Displaying publications 1 - 20 of 39 in total

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  1. Testing the agreement of medical instruments: overestimation of bias in the Bland-Altman analysis
    Zaki R, Bulgiba A, Ismail NA
    Prev Med, 2013;57 Suppl:S80-2.
    PMID: 23313586 DOI: 10.1016/j.ypmed.2013.01.003
    The Bland-Altman method is the most popular method used to assess the agreement of medical instruments. The main concern about this method is the presence of proportional bias. The slope of the regression line fitted to the Bland-Altman plot should be tested to exclude proportional bias. The aim of this study was to determine whether the overestimation of bias in the Bland-Altman analysis is still present even when the proportional bias has been excluded.
  2. Fulltext Accelerating action on cervical screening in lower- and middle-income countries (LMICs) post COVID-19 era
    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. Correlates between risk perceptions of cervical cancer and screening practice
    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
  4. Prevalence and factors associated with HIV/AIDS-related stigma and discriminatory attitudes: a cross-sectional nationwide study
    Wong LP
    Prev Med, 2013;57 Suppl:S60-3.
    PMID: 23583477 DOI: 10.1016/j.ypmed.2013.03.013
    OBJECTIVE: The prime purpose of this study is to assess HIV/AIDS-related self-stigma and discrimination (S&D) attitudes and associated factors using multivariate analysis of data from the 2010-11 National Survey of Understanding the Root of HIV/AIDS Related Stigma and Discrimination.
    METHOD: A national telephone survey was carried out with 2271 of the Malaysian public aged 18-60 years. The sample was contacted by random digit dialing covering the whole of Peninsular Malaysia from December 2010 to May 2011. The HIV-transmission knowledge, HIV-related self-stigma, and public stigma were investigated.
    RESULTS: Despite high level of HIV-transmission knowledge [mean (SD)=10.56 (2.42), mean score at 70th percentile] the respondents in this study had moderate levels (mean scores near midpoints) of self-stigma and public stigma attitudes. HIV-transmission knowledge score was not significantly correlated with self-stigma score, but showed a significantly small positive effect (r<0.2) for public stigma scores. Ethnicity is the strongest correlate of HIV-transmission knowledge, self-stigma, and public stigma attitudes in the multivariate analyses. Other significant correlates were age, socioeconomic group, and urban-rural setting.
    CONCLUSIONS: The root causes of HIV stigma and discriminatory attitudes were not associated with knowledge deficiency. Interventions should be oriented towards promoting de-stigmatization of HIV/AIDS, and tailored socio-culturally.
    KEYWORDS: Discriminatory; HIV/AIDS; Knowledge; Stigma
  5. Temporal changes in psychobehavioral responses during the 2009 H1N1 influenza pandemic
    Wong LP, Sam IC
    Prev Med, 2010 Jul;51(1):92-3.
    PMID: 20403375 DOI: 10.1016/j.ypmed.2010.04.010
    This paper aimed to examine the temporal changes in psychobehavioral responses in relation to reported 2009 H1N1 influenza deaths.
  6. Association between self-reported physical activity and indicators of body composition in Malaysian adolescents
    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. Clinical Epidemiology (CE) and Evidence-Based Medicine (EBM) in the Asia Pacific region (Round Table Forum)
    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.
  8. Socioeconomic consequences of the 2004 tsunami: policy implications for natural disaster management
    Su TT, Saimy BI, Bulgiba AM
    Prev Med, 2013;57 Suppl:S74-6.
    PMID: 23313790 DOI: 10.1016/j.ypmed.2012.12.024
    The objective of the study is to assess the socioeconomic status of the households affected by the tsunami of 2004 & to determine the factors associated with the recovery of household economic status.
  9. Metabolic syndrome and antipsychotic monotherapy treatment among schizophrenia patients in Malaysia
    Said MA, Hatim A, Habil MH, Zafidah W, Haslina MY, Badiah Y, et al.
    Prev Med, 2013;57 Suppl:S50-3.
    PMID: 23337566 DOI: 10.1016/j.ypmed.2013.01.005
    OBJECTIVE: The objective of this study is to determine the prevalence of metabolic syndrome among schizophrenia patients receiving antipsychotic monotherapy in Malaysia.
    METHOD: A cross-sectional study was conducted at multiple centres between June 2008 and September 2011. Two hundred and five patients who fulfilled the DSM IV-TR diagnostic criteria for schizophrenia and who had been on antipsychotic medication for at least one year, were screened for metabolic syndrome. Patients receiving a mood stabilizer were excluded from the study. Metabolic syndrome was defined by using the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults Treatment Panel III (ATP III) modified for Asian waist circumference.
    RESULTS: In the first-generation antipsychotic (FGA) group, the highest prevalence of metabolic syndrome was among patients treated with trifluoperazine and flupenthixol decanoate (66.7% each). For the second-generation antipsychotic (SGA) group, the highest prevalence of metabolic syndrome was among patients treated with clozapine (66.7%). The component with the highest prevalence in metabolic syndrome was waist circumference in both FGA and SGA groups except for aripiprazole in SGA.
    CONCLUSION: The prevalence of metabolic syndrome in schizophrenia patients receiving antipsychotic monotherapy in Malaysia was very high. Intervention measures are urgently needed to combat these problems.
    KEYWORDS: Antipsychotics; Metabolic syndrome; Monotherapy; Prevalence; Schizophrenia
  10. Behavioural and psychological symptoms of dementia, cognitive impairment and caregiver burden in patients with dementia
    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
  11. A comparison of smoking behaviour characteristics between Caucasian smokers in the United Kingdom and Malay smokers in Malaysia
    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
  12. Does one cigarette make an adolescent smoker, and is it influenced by age and age of smoking initiation? Evidence of association from the U.S. Youth Risk Behavior Surveillance System (2011)
    Reidpath DD, Davey TM, Kadirvelu A, Soyiri IN, Allotey P
    Prev Med, 2014 Feb;59:37-41.
    PMID: 24270054 DOI: 10.1016/j.ypmed.2013.11.011
    OBJECTIVES: Evidence that age of smoking initiation represents a risk factor for regular smoking in adolescence is complicated by inconsistencies in the operational definition of smoking initiation and simultaneous inclusion of age as an explanatory variable. The aim of this study was to examine the relationship between age, age of smoking initiation and subsequent regular smoking.
    METHODS: A secondary analysis was conducted of the U.S. Youth Risk Behavior Survey 2011. A sex stratified multivariable logistic regression analysis was used to model the likelihood of regular smoking with age and age of smoking initiation as explanatory variables and race/ethnicity as a covariate.
    RESULTS: After controlling for race/ethnicity, age and age of smoking initiation were independently associated with regular smoking in males and females. Independent of age, a one year's decrease in the age of smoking initiation was associated with a 1.27 times increase in odds of regular smoking in females (95% CI: 1.192-1.348); and similar associations for males (OR: 1.28; 95% CI: 1.216-1.341).
    CONCLUSION: While the majority of high school students do not become regular smokers after initiating smoking, earlier initiation of smoking is associated with subsequent regular smoking irrespective of sex or race/ethnicity. These findings have potentially important implications for intervention targeting.
    KEYWORDS: Adolescent; Epidemiology; Smoking
  13. Low nocturnal ocular perfusion pressure as a risk factor for normal tension glaucoma
    Ramli N, Nurull BS, Hairi NN, Mimiwati Z
    Prev Med, 2013;57 Suppl:S47-9.
    PMID: 23352960 DOI: 10.1016/j.ypmed.2013.01.007
    In the absence of raised intraocular pressure (IOP), haemodynamic parameters have been implicated in the development of normal tension glaucoma (NTG). The purpose of this study is to compare 24-hour IOP and haemodynamic parameters in NTG patients and non-glaucoma patients.
  14. Risk factors of leptospirosis among febrile hospital admissions in northeastern Malaysia
    Rafizah AA, Aziah BD, Azwany YN, Imran MK, Rusli AM, Nazri SM, et al.
    Prev Med, 2013;57 Suppl:S11-3.
    PMID: 23295174 DOI: 10.1016/j.ypmed.2012.12.017
    Leptospirosis is a worldwide zoonotic disease. Risk factors for the disease may vary among countries.
  15. Fulltext The status of men's health in Asia
    Ng CJ, Teo CH, Ho CC, Tan WP, Tan HM
    Prev Med, 2014 Oct;67:295-302.
    PMID: 25117523 DOI: 10.1016/j.ypmed.2014.08.007
    This study aims to compare health status and its risk factors between men and women who are from countries of different income status in Asia.
  16. Stroke incidence in the South West District of the Penang Island, Malaysia: PEARLs: Penang Acute Stroke Research Longitudinal Study
    Neelamegam M, Looi I, Cheah WK, Narayanan P, Hamid AM, Ong LM
    Prev Med, 2013;57 Suppl:S77-9.
    PMID: 23295169 DOI: 10.1016/j.ypmed.2012.12.022
    This community based incidence study aims to report the stroke incidence in the south-west region of the Penang Island.
  17. Delays in time to primary treatment after a diagnosis of breast cancer: does it impact survival?
    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.
  18. Electronic nicotine delivery system use and its relation to waterpipe smoking among youth in seven Arab countries
    Mohammad MS, Aburezq M, AlSaeed N, Abdullah Z, Fayrouz S, Almunefi K, et al.
    Prev Med, 2024 Apr 02;182:107945.
    PMID: 38574972 DOI: 10.1016/j.ypmed.2024.107945
    OBJECTIVES: Electronic Nicotine Delivery System (ENDS) use and Waterpipe Tobacco Smoking (WTS) are reported to be a growing strain of tobacco epidemic among youth in the Arab world. Therefore, we aimed to: (1) estimate the regional prevalence of ENDS use among youth in 7 Arab countries and, (2) to explore the bidirectional relationship between ENDS use and WTS among Arab adolescents.

    METHODS: We analyzed data from the World Health Organization Global Youth Tobacco Survey (GYTS 2014-2018) of 18,536 schoolchildren aged 12-16 from Iraq, Mauritania, Morocco, Oman, Qatar, Tunisia, and Yemen. The weighted prevalence was calculated to generate nationally representative estimates. Adjusted multilevel logistic regression models were conducted to assess the association between ENDS use and WTS.

    RESULTS: The pooled weighted prevalence of ENDS use was 9.5%. Higher odds of ENDS use were significantly associated with WTS (AOR: 5.26, 95%CI: 4.28-6.46), smoking conventional cigarettes (AOR: 1.54, 95%CI: 1.23-1.94) and first tobacco use prior to the age of 12 (AOR: 1.40, 95%CI: 1.14-1.72). Females and children who were taught in school the dangers of tobacco had less odds of using ENDS.

    CONCLUSION: WTS was associated with increased odds of ENDS use by >5 folds, and vice versa. Tobacco consumption at age younger than 12 years was associated with higher odds of ENDS use, but less odds of WTS. Females and those who were taught in school the dangers of tobacco were less likely to report ENDS use.

  19. Prevalence and associated factors of stress in the Malaysian Police Force
    Masilamani R, Bulgiba A, Chinna K, Darus A, Isahak M, Kandiben S, et al.
    Prev Med, 2013;57 Suppl:S57-9.
    PMID: 23352959 DOI: 10.1016/j.ypmed.2013.01.008
    This study aims to determine the prevalence of stress and the associated socio-demographic and work factors among police personnel in Metropolitan Kuala Lumpur, Malaysia.
  20. Suicide prevention program for at-risk groups: pointers from an epidemiological study
    Maniam T, Chinna K, Lim CH, Kadir AB, Nurashikin I, Salina AA, et al.
    Prev Med, 2013;57 Suppl:S45-6.
    PMID: 23454536 DOI: 10.1016/j.ypmed.2013.02.022
    The aim of this paper is to identify at-risk groups for a focused suicide prevention program for Malaysia.
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