Displaying publications 1 - 20 of 39 in total

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  1. Robson N, Bond A, Wolff K
    Prev Med, 2013;57 Suppl:S8-10.
    PMID: 23624111 DOI: 10.1016/j.ypmed.2013.04.010
    OBJECTIVES: There is evidence that smoking behaviour differs by ethnicity. This study aims to compare smoking behaviour characteristics between Caucasian and Malay smokers.
    METHODS: A cross sectional survey, involving 175 smokers attending smoking cessation clinics at the Institute of Psychiatry, London, United Kingdom and University Malaya, Kuala Lumpur, Malaysia between May 2005 and February 2007. Data on demographics, smoking history, nicotine dependence and smoking behaviour were collected.
    RESULTS: All participants were males, mean age 30.7 ± 10.3 years. Caucasians initiated smoking significantly earlier (mean age 14.8 ± 2.8 years) (p = 0.001) and smoked regularly significantly earlier (mean age 17.3 ± 3.5) (p = 0.003) than Malays (mean starting age 16.9 ± 4.4 years and mean age regular use 19.5 ± 4.5 years), respectively. Caucasians smoked less for social integration than Malays (p = 0.03) but smoked more for regulation of negative affect than Malays (p = 0.008) and smoked more for hedonism than Malays (p < 0.001).
    CONCLUSION: Malays smoke as a means of socially integrating. This has important public health implications. Social reasons and the social environment play a role in smoking uptake, smoking maintenance and smoking cessation and this should be borne in mind for strategies planning to promote smoking cessation.
    KEYWORDS: Behaviour; Caucasian; Character; Cigarette; Malay; Nicotine; Smoking
  2. Woo YL, Gravitt P, Khor SK, Ng CW, Saville M
    Prev Med, 2021 03;144:106294.
    PMID: 33678225 DOI: 10.1016/j.ypmed.2020.106294
    Cervical cancer remains the fourth most common cancer in women, with 85% of deaths occurring in LMICs. Despite the existence of effective vaccine and screening tools, efforts to reduce the burden of cervical cancer must be considered in the context of the social structures within the health systems of LMICs. Compounding this existing challenge is the global COVID-19 pandemic, declared in March 2020. While it is too soon to tell how health systems priorities will change as a result of COVID-19 and its impact on the cervical cancer elimination agenda, there are opportunities to strengthen cervical screening by leveraging on several trends. Many LMICs maximized the strengths of their long established community-based primary care and public health systems with expansion of surveillance systems which incorporated mobile technologies. LMICs can harness the momentum of the measures taken against COVID-19 to consolidate the efforts against cervical cancer. Self-sampling, molecular human papillomavirus (HPV) testing and digital health will shift health systems towards stronger public health and primary care networks and away from expensive hospital-based care investments. While COVID-19 will change health systems priorities in LMICs in ways that may de-prioritize cervical cancer screening, there are significant opportunities for integration into longer-term trends towards universal health coverage, self-care and digital health.
  3. Gravitt PE, Silver MI, Hussey HM, Arrossi S, Huchko M, Jeronimo J, et al.
    Prev Med, 2021 03;144:106322.
    PMID: 33678230 DOI: 10.1016/j.ypmed.2020.106322
    The World Health Organization (WHO) is leading a call to action to eliminate cervical cancer by the end of the century through global implementation of two effective evidence-based preventive interventions: HPV vaccination and cervical screening and management (CSM). Models estimate that without intervention, over the next 50 years 12.2 million new cases of cervical cancer will occur, nearly 60% of which are preventable only through CSM. Given that more than 80% of the cervical cancer occurs in low- and middle-income countries (LMICs), scaling up sustainable CSM programs in these countries is a top priority for achieving the global elimination goals. Multiple technologies have been developed and validated to meet this need. Now it is critical to identify strategies to implement these technologies into complex, adaptive health care delivery systems. As part of the coordinated cervical cancer elimination effort, we applied a systems thinking lens to reflect on our experiences with implementation of HPV-based CSM programs using the WHO health systems framework. While many common health system barriers were identified, the effectiveness of implementation strategies to address them was context dependent; often reflecting differences in stakeholder's belief in the quality of the evidence supporting a CSM algorithm, the appropriateness of the evidence and algorithm to context, and the 'implementability' of the algorithm under realistic assessments of resource availability and constraints. A structured planning process, with early and broad stakeholder engagement, will ensure that shared-decisions in CSM implementation are appropriately aligned with the culture, values, and resource realities of the setting.
  4. Abdullah F, Su TT
    Prev Med, 2013;57 Suppl:S83-6.
    PMID: 23415623 DOI: 10.1016/j.ypmed.2013.02.001
    The objective of this study was to evaluate the effect of a call-recall approach in enhancing Pap smear practice by changes of motivation stage among non-compliant women.
  5. Bulgiba AM
    Prev Med, 2005 Jun;40(6):696-701.
    PMID: 15850867
    The objective of this study is to look at how well patient history and examination findings can be used in screening for angina.
  6. Su TT, Sim PY, Nahar AM, Majid HA, Murray LJ, Cantwell MM, et al.
    Prev Med, 2014 Oct;67:100-5.
    PMID: 25016043 DOI: 10.1016/j.ypmed.2014.07.001
    BACKGROUND: Obesity and lack of physical activity are fast becoming a concern among Malaysian adolescents.

    OBJECTIVE: This study aims to assess physical activity levels among Malaysian adolescents and investigate the association between physical activity levels and body composition such as body mass index (BMI), waist circumference (WC) and percentage of body fat.

    SUBJECTS AND METHODS: 1361 school-going 13 year old multi-ethnic adolescents from population representative samples in Malaysia were involved in our study. Self-reported physical activity levels were assessed using the validated Malay version of the Physical Activity Questionnaire for Older Children (PAQ-C). Height, weight, body fat composition and waist circumference (WC) were measured. Data collection period was from March to May 2012.

    RESULTS: 10.8% of the males and 7.4% of the females were obese according to the International Obesity Task Force standards. A majority of the adolescents (63.9%) were physically inactive. There is a weak but significant correlation between physical activity scores and the indicators of obesity. The adjusted coefficient for body fatness was relatively more closely correlated to physical activity scores followed by waist circumference and lastly BMI.

    CONCLUSION: This study demonstrates that high physical activity scores were associated with the decreased precursor risk factors of obesity.

  7. Chu AH, Moy FM
    Prev Med, 2013;57 Suppl:S14-7.
    PMID: 23276774 DOI: 10.1016/j.ypmed.2012.12.011
    This study investigates physical activity in different domains and its association with metabolic risk factors among middle-aged adults.
  8. Rosdinom R, Zarina MZ, Zanariah MS, Marhani M, Suzaily W
    Prev Med, 2013;57 Suppl:S67-9.
    PMID: 23313789 DOI: 10.1016/j.ypmed.2012.12.025
    OBJECTIVE: This study aims to determine the relationships between behavioural and psychological symptoms of dementia (BPSD), cognitive impairment and burden of care of patients with dementia.
    METHOD: A cross-sectional, non-randomised study of 65 elderly patients with dementia and their caregivers was conducted over a 3-month period in January 2007 at the memory clinics of Universiti Kebangsaan Malaysia Medical Centre and Hospital Kuala Lumpur. Patients' cognitive functions were assessed with the Mini Mental State Examination (MMSE). Caregivers were interviewed to determine the severity of BPSD and caregiver burden (CB) using the Neuropsychiatric Inventory (NPI) Questionnaire and Zarit Burden Interview (BI) respectively.
    RESULTS: Cognitive impairment did not contribute significantly to CB. Multiple linear regression analysis showed that high BPSD scores contributed 0.27 more in BI score, female patients contributed 0.37 less in BI score and caregivers with higher educational level contribute 0.5 more in BI score.
    CONCLUSION: Patients' BPSD and male gender, but not cognitive impairment, were associated with CB. Even though CB was experienced more among caregivers with better education, all caregivers should be screened to ensure their general well-being.
    KEYWORDS: BPSD; Caregiver burden; Cognitive impairment
    Study site: Memory clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) and Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
  9. Dahlui M, Gan DE, Taib NA, Lim JN
    Prev Med, 2013;57 Suppl:S18-20.
    PMID: 23276776 DOI: 10.1016/j.ypmed.2012.12.010
    OBJECTIVE:
    This study investigated rural women's knowledge of breast cancer and screening methods by ethnicity and examined the predictors of breast screening methods.

    METHODS:
    A cross-sectional survey was conducted in 2011 in five rural districts of Perak; 959 women were interviewed using a semi-structured questionnaire. ANOVA and regression analysis were used in data analysis.

    RESULTS:
    Women below 50 years old, of Malay ethnicity and who had secondary education scored better than those older, of Chinese ethnicity and had primary education (p<0.001). The uptake of breast self-examination (BSE), clinical breast examination (CBE) and mammogram was 59%, 51% and 6.8%, respectively. Multivariate analysis revealed knowledge of breast cancer and CBE as top predictors of BSE, being married and knowledge of breast cancer as top predictors for CBE; and CBE as the top predictor of mammography uptake. Support from husbands and family members for breast cancer screening was a predictor for CBE and BSE.

    CONCLUSION:
    Knowledge of breast cancer and its screening uptake varies by ethnicity, location and the type of support received. Efforts and approaches to improve the women's knowledge of breast cancer and its screening uptake therefore should be customized to address the different influencing factors.
  10. Garegnani L, Franco JVA, Escobar Liquitay CM, Brant LCC, Lim HM, de Jesus Jessen NP, et al.
    Prev Med, 2023 Jul;172:107534.
    PMID: 37146731 DOI: 10.1016/j.ypmed.2023.107534
    BACKGROUND: In 2010 the American Heart Association defined the concept of ideal cardiovascular health to renew the focus on primordial prevention for cardiovascular disease. Evidence primarily from high-income countries suggests ideal CVH prevalence is low and decreases with age, with vulnerable populations differentially affected. We aimed to identify and characterize the evidence relevant to CVH metrics in low- and middle-income countries (LMICs).

    METHODS: We followed the Joanna Briggs Institute guideline for the conduct of this scoping review. We searched MEDLINE, Embase, LILACS and study registers from inception to 14 March 2022. We included cross-sectional and cohort studies in populations representing a geographically-defined unit (urban or rural) in LMICs, and with data on CVH metrics i.e. all health or clinical factors (cholesterol, blood pressure, glycemia and body mass index) and at least one health behavior (smoking, diet or physical activity). We report findings following the PRISMA-Scr extension for scoping reviews.

    RESULTS: We included 251 studies; 85% were cross-sectional. Most studies (70.9%) came from just ten countries. Only 6.8% included children younger than 12 years old. Only 34.7% reported seven metrics; 25.1%, six. Health behaviors were mostly self-reported; 45.0% of studies assessed diet, 58.6% physical activity, and 90.0% smoking status.

    CONCLUSIONS: We identified a substantial and heterogeneous body of research presenting CVH metrics in LMICs. Few studies assessed all components of CVH, especially in children and in low-income settings. This review will facilitate the design of future studies to bridge the evidence gap. This scoping review protocol was previously registered on OSF: https://osf.io/sajnh.

  11. Hairi NN, Bulgiba A, Mudla I, Said MA
    Prev Med, 2011 Oct;53(4-5):343-6.
    PMID: 21864564 DOI: 10.1016/j.ypmed.2011.07.020
    To determine prevalence and prevalence ratio of functional limitation amongst older people with combined chronic diseases and co-morbid depressive symptoms compared with older people with either chronic disease or depressive symptoms alone.
  12. Su TT, Bulgiba AM, Sampatanukul P, Sastroasmoro S, Chang P, Tharyan P, et al.
    Prev Med, 2013;57 Suppl:S5-7.
    PMID: 23624253 DOI: 10.1016/j.ypmed.2013.04.009
    Clinical Epidemiology (CE) and Evidence-Based Medicine (EBM) have become increasingly important in an era of rising costs, patient safety concerns and evidence-based health care. CE and EBM research in the Asia Pacific region have grown significantly. However, there are three main challenges such as linking evidence to practice and policy; developing a strong collaborative network; and a need for resources and technical expertise to produce evidence. The Cochrane Collaboration is a possible solution to resolve above challenges identified, particularly the challenge of transforming evidence to practice. In addition, training can be carried out to enhance technical expertise in the region and there is also the promising potential that collaborations could extend beyond systematic reviews. To improve the adoption of evidence-based health policy, selection of the best evidence for the right audience and focusing on the relevant issues through appropriate methodology are essential. Information on effectiveness and cost effectiveness needs to be highlighted for policy makers. The way forward to strengthen research and capacity building is to establish the Asia Pacific Consortium for CE and EBM. The consortium would help to create mutually rewarding scientific research and collaborations that will augur well for advances in CE and EBM.
  13. Gan DE, Jawan RA, Moy FM
    Prev Med, 2013;57 Suppl:S21-3.
    PMID: 23313791 DOI: 10.1016/j.ypmed.2012.12.026
    The aim of this study was to evaluate the accuracy of hysteroscopic impression for diagnosing benign and malignant endometrial pathology.
  14. Wong YL, Chinna K, Mariapun J, Wong LP, Khoo EM, Low WY, et al.
    Prev Med, 2013;57 Suppl:S24-6.
    PMID: 23318158 DOI: 10.1016/j.ypmed.2013.01.004
    OBJECTIVES: To identify the correlates between risk perceptions and cervical cancer screening among urban Malaysian women.
    METHOD: A cross-sectional household survey was conducted among 231 women in Petaling Jaya city in 2007. The association of risk perceptions of cervical cancer and screening practice was analyzed using Poisson regression.
    RESULTS: 56% of the respondents ever had a Pap smear test. Knowledge of signs and symptoms (aPR=1.11, 95% CI=1.03-1.19), age (aPR=1.02, 95% CI=1.01-1.03), number of pregnancies (aPR=1.06, 95% CI=1.01-1.11), marital status, education level and religion were found to be significant correlates of Pap smear screening. Respondents who were never married were less likely to have had a Pap smear. Those who had no education or primary education were less likely to have had a Pap smear compared to those with degree qualification. The prevalence of screening was significantly higher among Christians and others (aPR=1.35; 95% CI=1.01-1.81) and Buddhists (aPR=1.38; 95% CI=1.03-1.84), compared to Muslims.
    CONCLUSION: Eliminating anecdotal beliefs as risks via targeted knowledge on established risk factors and culturally sensitive screening processes are strategic for increasing and sustaining uptake of Pap smear screening versus current opportunistic screening practices.
    KEYWORDS: Cervical cancer; Malaysia; Pap smear; Risk perception; Screening; Targeted knowledge
  15. Mujar M, Dahlui M, Yip CH, Taib NA
    Prev Med, 2013 Mar;56(3-4):222-4.
    PMID: 23234860 DOI: 10.1016/j.ypmed.2012.12.001
    OBJECTIVE: Treatment delays in breast cancer are generally thought to affect prognosis but the impact on survival remains unclear. Indicators for breast cancer care include time to primary treatment. The purpose of this study was to evaluate whether time to primary treatment (TPT) in breast cancer impacts survival.
    METHOD: A total of 648 breast cancer patients treated in the University Malaya Medical Center (UMMC), Malaysia between 2004 and 2005 were included in the study. TPT was calculated from the date of pathological diagnosis to the date of primary treatment. Mortality data was obtained from the National Registry of Births and Deaths. Last date of follow-up was November 2010.
    RESULTS: Median TPT was 18 days. Majority 508 (69.1%) of the patients received treatment within 30 days after diagnosis. The majority was surgically treated. Ethnicity (p=0.002) and stage at presentation (p=0.007) were significantly associated with delayed TPT. Malay ethnicity had delayed TPT compared to the Chinese; Hazard Ratio (HR) 1.9 (Confidence Interval (CI) 1.237, 2.987). Delayed TPT did not affect overall survival on univariate and multivariate analyses.
    CONCLUSION: Time to primary treatment after a diagnosis of breast cancer had no impact on overall survival. Further studies on care before diagnosis are important in drawing up meaningful quality indicators.
  16. Johar H, Schaefer A, Su TT
    Prev Med, 2023 Feb;167:107390.
    PMID: 36528114 DOI: 10.1016/j.ypmed.2022.107390
    The potential role of psychological distress as the pathway linking diabetes and subjective cognitive decline (SCD) is still unclear. This study aims to investigate whether depressive symptoms mediate the relationship between diabetes and SCD in older adults. Baseline data from 3428 adults (55-94 years) of the South East Asia Community Observatory (SEACO), Malaysia were utilized. Subjective cognitive complaints (SCC) were recorded at baseline and five years later. Mediation analyses with non-parametric bootstrapping methods were employed. A proportion of 20% of participants without SCC at baseline reported a decline in SCC after 5 years of follow-up. Known diabetes (β = -0.13, SE = 0.05, p = 0.02) and depressive symptoms (ß = -0.18, SE = 0.05, p = 0.001) were independently associated with SCD. Previously diagnosed diabetes was associated with depressive symptoms at baseline (ß = 0.04, SE = 0.02, p = 0.01), and greater SCD at follow-up (β = -0.19, SE = 0.06, p = 0.001). Mediation analyses revealed that 9% of the association between diabetes and SCD was attributable to an indirect effect through depressive symptoms (ß = -0.01, 95% CI 0.02-0.001, p 
  17. Ismail I, Bulgiba A
    Prev Med, 2013;57 Suppl:S27-30.
    PMID: 23295172 DOI: 10.1016/j.ypmed.2012.12.023
    To determine predictors of unsuccessful treatment in HIV-infected tuberculosis (TB) patients.
  18. Fransen HP, Beulens JW, May AM, Struijk EA, Boer JM, de Wit GA, et al.
    Prev Med, 2015 Aug;77:119-24.
    PMID: 26007298 DOI: 10.1016/j.ypmed.2015.05.014
    Dietary patterns have been associated with the incidence or mortality of individual non-communicable diseases, but their association with disease burden has received little attention.
  19. Hairi NN, Bulgiba A, Peramalah D, Mudla I
    Prev Med, 2013 Jan;56(1):8-11.
    PMID: 23103916 DOI: 10.1016/j.ypmed.2012.10.016
    Managing stairs is a challenging activity of daily living (ADL) for older people. This study aims to examine the association between visual impairment and difficulty in managing stairs among older people living alone and those living with others.
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