIKV pandemic. The insights gleaned from our research are valuable for shaping future interventions geared towards preventing the resurgence or facilitating the sustainable eradication of ZIKV.

  4. Lee WL, Danaee M, Abdullah A, Wong LP
    Cardiol Res, 2023 Dec;14(6):437-445.
    PMID: 38187511 DOI: 10.14740/cr1569
    BACKGROUND: The popular wrist-worn wearables recording a variety of health metrics such as blood pressure (BP) in real time could play a potential role to advance precision medicine, but these devices are often insufficiently validated for their performance to enhance confidence in its use across diverse populations. The accuracy of BP-enabled smartwatch is assessed among the multi-ethnic Malaysians, and findings is discussed in comparison with conventional automated upper-arm BP device.

    METHODS: Validation procedures followed the guidelines by the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Universal Standard (ISO 81060-2:2018). Quota sampling was employed to obtain eligible patients with normal and abnormal BP as per guideline. The measurements of BP were taken at wrist using HUAWEI WATCH D (test BP); and the readings were assessed against reference BP by the mercury sphygmomanometer. Agreement statistics and linear regression analyses were performed.

    RESULTS: BP measurements (234 data pairs) from 78 patients that fulfilled AAMI/ESH/ISO protocol were analyzed. The BP readings taken by the HUAWEI WATCH D were comparable to reference BP by sphygmomanometer based on 1) Criterion 1: systolic blood pressure (SBP) = -0.034 (SD 5.24) and diastolic blood pressure (DBP) = -0.65 (SD 4.66) mm Hg; and 2) Criterion 2: SBPs = -0.034 (SD 4.18) and DBPs = -0.65 (SD 3.94) mm Hg. Factors of sociodemographic characteristics, anthropometric measurements, cardiovascular comorbidities, and wrist hair density were not significantly associated with the mean BP differences.

    CONCLUSIONS: HUAWEI WATCH D fulfilled criteria 1 and 2 of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018) guidelines. It can be recommended for clinical use across a wider population. The rich data from real-time BP measurements in concurrent with other health-related parameters recorded by the smartwatch wearable offer opportunities to drive precision medicine in tackling therapeutic inertia by personalizing BP control regimen.

  5. Wong LP, Tan SL, Alias H, Sia TE, Saw A
    Omega (Westport), 2023 Nov;88(1):157-170.
    PMID: 34490819 DOI: 10.1177/00302228211043613
    This study assessed death anxiety (Death Anxiety Questionnaire, DAQ) and psychophysical- (psychological and physical) symptom experience following cadaveric dissection among the Silent Mentor Program (SMP) participants before thawing (T1), after the suturing, dressing and coffining session (T2), and one month post-program (T3). There was a significant decline in the total DAQ score comparing T1 and T2 (t = 7.69, p 
  6. Tang YM, Tan KT, Wong LP
    Water Sci Technol, 2023 Sep;88(6):1404-1416.
    PMID: 37768744 DOI: 10.2166/wst.2023.264
    Residual oil from palm oil mill effluent (POME) can be valorized into value-added products like biofuel. However, the complex structure in POME limits the full recovery of intracellular lipids. To address this challenge, low-frequency ultrasonication was used as a pre-treatment prior to oil recovery to improve the yield by liberating the entrapped oil via the cell disruption technique. This study focused on optimizing the ultrasound conditions (i.e., ultrasonication amplitude, ultrasonication duration, and probe immersion depth) to maximize the improvement of oil recovery yield using response surface methodology. The optimized conditions were 30.074% ultrasonication amplitude, 0.167 min ultrasonication duration, and 2 cm probe immersion depth. This resulted in an additional 42.50% improvement in oil recovery yield over non-ultrasonicated POME, which is in close agreement with the model prediction. Additionally, a cost-benefit analysis was incorporated to determine the feasibility of ultrasonication for enhancing oil recovery. The study also explored the synthesis of biodiesel from POME-recovered oil and characterized the fuel attributes according to American Society for Testing and Materials- and European Standards-prescribed procedures. The attributes of biodiesel produced from POME-recovered oil are comparable to those of palm-based biodiesel in Malaysia, demonstrating its potential as an alternative source for biodiesel production.
  7. Wong LP, Alias H, Tan SL, Saw A
    Anat Sci Int, 2023 Sep;98(4):558-565.
    PMID: 37072599 DOI: 10.1007/s12565-023-00723-9
    The new coronavirus disease 2019 (COVID-19) has had a substantial impact on the Silent Mentor Programme (SMP), a programme in which members of the public may pledge their bodies to be used for medical training and research after their death. This study aimed to explore the conduct of body donations and simulation surgery training during the COVID-19 pandemic from the viewpoints of the committee members of the SMP and the next-of-kin of body donor pledgers. This study utilised a qualitative exploration method to seek an in-depth understanding of this phenomenon. In-depth individual interviews were carried out. Thematic analysis was used to identify patterns of themes. The COVID-19 polymerase chain reaction (RT-PCR) test is compulsory before accepting a body donation, and this resulted in the turning down of several donations. Being a donor is the final wish of pledgers and this turning down led to a negative emotional remorseful feeling in the next-of-kin of pledgers. From the perspective of students, it is feared that the conduct of the programme, particularly the home visit session being held online, has impeded teaching of humanistic values, compassion, and empathy, which is the prime philosophy of the programme. Previous to the pandemic, the programme ceremonies were well-attended, denoting the utmost respect and recognition of the mentors; however, travel restrictions due to the pandemic limiting in-person attendance resulted in ceremonies becoming less impactful. Continuous postponements of cadaveric dissection training also resulted in students missing training opportunities, hence potentially impairing their professional practice and humanistic values in the medical profession. Counselling interventions should be directed at easing the negative psychological impact on the next-of-kin of pledgers. As the COVID-19 pandemic may pose a significant impediment to achieving the educational outcomes of cadaveric dissection training, efforts to make up for these gaps are essential.
  8. Huang Z, Hu Z, Wong LP, Lin Y
    BMJ Open, 2023 Jul 20;13(7):e073925.
    PMID: 37474189 DOI: 10.1136/bmjopen-2023-073925
    OBJECTIVES: This study aimed to identify the determinants of gastric cancer screening attendance among individuals aged 40 years in a region with high gastric cancer in China.

    DESIGN: An anonymous, cross-sectional survey was conducted between October 2021 and March 2022.

    SETTING: A self-administered online survey was conducted in Fujian Province in Southeastern China.

    PARTICIPANTS: People aged 40 years living in five selected cities in Fujian Province with no history of cancer.

    MAIN OUTCOME MEASURES: Gastric cancer screening attendance was measured with the question 'Have you ever been screened for gastric cancer in the past'.

    RESULTS: In total, 2547 complete responses were obtained. The mean age of respondents was 47.72±7.20 years, and 59.8% were men. A total of 42.6% of participants reported that they had undergone gastric cancer screening. The result of multivariable logistic regression analysis showed that participants with a first-degree relative affected with gastric cancer (OR=2.02, 95% CI: 1.58 to 2.59) and high perceived susceptibility of gastric cancer (OR=2.03, 95% CI: 1.58 to 2.59) were the strongest facilitators for screening attendance. Other factors positively associated with screening attendance were age 51-60 years (OR=1.69, 95% CI: 1.31 to 2.18), living in urban regions (OR=1.27, 95% CI: 1.05 to 1.55), friends/neighbours/colleagues with gastric cancer (OR=1.30, 95% CI: 1.07 to 1.58), history of chronic gastric disease (OR=1.90, 95% CI: 1.57 to 2.30), perceived high cost (OR=1.28, 95% CI: 1.01 to 1.61) and physician recommendation (OR=1.71, 95% CI: 1.36 to 2.16). On the other hand, factors negatively associated with screening attendance included perceived barriers, namely screening is only necessary when symptoms present (OR=0.71, 95% CI: 0.58 to 0.87) and perceived appointment for gastroscopy screening is difficult and time-consuming (OR=0.75, 95% CI: 0.60 to 0.94). No significant association was found between knowledge level and participation in screening.

    CONCLUSION: This study highlights important individual-level factors and barriers to gastric cancer screening. Strategies targeting under-screened populations and eliminating patient-perceived barriers to gastric cancer screening are essential.

  9. Wong LP, Tan SL, Alias H, Sia TE, Saw A
    Omega (Westport), 2023 Mar;86(4):1176-1189.
    PMID: 33818157 DOI: 10.1177/00302228211000952
    The COVID-19 pandemic has put a hold on the Silent Mentor Programme (SMP); this pause has not only caused unprecedented challenges for the delivery of medical education but has forced changes in the programme ceremony sessions. We aimed to describe the psychological impact and experiences of family members of silent mentors during the COVID-19 pandemic using qualitative interviews. Many expressed feelings of remorse and unrest about the unprecedented delay of the SMP. The delay increased negative emotions particularly among some elderly family members; however, there was no prominent negative effect on their functional health and well-being. Several participants relayed the belief that the soul cannot rest until the body receives a proper burial while some worried about the deterioration of the physical condition of the mentors. In conclusion, findings provide insights into the importance of not overlooking the mental health implications of delaying the SMP in future outbreaks or crises.
  10. Wong LP, Alias H, Tan KM, Wong PF, Murugan DD, Hu Z, et al.
    Front Pharmacol, 2023;14:1254470.
    PMID: 37869747 DOI: 10.3389/fphar.2023.1254470
    Objective: The field of targeting cellular senescence with drug candidates to address age-related comorbidities has witnessed a notable surge of interest and research and development. This study aimed to gather valuable insights from pharmaceutical experts and healthcare practitioners regarding the potential and challenges of translating senolytic drugs for treatment of vascular aging-related disorders. Methods: This study employed a qualitative approach by conducting in-depth interviews with healthcare practitioners and pharmaceutical experts. Participants were selected through purposeful sampling. Thematic analysis was used to identify themes from the interview transcripts. Results: A total of six individuals were interviewed, with three being pharmaceutical experts and the remaining three healthcare practitioners. The significant global burden of cardiovascular diseases presents a potentially large market size that offer an opportunity for the development and marketability of novel senolytic drugs. The pharmaceutical sector demonstrates a positive inclination towards the commercialization of new senolytic drugs targeting vascular aging-related disorders. However potential important concerns have been raised, and these include increasing specificity toward senescent cells to prevent off-site targeting, thus ensuring the safety and efficacy of these drugs. In addition, novel senolytic therapy for vascular aging-related disorders may encounter competition from existing drugs that treat or manage risk factors of cardiovascular diseases. Healthcare practitioners are also in favor of recommending the novel senolytic drugs for vascular aging-related disorders but cautioned that its high cost may hinder its acceptance among patients. Besides sharing the same outcome-related concerns as with the pharmaceutical experts, healthcare practitioners anticipated a lack of awareness among the general public regarding the concept of targeting cellular senescence to delay vascular aging-related disorders, and this knowledge gap extends to healthcare practitioner themselves as well. Conclusion: Senolytic therapy for vascular aging-related disorders holds great promise, provided that crucial concerns surrounding its outcomes and commercial hurdles are effectively addressed.
  11. Zhang H, Wong LP, Hoe VCW
    Front Psychol, 2023;14:1042133.
    PMID: 37404587 DOI: 10.3389/fpsyg.2023.1042133
    OBJECTIVE: The aim of this study was to analyze the current status of research on nurses' turnover intention and to provide suggestions and references for promoting research on turnover intention and for promoting hospital talent development.

    METHODS: We used the bibliometric method "turnover intention" or "intention to leave" and "nurse*" as subject terms, and 1543 articles from 2017 to 2021 were retrieved from the WoS database using VOSViewer and CiteSpace software. Article based on this descriptive statistical analysis was performed on the year of publication, region, institution, journal of publication, and cited articles.

    RESULTS: A total of 1,500 articles met the inclusion criteria. There is an overall upward trend in the number of articles published in the field of nursing in terms of turnover intention from 2017 to 2021. The United States has the highest number of publications and the highest number of institutions, while China ranks second in terms of publications, but there are no Chinese research institutions in the top 10. The top three journals in terms of the number of articles published are the Journal of nursing management, the Journal of advanced nursing, and the Journal of clinical nursing; Oman's League had the highest number of citations for their article in 2021; the most frequently occurring keywords are burnout, stress, satisfaction, model, work environment, organizational commitment, perception, predictor, mental health, and mediating role.

    CONCLUSION: There is a great need for further research on how to develop sound measures to tackle nurse turnover intention. The following improvements should be made, such as to enhance research institutional settings for nurses' turnover intention in China and to increase attention to nurse burnout and possible mediating influences in future studies.

  12. Wong LP, Farid NDN, Alias H, Yusop SM, Musa Z, Hu Z, et al.
    Front Psychiatry, 2023;14:1165023.
    PMID: 37255690 DOI: 10.3389/fpsyt.2023.1165023
    INTRODUCTION: This study aimed to shed light on how young people from low-income families were responding to COVID-19.

    METHODS: This cross-sectional study recruited young people aged between 18 and 24 years from the low-income-group communities. A convenience sampling approach was used. Google Surveys were used to gather data from the survey. The questionnaire consisted of an assessment of demographic characteristics, lifestyle factors, parent-youth conflict (Parental Environment Questionnaire, PEQ), resilient coping (Brief Resilient Coping Scale, BRCS), and psychological distress (Depression, Anxiety, and Stress Scale-short form, DASS-21).

    RESULTS: A total of 561 complete responses were received. The results showed a low level of parent-child conflict in the overall study population, with a median PEQ of 48.0 [interquartile range (IQR) 36-48]. Higher parent-child conflicts were found in females than in males (OR = 1.75, 95% CI 1.19-2.57) and in youth from households with an income below MYR 2000 than those earning MYR 3,001-5,000 (OR = 4.39, 95% CI 2.40-8.03). A low prevalence of depression (12.5%), anxiety (15.2%), and stress (6.4%) was found. Parent-child conflict remains the strongest significant predictor for higher levels of depression (OR = 10.90, 95% CI 4.31-27.57), anxiety (OR = 11.92, 95% CI 5.05-28.14), and stress (OR = 4.79, 95% CI 1.41-16.33) symptoms. Poor resilient coping was the second strongest predictor for depression and anxiety symptoms. Regarding lifestyle factors, a lower level of physical exercise was associated with higher symptoms of depression. By demographics, females reported more severe symptoms of depression and anxiety than males. Young people from low-income households reported greater severity in symptoms of depression, anxiety, and stress than those from high-income households. Young people who are employed also reported greater severity of anxiety symptoms than those who are unemployed.

    DISCUSSION: The COVID-19 pandemic continues to have an unpredictable impact on the lives of vulnerable youth in low-income families that warrants attention in future advocacy efforts.

  13. Tok PSK, Wong LP, Liew SM, Razali A, Mahmood MI, Chinnayah T, et al.
    PLoS One, 2023;18(9):e0289222.
    PMID: 37676902 DOI: 10.1371/journal.pone.0289222
    BACKGROUND: Loss to follow-up (LTFU) is an unsuccessful treatment outcome for tuberculosis (TB) patients. In Malaysia, LTFU affects around 1 in 20 TB patients. Integration of qualitative research methods and evidence will provide a better understanding of LTFU and its underlying issues. In this study, we qualitatively explored TB patients' experiences in receiving treatment and their reasons for leaving TB care.

    METHOD: In-depth interviews of 15 patients with a history of LTFU were conducted from January to September 2020. Interview guides were developed to explore TB patients' experiences while receiving treatment, including challenges faced and reasons for treatment interruption. Data were thematically analysed using the framework method.

    RESULTS: We identified 11 emerging themes that occurred at four levels of interaction with TB patients. First, at the patient personal level, TB beliefs referring to patients' perception of illness and wellness, patients' perceived role of traditional and complementary medicine, and substance abuse were important. Second, the healthcare system and treatment factors that were highlighted included the organisation of care and treatment, interaction with healthcare professionals, particularly in communication and counselling, and TB medications' side effects. Third, structural factors including financial burden, logistical and transportation issues and work-related factors were identified to be barriers to treatment continuation. Fourth, the interpersonal level interaction of patients should not be neglected; this includes family relationships and support as well as peer influence.

    CONCLUSION: Study findings put forth issues and challenges faced by TB patients while receiving treatment and underscore areas where actions can be taken. This will contribute to informing the development and implementation of future TB control strategies that are responsive to TB patients' needs and concerns, to effectively address LTFU and ensure better treatment completion rates among TB patients in Malaysia.

  14. Wong LP, Alias H, Farid NDN, Yusop SM, Musa Z, Hu Z, et al.
    Front Public Health, 2023;11:1158698.
    PMID: 37213607 DOI: 10.3389/fpubh.2023.1158698
    INTRODUCTION: This study aims to shed light on parent-child relationships and the psychological health of parents from low-income families after the easing of the COVID-19 pandemic restrictions.

    METHODS: This cross-sectional study recruited 553 parents of children aged 13-24 years in low-income community settings. The Parent-Child Conflict scale of the Parental Environment Questionnaire (PEQ) was used to measure parent-child conflict. Psychological distress was assessed using the Depression, Anxiety, and Stress Scale short form (DASS-21).

    RESULTS: The study revealed a low level of parent-child conflict in the overall study population, with a median PEQ of 48.0 (interquartile range [IQR] 36 to 48). Concerning demographics, married parents reported a likelihood of having a higher level of parent-child conflict over 3 times higher than single parents (OR = 3.18 95%, CI 1.30-7.75). More parent-child conflicts were also found in parents aged 60-72 years old who were unemployed, retired, or housewives and from lower-income groups. In regard to lifestyle factors, a higher level of physical activity and having enough sleep were associated with lower levels of parent-child conflict. Only approximately 1% of the participants reported symptoms of depression, anxiety, or stress.

    DISCUSSION: Low risk exists for parent-child conflict and psychological sequelae following the easing of the COVID-19 pandemic restrictions, which could be due to various support measures implemented by the government. Vulnerable parents identified as being at risk of parent-child conflict warrant attention in future advocacy efforts.

  15. Di KN, Tay ST, Sri La Sri Ponnampalavanar S, Pham DT, Wong LP
    Healthcare (Basel), 2022 Dec 31;11(1).
    PMID: 36611587 DOI: 10.3390/healthcare11010126
    (1) Background: The antibiotic resistance (ABR) rates are escalating to seriously high levels worldwide. This study was conducted to determine physicians' perspectives on factors influencing ABR in Vietnam. (2) Methods: Focus group discussion (FGD) was conducted through in-depth interviews on ABR perspectives with 5-6 physicians from different geographical locations and hospitals in Vietnam between March and June 2020. The research questions were focused on three main themes of (a) knowledge deficiency on ABR and hospital-acquired infection, (b) antibiotic prescribing practice among clinicians in the healthcare setting, and (c) regulations and hospital policies on antibiotic use. The descriptive analysis was performed using QRS NVivo software. (3) Results: A total of six FGDs were conducted among 34 physicians (18 males, 16 females) aged 26-53 years old from six public and six private hospitals in Vietnam. Most of the participants were attending physicians (85.3%) and had 5-10 years of experience in surgical wards (55.9%). For theme (a), a majority of participants agreed that they had adequate information updates on how ABR develops in their clinical setting; and were well aware of hospital-acquired infections. For theme (b), the participants agreed that WHO guidelines and Vietnam national guidelines were two important reference documents in guiding physicians in antibiotic use. For theme (c), the FGD study revealed awareness of ABR, hospital antibiotic policies, and procedures for administrators on antibiotic use that were updated and complied with. (4) Conclusions: While different levels of control measures against ABR are ongoing in Vietnam, several weaknesses in the current antibiotic prescribing strategies in the hospital and clinical setting management policies have been identified in the healthcare system. The research findings will be helpful for policymakers to have better plans of action against ABR in Vietnam.
  16. Lin Y, Cai CZ, Alias H, Wong LP, Hu Z
    Complement Ther Med, 2022 Dec;71:102898.
    PMID: 36372316 DOI: 10.1016/j.ctim.2022.102898
    OBJECTIVE: To investigate user behavioural profiles and the prevalence of self-medication with traditional Chinese medicine (TCM) for COVID-19 among the general public in China.

    DESIGN: Cross-sectional study.

    SETTING: Self-administered online survey was carried out between January and June 2021 in China.

    RESULTS: A total of 1132 complete responses were received from a nationwide sample. A considerable proportion viewed TCM to be more effective than Western medicine for treating COVID-19 (67.1 %) and stated that it is safer to use TCM (63.5 %) and easier to access TCM for treating COVID-19 (63.5 %). A total of 16.4 % (95 %CI 14.3-18.7) reported ever self-medicating with TCM to resolve COVID-19 symptoms and 12.2 % (95 % CI 10.3-14.2) ever using TCM to prevent SARS-CoV-2 infection. Lianhua Qingwen capsule/granule (53.2 %), Ganmao granule (50.5 %) and Banlangen granule (44.6 %) were most commonly used to resolve COVID-19 symptoms whereas Banlangen granule (60.1 %) was commonly used for the prevention of SARS-CoV-2 infection. Older age participants, from rural areas, with chronic diseases, higher socioeconomic status, and a positive attitude towards TCM were more likely to self-medicate using TCM to resolve COVID-19 symptoms.

    CONCLUSION: Self-medication with TCM during the COVID-19 pandemic for symptom control or prevention is prevalent. The findings of the user behavioural profile and types of TMCs commonly used in this study provide beneficial information for the development of strategies to improve public health-seeking behaviour and the performance of the country's healthcare system in the era of the COVID-19 pandemic.

  17. Lin Y, Huang Z, Xu X, Du W, Alias H, Hu Z, et al.
    Hum Vaccin Immunother, 2022 Nov 30;18(6):2126667.
    PMID: 36165498 DOI: 10.1080/21645515.2022.2126667
    This study aimed to investigate multi-dimensional psychological and social factors that influence the willingness to receive a COVID-19 vaccine booster in China. A nationwide cross-sectional online survey was conducted between March and April 2022. A total of 6375 complete responses were received. The majority were of age 18 to 40 years old (80.0%) and college-educated (49.2%). In total, 79% responded extremely willing to receive a COVID-19 vaccine booster. By demographics, younger age, females, higher education, and participants with the lowest income reported higher willingness. Having a very good health status (odds ratio [OR] 3.56, 95% confidence interval [CI] 2.92-4.34) and a higher score of vaccine confidence (OR 3.50, 95% CI 2.98-4.11) were associated with an increased willingness to receive a booster shot. Experiencing no side effects with primary COVID-19 vaccination (OR 2.46, 95% CI 1.89-3.20) and higher perceived susceptibility of COVID-19 infection (OR 2.38, 95% CI 1.92-2.95) were also associated with an increased willingness to receive a booster shot. A variety of psychosocial factors, namely having no chronic diseases, lower perceived concern over the safety of a booster shot, higher perceived severity of COVID-19 infection, and a higher level of institutional trust, were also significantly associated with greater willingness to get a booster shot. In conclusion, the present study adds evidence to the significant role of psychosocial factors in predicting COVID-19 vaccine booster acceptance and provides insights to design interventions to increase booster uptake in certain targeted demographic groups.
  18. Wong LP, Lee HY, Alias H, AbuBakar S
    Vaccines (Basel), 2022 Oct 25;10(11).
    PMID: 36366298 DOI: 10.3390/vaccines10111790
    Little was known about Malaysian parental attitudes, beliefs, and intentions surrounding coronavirus disease 2019 (COVID-19) vaccines for children when the National COVID-19 Immunization Program for Children (PICKids) was launched in February 2021. A cross-sectional online survey-based study was carried out from 15 March 2022 to 23 July 2022 on Malaysian parents/guardians of children between ages 5 and below 12 years old. A total of 15.7% reported being extremely willing, and 38.9% were somewhat willing to vaccinate children with a COVID-19 vaccine. Perceived low susceptibility to COVID-19 infection showed the greatest significant impact on vaccine acceptance (OR 35.46, 95% CI 15.26-82.40). Parents with a lower level of concern have a higher willingness for vaccination (OR 1.25, 95% CI 0.90-1.75). Of the parents that knew of the mRNA vaccine, 46.6% reported that they prefer their children to be vaccinated with conventional vaccines over mRNA vaccines. Poor knowledge about mRNA vaccines, lack of confidence in the mRNA technology, fear of unknown side effects, and perception that the mRNA vaccines contain microchips were significantly associated with a higher level of concern about their children receiving an mRNA vaccine. Public education campaigns to promote COVID-19 vaccination for children warrant addressing the concerns and knowledge deficits among vaccine-hesitant parents.
  19. Wong LP, Alias H, Tan SL, Sia TE, Saw A
    Omega (Westport), 2022 Oct 10.
    PMID: 36217612 DOI: 10.1177/00302228221132902
    Background: This study assesses the level of death anxiety among the family members of the Silent Mentor Programme (SMP) and determines whether their participation in various ceremonies during the training session impacted their death anxiety. Methods: The revised Collett-Lester Fear of Death Scale (CL-FODS) was administered to the study participants before the opening ceremony and after the sending-off ceremony of the programme. Results: All the four subscales that measure fear of one's own death, fear of the process of one's own dying, fear of the death of others and fear of the process of others dying in the CL-FODS showed significant reduction after the sending-off ceremony compared with before the opening ceremony. Younger family members reported significantly higher mean total death anxiety scores compared to the older members. Conclusion: The SMP not only nurtures doctors with humanity but also helps the family members to cope with grief and loss.
  20. Isa MH, Bashir MJK, Wong LP
    Environ Sci Pollut Res Int, 2022 Jun;29(29):44779-44793.
    PMID: 35138542 DOI: 10.1007/s11356-022-19022-3
    In this study, palm oil mill effluent (POME) treated by ultrasonication at optimum conditions (sonication power: 0.88 W/mL, sonication duration: 16.2 min and total solids: 6% w/v) obtained from a previous study was anaerobically digested at different hydraulic retention times (HRTs). The reactor biomass was subjected to metagenomic study to investigate the impact on the anaerobic community dynamics. Experiments were conducted in two 5 L continuously stirred fill-and-draw reactors R1 and R2 operated at 30 ± 2 °C. Reactor R1 serving as control reactor was fed with unsonicated POME with HRT of 15 and 20 days (R1-15 and R1-20), whereas reactor R2 was fed with sonicated POME with the same HRTs (R2-15 and R2-20). The most distinct archaea community shift was observed among Methanosaeta (R1-15: 26.6%, R2-15: 34.4%) and Methanobacterium (R1-15: 7.4%, R2-15: 3.2%). The genus Methanosaeta was identified from all reactors with the highest abundance from the reactors R2. Mean daily biogas production was 6.79 L from R2-15 and 4.5 L from R1-15, with relative methane gas abundance of 85% and 73%, respectively. Knowledge of anaerobic community dynamics allows process optimization for maximum biogas production.
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