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Fulltext A Longitudinal Evaluation of the Preferences of Patients With Advanced Cancer for Quality of Life and Survival in Malaysia: A Discrete Choice Experiment

Yong ASJ, Lim KK, Fox-Rushby J, Ismail F, Hamzah E, Cheong MWL, et al.

Value Health, 2023 Dec;26(12):1772-1781.
PMID: 37741445 DOI: 10.1016/j.jval.2023.08.009

OBJECTIVES: This study aims to quantify the preferences of patients with advanced cancer for quality of life (QoL) outcomes versus survival extension in Malaysia. The secondary aim of this study is to explore the change in preferences over time.
METHODS: A discrete choice experiment was developed to include 7 attributes valued in cancer management: physical, psychological and social functioning, pain control, survival, place of death, and cost. Patients were recruited via convenience sampling from 2 Malaysian public hospitals. The survey questionnaire was administered to patients within 6 months of their cancer diagnosis with a follow-up 3 months later. Conditional logit regression was used to estimate the preference weight, relative attribute importance, and willingness to pay.
RESULTS: One hundred valid responses were collected at baseline and 45 at follow-up. Respondents placed higher values on QoL improvements from severe to moderate or mild levels and to achieve home death over survival extension from 6 to 18 months. However, additional improvements (from moderate to mild) in some of the QoL outcomes were not valued as highly as life extension from 12 to 18 months, showing that it was vital for patients to avoid being in "severe" health dysfunction. Improving physical dysfunction from severe to mild yielded 3 times as much value as additional 1-year survival. After 3 months, the respondents' preferences changed significantly, with increased relative attribute importance of physical functioning, pain control, and cost.
CONCLUSIONS: As QoL outcomes are valued more than survival, palliative care should be introduced as early as possible to alleviate suffering related to advanced cancer.

Matched MeSH terms: Choice Behavior
A choice experiment analysis for solid waste disposal option: a case study in Malaysia

Pek CK, Jamal O

J Environ Manage, 2011 Nov;92(11):2993-3001.
PMID: 21820795 DOI: 10.1016/j.jenvman.2011.07.013

In Malaysia, most municipal wastes currently are disposed into poorly managed 'controlled tipping' systems with little or no pollution protection measures. This study was undertaken to assist the relevant governmental bodies and service providers to identify an improved waste disposal management strategy. The study applied the choice experiment technique to estimate the nonmarket values for a number of waste disposal technologies. Implicit prices for environmental attributes such as psychological fear, land use, air pollution, and river water quality were estimated. Compensating surplus estimates incorporating distance from the residences of the respondents to the proposed disposal facility were calculated for a number of generic and technology-specific choice sets. The resulting estimates were higher for technology-specific options, and the distance factor was a significant determinant in setting an equitable solid waste management fee.

Matched MeSH terms: Choice Behavior
Fulltext A study of marketing and its effect on infant feeding practices

Suleiman A

Med J Malaysia, 2001 Sep;56(3):319-23.
PMID: 11732077

A baby milk market was created in the late nineteenth and early twentieth centuries and was conceived through the mutual attraction of the manufacturers and doctors. This has partly attributed to the change from breast to artificial feeding. This study was conducted to determine whether marketing had any effect on infant feeding practices. Fifty Malay mothers whose last child was aged less than five years were asked, by questionnaire and by interview, to identify whether several marketing methods influenced their decision on the selection of infant feeding practice. It was found that these mothers felt milk advertisements on television were attractive (72%), were influenced by others to buy a particular brand of formula (38.4%), were influenced by free milk samples to buy a particular brand of milk formula (65.2%) and were not influenced by their doctors on the chosen method of feeding (68%). More studies should be conducted on a bigger sample in other settings and targeting other methods of marketing to substantiate the above results. Further, similar studies among Chinese and Indian mothers are also required.

Matched MeSH terms: Choice Behavior*
Fulltext Acute coronary syndrome in the elderly: the Malaysian National Cardiovascular Disease Database-Acute Coronary Syndrome registry

Zuhdi AS, Ahmad WA, Zaki RA, Mariapun J, Ali RM, Sari NM, et al.

Singapore Med J, 2016 Apr;57(4):191-7.
PMID: 26768171 DOI: 10.11622/smedj.2015145

The elderly are often underrepresented in clinical trials for acute coronary syndrome (ACS), and cardiologists commonly face management dilemmas in the choice of treatment for this group of patients, particularly concerning the use of invasive revascularisation. This study analysed the characteristics of hospitalised elderly patients with ACS, and compared the outcomes of treatments.

Matched MeSH terms: Choice Behavior
Assessing clinical reasoning skills of final year medical students using the script concordance test

Velayudhan Menon, Rifdy Mohideen

International e-Journal of Science, Medicine & Education, 2016;10(1):36-40.
MyJurnal

Background: Clinical reasoning is the name given to
the cognitive processes by which doctors evaluate and
analyse information from patients. It is a skill developed
by experiential learning and is difficult to assess
objectively. The script concordance test, an assessment
tool introduced into the health sciences about 15 years
ago, is a way of assessing clinical reasoning ability in
an objective manner and allows comparisons of the
decisions made by medical students and experts in
situations of uncertainty.

Methods: Twenty-six final year medical students from
the International Medical University, Kuala Lumpur,
were tested on their decision making skills regarding a
young febrile patient. The students evaluated different
pieces of information in five different scenarios and
made decisions on a five-point Likert scale in the
standard format of the script concordance test. Their
decisions were compared to the decisions of a panel of
experienced clinicians in Internal Medicine.

Results: The script concordance test scores for the
different scenarios were calculated with higher scores
being indicative of greater concordance between the
reasoning of students and doctors. The students showed
poor concordance with doctors in evaluating clinical
information. Overall, only 20 percent of the choices
made by students were the same as the choices made by
the majority of doctors.

Conclusion: Medical students vary in their ability to
interpret the significance of clinical information. Using
the script concordance test, this preliminary study looked
at the ability of final year medical students to interpret
information about a patient with a febrile illness. The
results showed poor concordance between students and
doctors in the way they interpreted clinical information.
The script concordance test has the potential to be a
tool for teaching and assessing clinical reasoning.

Matched MeSH terms: Choice Behavior
Assessment of health seeking behaviour and self-medication among general public in the state of Penang, Malaysia

Dawood OT, Hassali MA, Saleem F, Ibrahim IR, Abdulameer AH, Jasim HH

Pharm Pract (Granada), 2017 Jul-Sep;15(3):991.
PMID: 28943981 DOI: 10.18549/PharmPract.2017.03.991

BACKGROUND: Patients' behaviour in making decisions regarding health is currently changing from passive recipients to recipients who play an active role in taking action to control their health and taking self-care initiatives.
OBJECTIVES: This study was conducted to evaluate the health seeking behaviour among general public and its associated factors; and to evaluate the medicine taking behaviour in public and the practice of self-medication.
METHODS: A cross-sectional study was undertaken among general public in Penang Island, Malaysia. A convenience sampling of 888 participants successfully completed the survey. Self-administered questionnaires were distributed among the residents in the north east of Penang Island.
RESULTS: This study showed that most of the participants chose to consult the physician when they experience any health problems (66.7%), followed by self-medication (20.9%). The first action for consulting the physician was significantly predicted by Malay respondents and retired people (OR 3.05, 95% CI 1.04-8.89). The prevalence of self-medication was 54%. The practice of self-medication was significantly associated with Chinese participants, educated people, people with alone living status and people with more self-care orientation.
CONCLUSION: Increasing the awareness of the public about the rational choice of getting medical assistance is a very important issue to control their health. A health education program is needed to increase the awareness about the use of medicines among the general public and to enable them to make the right decisions relating to health problems.

Matched MeSH terms: Choice Behavior
Fulltext Attributes of a competent forensic odontologist

Rahmat, R.A., James, H., Nambiar, P.

Malaysian Dental Journal, 2015;37(1):9-16.
MyJurnal

Forensic odontology has been an interdisciplinary part of forensic science for many years. In Malaysia, this forensic discipline has been practiced for more than two decades however it is still considered a new discipline as there are a limited number of specialists. To date, there are less than ten practicing forensic odontologists in Malaysia. Many dentists do not have a clear perception of this field, thus forensic odontology rarely becomes a career of choice. The purpose of this article is to highlight the attributes of a competent forensic odontologist and encourage dentists towards this challenging career path.

Matched MeSH terms: Choice Behavior
Fulltext Behaviour-Based Safety (BBS) implementation reduce incidents at the workplace in major industry

Rosliza Osman, Noorhasimah Awang, Siti Nasyrah Ibrahim, Siti Nurani Hassan, Norsyahidah Mohammad Yusof, Jais Suratman, et al.

Journal of Occupational Safety and Health, 2015;12(1):105-108.
MyJurnal

Unsafe behaviour is the key factor which contributes to the high number of incidents. Applying Behavior-Based
Safety (BBS) into safety risk controls has been adopted in major industry toward improving safety performance.
This approach to prevent incident has a number of advantages. The objective of this study is to identify the BBS
factors which can contribute to reduce incidents at the workplace. Human factors, behaviour and environment have
been identified as BBS factors. Human factors are influenced by knowledge and understanding of the workers while
behaviour factors are influenced by culture and practices in a daily life. In addition, environmental factor involves
equipment and work area. For an effective BBS approach, level of knowledge, understanding and practices by the
workers become the main concerns in the implementation of BBS. The findings can become the reference model for
future implementation in other organizations and as a guidance for better safety management.

Matched MeSH terms: Choice Behavior
Fulltext Career choices of Malaysian medical students

Deva MP

Med J Malaysia, 1981 Sep;36(3):188-92.
PMID: 7329378
Matched MeSH terms: Choice Behavior*
Choice and constraints in floodplain occupation: the influence of structural factors on residential location in peninsular Malaysia

Chan NW

Disasters, 1995 Dec;19(4):287-307.
PMID: 8564454

In Peninsular Malaysia 'structural' factors are found to influence strongly people's persistent occupation of floodplains. Thus, despite a high level of flood hazard awareness, a high level of pessimism and a high level of expectation of future floods, poorer individuals seldom attempt to leave for more advantageous locations but are instead trapped in their present locations by structural factors such as poverty, low residential and occupational mobility, low educational attainment, traditional land inheritance, government aid, and government disaster preparedness, relief and rehabilitation programmes. These forces exert a strong influence upon individuals and largely control their choice of residential location in response to flood hazards, thereby reinforcing the persistent occupation of floodplains. Structural factors such as landlessness, rural-urban migration, floodplain encroachment and squatting are also highly influential in leading people to move. Even for those who move, structural factors have largely confined their choice of residential location to urban floodplains.

Matched MeSH terms: Choice Behavior*
Choice of noxious facilities: case of a solid waste incinerator versus a sanitary landfill in Malaysia

Othman J, Khee PC

Waste Manag Res, 2014 May;32(5):454-7.
PMID: 24595362 DOI: 10.1177/0734242X14523662

A choice experiment analysis was conducted to estimate the preference for specific waste disposal technologies in Malaysia. The study found that there were no significant differences between the choice of a sanitary landfill or an incinerator. What matters is whether any disposal technology would lead to obvious social benefits. A waste disposal plan which is well linked or integrated with the community will ensure its acceptance. Local authorities will be challenged to identify solid waste disposal sites that are technically appropriate and also socially desirable.

Matched MeSH terms: Choice Behavior
Choosing health, constrained choices

Chee Khoon Chan

Glob Health Promot, 2009 Dec;16(4):54-7.
PMID: 20028669 DOI: 10.1177/1757975909348131

In parallel with the neo-liberal retrenchment of the welfarist state, an increasing emphasis on the responsibility of individuals in managing their own affairs and their well-being has been evident. In the health arena for instance, this was a major theme permeating the UK government's White Paper Choosing Health: Making Healthy Choices Easier (2004), which appealed to an ethos of autonomy and self-actualization through activity and consumption which merited esteem. As a counterpoint to this growing trend of informed responsibilization, constrained choices (constrained agency) provides a useful framework for a judicious balance and sense of proportion between an individual behavioural focus and a focus on societal, systemic, and structural determinants of health and well-being. Constrained choices is also a conceptual bridge between responsibilization and population health which could be further developed within an integrative biosocial perspective one might refer to as the social ecology of health and disease.

Matched MeSH terms: Choice Behavior*
Fulltext Clinical decision making ability of nursing students in a tertiary hospital

Ho, S.E., Koo, Y.L., Ismail, S., Hing, H.L., Widad, O., Chung, H.T., et al.

Medicine & Health, 2013;8(2):73-80.
MyJurnal

Decision making in nursing is one of the most important skills nurses must apply and utilize in their nursing practice. The aim of this study was to determine the perception of clinical decision making ability among nursing students. A descriptive cross-sectional study was conducted in a tertiary hospital. A total of 54 nursing students were recruited using a modified version of Clinical Decision Making in Nursing Scale (CDMNS) adapted from Jenkins (1985). The findings showed good CDMNS score with mean and standard deviation of (124.24±12.713). The four sub-scales of CDMNS were: searching for alternative (33.24±4.821), canvassing (28.74±3.514), evaluation and re-evaluation (31.43±3.922), searching for information (30.83±4.765). Nineteen (35%) of the participants chose nursing as their first choice, whereas 35 participants (65%) did not. Thirthy seven (69%) participants were satisfied with their nursing competency, 17 (31%) were unsatisfied. There were significant differences between searching for alternatives, evaluation and re-evaluation, and nursing as their first choice (p=

Study site: Nursing students, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

Matched MeSH terms: Choice Behavior
Fulltext Consumers’ demand and willingness to pay for rice attributes in Malaysia

Ahmad Hanis, I.A.H., Jinap, S, Mad Nasir, S., Alias, R., Muhammad Shahrim, A.K.

International Food Research Journal, 2012;19(1):363-369.
MyJurnal

The growth of the Malaysian’s per capita income has generally empowered consumers to have more choices for food, more purchasing power, health consciousness and demand for more nutritional values of their food intake. Motivated by the changes in Malaysian consumer’s food choice, a conjoint analysis was performed to investigate Malaysian consumers’ demand for rice attributes and how much consumers are willing to pay for the demanded attribute. A conjoint analysis is a method used in identifying and understanding the combined effects of product attributes on preferences for a product or service. In conjoint analysis, utility is the conceptual basis for assessing the value of a product or service, where individuals make decisions between bundles of products based on their budget constraints. The findings suggested that the most important attribute for rice was food safety, followed by taste and size of grain. Consumers were also willing to pay premium prices for the demanded attributes. The findings would have positive implications for the agrifood industry if it responds effectively to translate into business opportunities to these changes.

Matched MeSH terms: Choice Behavior
Contraceptive choice and acceptability: the future for STI risk in Kelantan, Malaysia

Shiely F, Saifuddin MS

Int J STD AIDS, 2014 Mar;25(3):219-27.
PMID: 23970646 DOI: 10.1177/0956462413497699

More than 150 million women become pregnant in developing countries annually and an estimated 287,000 die from pregnancy-related causes. Contraception is vital to prevent unnecessary maternal deaths, as well as sexually transmitted infections. The objective of this study was to investigate preferred contraceptive methods and the factors that influence contraceptive choice among women in Kelantan, Malaysia. A cross-sectional study using interview-based questionnaires was conducted, during July and August 2009, in local family planning clinics in Kelantan. The questionnaire was administered to adult women (age 20-50). Prevalence of unplanned pregnancies was high (48%). Contraceptive preference was Depo contraceptive injection (32%), oral contraceptive pills (27%), intrauterine devices (15%) and contraceptive implants (12%); 9% used condoms. Only 2% used contraception to protect against sexually transmitted infections or HIV/AIDS. Younger women (OR 0.90; 95% CI 0.807-0.993) were more likely to use contraception. In conclusion, non-interrupted contraceptive methods were preferred. More than 60% would stop using contraception if it interrupted intercourse. From both a public health and infectious disease perspective, this is extremely worrying.

Matched MeSH terms: Choice Behavior*
Contraceptive method switching over women's reproductive careers: evidence from Malaysian life history data, 1940s-70s

DaVanzo J, Reboussin D, Starbird E, Tan BA, Hadi SA

J Biosoc Sci Suppl, 1989;11:95-116.
PMID: 2489987

Several new concepts are used to describe contraceptive use histories for nearly 1200 women in Peninsular Malaysia. These histories are summarized by 81 episode histories. Transition matrices provide useful summaries of the changes women make in their contraceptive practice from one pregnancy interval to the next. Data from the mid-1940s to mid-1970s, during which period there was a dramatic increase in contraceptive use, reveal considerable inertia in individual couples' contraceptive practice. Persistence with a method was greater the less effective the method: while 86% of couples using no method in one interval used no method in the next, only 56% of couples using the pill in one interval also used it in the next. Virtually all transitions are of three types: continuation with the same method, a change from no method to some method, or a change from some method to no method. For only 1% of all pregnancies did couples use one contraceptive method before a pregnancy and a different method after the pregnancy. Differences are examined by calendar year and education.

Matched MeSH terms: Choice Behavior*
Fulltext Contrasting Computational Models of Mate Preference Integration Across 45 Countries

Conroy-Beam D, Buss DM, Asao K, Sorokowska A, Sorokowski P, Aavik T, et al.

Sci Rep, 2019 11 15;9(1):16885.
PMID: 31729413 DOI: 10.1038/s41598-019-52748-8

Humans express a wide array of ideal mate preferences. Around the world, people desire romantic partners who are intelligent, healthy, kind, physically attractive, wealthy, and more. In order for these ideal preferences to guide the choice of actual romantic partners, human mating psychology must possess a means to integrate information across these many preference dimensions into summaries of the overall mate value of their potential mates. Here we explore the computational design of this mate preference integration process using a large sample of n = 14,487 people from 45 countries around the world. We combine this large cross-cultural sample with agent-based models to compare eight hypothesized models of human mating markets. Across cultures, people higher in mate value appear to experience greater power of choice on the mating market in that they set higher ideal standards, better fulfill their preferences in choice, and pair with higher mate value partners. Furthermore, we find that this cross-culturally universal pattern of mate choice is most consistent with a Euclidean model of mate preference integration.

Matched MeSH terms: Choice Behavior/physiology*
Fulltext Customer Restaurant Choice: An Empirical Analysis of Restaurant Types and Eating-out Occasions

Chua BL, Karim S, Lee S, Han H

Int J Environ Res Public Health, 2020 08 28;17(17).
PMID: 32872267 DOI: 10.3390/ijerph17176276

This study investigated restaurant customers' perceived importance of key factors in accordance with dining occasions and restaurant segments. Our investigation into restaurant selection and situational factors present two types of empirical evidence regarding customers' choice of restaurant. First, menu price was customers' top priority in restaurant selections for full-service, quick-casual, and quick-service restaurants. Second, restaurant customers rated the importance level of restaurant selection criteria differently according to eating-out occasions. The importance of menu price was greatest for both quick meal/convenience and social occasion, brand reputation was the most important factor for business necessity, and word-of-mouth recommendation was greatest for celebration.

Matched MeSH terms: Choice Behavior*
Fulltext Decision making procedure based on Jaccard similarity measure with z-numbers

Mohamad, D., Ibrahim, S.Z.

Pertanika Journal of Science & Technology, 2017;25(2):561-574.
MyJurnal

Fuzzy set with similarity measure approaches are known to be effective in handling imprecise and
subjective information to solve decision making problems. Many methods have been introduced based on these two concepts. However, most methods do not take into account the reliability factor of the imprecise information in the evaluation process. In 2010, Zadeh coined the idea of Z-number that has the ability to consider the reliability factor or the level of confidence of human’s information expression. Since then, some decision-making methods have included this concept. In this paper, we present a new fuzzy decision making procedure by integrating the Jaccard similarity measure with Z-number to solve a multi criteria decision making problem. The conversion method of the Z-number based linguistic value to trapezoidal fuzzy numbers is used and the Jaccard similarity measure of the expected intervals of trapezoidal fuzzy numbers is applied to obtain the final decision. The feasibility of the methodology is demonstrated by investigating the preference factors that could influence customers to buy their preferred choice of car. The proposed methodology is applicable to solving decision making with a fuzzy environment to achieve a reliable and optimal decision.

Matched MeSH terms: Choice Behavior
Fulltext Determining the impact of pre-lecture educational video on comprehension of a difficult gross anatomy lecture

Hadie SNH, Simok AA, Shamsuddin SA, Mohammad JA

J Taibah Univ Med Sci, 2019 Aug;14(4):395-401.
PMID: 31488974 DOI: 10.1016/j.jtumed.2019.06.008

Objective: Students commonly perceive gross anatomy lectures as difficult because they contain complex information that requires three-dimensional visualisation in order to be understood. Without prior preparation, a gross anatomy topic expounded via lecture can be cognitively challenging. Hence, this study aimed to investigate the impact of a pre-lecture activity in the form of viewing a video on students' lecture comprehension.
Method: A quasi-experimental study was conducted using 254 first-year medical students with no prior exposure to the lecture topic during the 2016/17 and 2017/18 academic sessions. The students from each batch were divided into two groups and exposed to different video material. Group A watched an action movie, while Group B watched an educational video related to the lecture topic. After 15 min, both groups attended a lecture on the gross anatomy of the heart, which was delivered by a qualified anatomist. At the end of the lecture, their understanding of the material was measured through a post-lecture test using ten vetted multiple choice true/false questions.
Results: Group B's test scores were found to be significantly higher than Group A's (p > 0.001, t-stats [df] = -4.21 [252]).
Conclusion: This study concluded that the pre-lecture activity had successfully provided the students with some prior knowledge of the subject before they attended the lecture sessions. This finding was aligned with cognitive load theory, which describes a reduction in learners' cognitive load when prior knowledge is stimulated.

Matched MeSH terms: Choice Behavior

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