Displaying publications 1 - 20 of 228 in total

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  1. Future Priorities in Tackling Infections Due to Brain-Eating Amoebae
    Khan NA, Anwar A, Siddiqui R
    ACS Chem Neurosci, 2017 11 15;8(11):2355.
    PMID: 28933530 DOI: 10.1021/acschemneuro.7b00343
    Brain-eating amoebae (Acanthamoeba spp., Balamuthia mandrillaris, and Naegleria fowleri) can cause opportunistic infections involving the central nervous system. It is troubling that the mortality rate is more than 90% despite advances in antimicrobial chemotherapy over the last few decades. Here, we describe urgent key priorities for improving outcomes from infections due to brain-eating amoebae.
    Matched MeSH terms: Health Services Accessibility
  2. Fulltext Gender Differences in HIV Risk Behaviors Among Persons Involved in the U.S. Criminal Justice System and Living with HIV or at Risk for HIV: A "Seek, Test, Treat, and Retain" Harmonization Consortium
    Loeliger KB, Biggs ML, Young R, Seal DW, Beckwith CG, Kuo I, et al.
    AIDS Behav, 2017 Oct;21(10):2945-2957.
    PMID: 28188460 DOI: 10.1007/s10461-017-1722-9
    The U.S. female criminal justice (CJ) population is rapidly growing, yet large-scale studies exploring gender-specific HIV risk behaviors in the CJ population are lacking. This analysis uses baseline data on adults with a CJ history from eight U.S. studies in an NIH-funded "Seek, Test, Treat, Retain" harmonization consortium. Data were collected using a standardized HIV risk behavior assessment tool and pooled across studies to describe participants' characteristics and risk behaviors. Multilevel mixed-effects logistic regression models were used to test for gender-based behavior differences. Among 784 HIV-positive (21.4% female) and 5521 HIV-negative (8.5% female) participants, HIV-positive women had higher odds than HIV-positive men of engaging in condomless sexual intercourse (AOR 1.84 [1.16-2.95]) with potentially sero-discordant partners (AOR 2.40 [1.41-4.09]) and of sharing injection equipment (AOR 3.36 [1.31-8.63]). HIV risk reduction interventions targeting CJ-involved women with HIV are urgently needed as this population may represent an under-recognized potential source of HIV transmission.
    Matched MeSH terms: Health Services Accessibility
  3. Meta-synthesis of Qualitative Research of Pre-exposure Prophylaxis (PrEP) Adherence Among Men Who Have Sex With Men (MSM)
    Ching SZ, Wong LP, Said MAB, Lim SH
    AIDS Educ Prev, 2020 10;32(5):416-431.
    PMID: 33112675 DOI: 10.1521/aeap.2020.32.5.416
    The aim of the study was to consolidate evidence on barriers and facilitators to PrEP adherence among men who have sex with men. PubMed, Science Direct, and EBSCO host were utilized to search for relevant articles. Six articles from PubMed, published between 2010 and 2018, were reviewed. Thematic analysis was employed to synthesize findings. At the individual level, HIV susceptibility, knowledge of PrEP, and individual lifestyle affected PrEP adherence. At the organizational level, cost of PrEP and quality of PrEP services influenced adherence to PrEP. At the societal level, social stigma, financial assistance or medical insurance, and family and peer support were determinants of PrEP adherence. Facilitators included perceived high risk of HIV infection and payment assistance, while barriers included social stigma and high cost of PrEP. Social stigma and structural level factors such as payment assistance and cost of PrEP need to be examined to ensure optimal adherence to PrEP.
    Matched MeSH terms: Health Services Accessibility*
  4. A Qualitative Study of Young Men Who Have Sex With Men and Multilevel Factors Related to HIV Risks in Malaysia
    Burch WJ, Hart GJ, Lim SH
    AIDS Educ Prev, 2018 04;30(2):85-95.
    PMID: 29688771 DOI: 10.1521/aeap.2018.30.2.85
    Young men who have sex with men (YMSM) are a group at high risk for HIV infection, yet no research has been conducted to understand this population in Malaysia. Semistructured interviews from a combination of YMSM aged 18-25 (n = 20) and local service providers of sexual health services (n = 4) were conducted from May to June 2015. Thematic analysis was used to identify common themes in participant responses from transcripts. Participants reported societal and internalized homophobia, an absence of sex education and difficulty accessing confidential HIV testing. This study provides insights into how homophobia in Malaysian society influences individual risk behavior for HIV in Malaysian YMSM, and makes practical suggestions for more effective HIV prevention in this population.
    Matched MeSH terms: Health Services Accessibility*
  5. Mapping timely access to emergency and essential surgical services: The Malaysian experience
    Hoh SM, Wahab MYA, Hisham AN, Guest GD, Watters DAK
    ANZ J Surg, 2021 Jun 01.
    PMID: 34075677 DOI: 10.1111/ans.16986
    BACKGROUND: Surgical conditions form a significant proportion of the global burden of disease. Since the 2015 World Health Assembly resolution A68.15, there is recognition that the provision of essential surgical care is an integral part of universal access to health care. The Lancet Commission on Global Surgery proposed its first surgical indicator to measure a population's access to the Bellwether procedures (laparotomy, caesarean section and treatment of open fracture) within two hours. Bellwether access is a proxy for emergency and essential surgical care. This project aims to map essential surgical access to the Bellwether procedures in Malaysia.

    METHODS: The location and capability of hospitals to perform the Bellwether procedures was obtained from the Ministry of Health (MoH) and MoH hospital specific websites. The Malaysian population data were retrieved from the national department of statistics. Times for patients to travel to hospital were calculated by combining manual contouring and geospatial mapping.

    RESULTS: There were 49 Bellwether-capable MoH hospitals serving a national population of 32.5 million. Overall 94% of Malaysia's population have access to the Bellwethers within two hours. This coverage is universal in West (Peninsular) Malaysia, but there is only 73% coverage in East Malaysia, with 1.8 million residents of Sabah and Sarawak not having timely access. Malaysia's Bellwether capacity compares well with other countries in World Health Organisation's Western Pacific region.

    CONCLUSION: There is good access to essential and emergency surgical services in Malaysia. The incomplete access for 1.8 million people in East Malaysia will inform national surgical planning.

    Matched MeSH terms: Health Services Accessibility
  6. Balancing access and safety in prescribing opioid agonist therapy to prevent HIV transmission
    Bachireddy C, Weisberg DF, Altice FL
    Addiction, 2015 Dec;110(12):1869-71.
    PMID: 26464200 DOI: 10.1111/add.13055
    Matched MeSH terms: Health Services Accessibility
  7. Fulltext Cessation assistance reported by smokers in 15 countries participating in the International Tobacco Control (ITC) policy evaluation surveys
    Borland R, Li L, Driezen P, Wilson N, Hammond D, Thompson ME, et al.
    Addiction, 2012 Jan;107(1):197-205.
    PMID: 21883605 DOI: 10.1111/j.1360-0443.2011.03636.x
    AIMS: To describe some of the variability across the world in levels of quit smoking attempts and use of various forms of cessation support.

    DESIGN: Use of the International Tobacco Control Policy Evaluation Project surveys of smokers, using the 2007 survey wave (or later, where necessary).

    SETTINGS: Australia, Canada, China, France, Germany, Ireland, Malaysia, Mexico, the Netherlands, New Zealand, South Korea, Thailand, United Kingdom, Uruguay and United States.

    PARTICIPANTS: Samples of smokers from 15 countries.

    MEASUREMENTS: Self-report on use of cessation aids and on visits to health professionals and provision of cessation advice during the visits.

    FINDINGS: Prevalence of quit attempts in the last year varied from less than 20% to more than 50% across countries. Similarly, smokers varied greatly in reporting visiting health professionals in the last year (<20% to over 70%), and among those who did, provision of advice to quit also varied greatly. There was also marked variability in the levels and types of help reported. Use of medication was generally more common than use of behavioural support, except where medications are not readily available.

    CONCLUSIONS: There is wide variation across countries in rates of attempts to stop smoking and use of assistance with higher overall use of medication than behavioural support. There is also wide variation in the provision of brief advice to stop by health professionals.

    Matched MeSH terms: Health Services Accessibility
  8. Neglected diseases and ethnic minorities in the Western Pacific Region exploring the links
    Schratz A, Pineda MF, Reforma LG, Fox NM, Le Anh T, Tommaso Cavalli-Sforza L, et al.
    Adv Parasitol, 2010;72:79-107.
    PMID: 20624529 DOI: 10.1016/S0065-308X(10)72004-2
    Ethnic minority groups (EMGs) are often subject to exclusion, marginalization and poverty. These characteristics render them particularly vulnerable to neglected diseases, a diverse group of diseases that comprise bacteria, ecto-parasites, fungi, helminths and viruses. Despite the health policy relevance, only little is known of the epidemiological profile of neglected diseases among EMGs. We reviewed country data from Australia, Cambodia, Lao People's Democratic Republic, Malaysia, the Philippines and Vietnam and found several overlaps between regions with high proportions of EMG population and high prevalence rates of neglected diseases (infections with soil-transmitted helminths, filarial worms, schistosomes, food-borne trematodes and cestodes). While the links are not always clearly evident and it is impossible to establish correlations among highly aggregated data without control variables-such as environmental factors-there appear indeed to be important linkages between EMGs, socio-economic status and prevalence of neglected diseases. Some determinants under consideration are lack of access to health care and general health status, poverty and social marginalization, as well as education and literacy. Further research is needed to deepen the understanding of these linkages and to determine their public health and socio-economic significance. In particular, there is a need for more data from all countries in the Western Pacific Region that is disaggregated below the provincial level. Selected case studies that incorporate other control variables-such as risk factors from the physical environment-might be useful to inform policy makers about the feasibility of prevention and control interventions that are targeted at high-risk EMGs.
    Matched MeSH terms: Health Services Accessibility
  9. Services for older people in Malaysia: issues and challenges
    Poi PJ, Forsyth DR, Chan DK
    Age Ageing, 2004 Sep;33(5):444-6.
    PMID: 15315917
    Matched MeSH terms: Health Services Accessibility/trends
  10. Fulltext The view of gastroenterologists on non-cardiac chest pain in Asia
    Cheung TK, Lim PW, Wong BC
    Aliment Pharmacol Ther, 2007 Aug 15;26(4):597-603.
    PMID: 17661763 DOI: 10.1111/j.1365-2036.2007.03403.x
    BACKGROUND: Non-cardiac chest pain is an important disorder in Asia. The practice and views of gastroenterologists on non-cardiac chest pain in this region are not known.
    AIMS: To determine the current understanding, diagnostic practice and treatment strategies among gastroenterologists on the management of non-cardiac chest pain in Asia.
    METHODS: A 24-item questionnaire was sent to gastroenterologists in Mainland China, Hong Kong, Malaysia, Indonesia, Philippines, Singapore, Taiwan and Thailand.
    RESULTS: 186 gastroenterologists participated with a response rate of 74%. 98% of gastroenterologists managed patients with non-cardiac chest pain over the last 6 months. 64% felt that the number of non-cardiac chest pain patients was increasing and 85% believed that the most common cause of non-cardiac chest pain was GERD. 94% of the gastroenterologists believed that they should manage non-cardiac chest pain patients, but only 41% were comfortable in diagnosing non-cardiac chest pain. The average number of investigations performed was four in non-cardiac chest pain patients, and oesophago-gastro-duodenoscopy was the most commonly used initial test. A proton pump inhibitor was considered the first-line treatment in non-cardiac chest pain and was reported as the most effective treatment by the gastroenterologists.
    CONCLUSION: Most gastroenterologists were practicing evidence-based medicine, but frequent use of investigations and a lack of awareness of the role of visceral hypersensitivity in non-cardiac chest pain patients were noted.
    Matched MeSH terms: Health Services Accessibility
  11. Semai Senoi mortality: Two-census method
    Fix AG
    Am J Hum Biol, 1989;1(4):471-477.
    PMID: 28514106 DOI: 10.1002/ajhb.1310010410
    The mortality pattern of a subpopulation of Semai Senoi of Malaysia is studied by using a two-census method. The method yields abridged life tables for both sexes as well as an estimate of the birth rate. The life tables show that Semai mortality is reduced compared to estimates based on stable population methods for the population prior to 1969. Increased health care availability seems to account for this lower mortality.
    Matched MeSH terms: Health Services Accessibility
  12. Dialysis Care and Dialysis Funding in Asia
    Tang SCW, Yu X, Chen HC, Kashihara N, Park HC, Liew A, et al.
    Am J Kidney Dis, 2020 05;75(5):772-781.
    PMID: 31699518 DOI: 10.1053/j.ajkd.2019.08.005
    Asia is the largest and most populated continent in the world, with a high burden of kidney failure. In this Policy Forum article, we explore dialysis care and dialysis funding in 17 countries in Asia, describing conditions in both developed and developing nations across the region. In 13 of the 17 countries surveyed, diabetes is the most common cause of kidney failure. Due to great variation in gross domestic product per capita across Asian countries, disparities in the provision of kidney replacement therapy (KRT) exist both within and between countries. A number of Asian nations have satisfactory access to KRT and have comprehensive KRT registries to help inform practices, but some do not, particularly among low- and low-to-middle-income countries. Given these differences, we describe the economic status, burden of kidney failure, and cost of KRT across the different modalities to both governments and patients and how changes in health policy over time affect outcomes. Emerging trends suggest that more affluent nations and those with universal health care or access to insurance have much higher prevalent dialysis and transplantation rates, while in less affluent nations, dialysis access may be limited and when available, provided less frequently than optimal. These trends are also reflected by an association between nephrologist prevalence and individual nations' incomes and a disparity in the number of nephrologists per million population and per thousand KRT patients.
    Matched MeSH terms: Health Services Accessibility
  13. Fulltext Oral health care for children in countries using dental therapists in public, school-based programs, contrasted with that of the United States, using dentists in a private practice model
    Mathu-Muju KR, Friedman JW, Nash DA
    Am J Public Health, 2013 Sep;103(9):e7-e13.
    PMID: 23865650 DOI: 10.2105/AJPH.2013.301251
    The United States faces a significant problem with access to oral health care, particularly for children. More than 50 countries have developed an alternative dental provider, a dental therapist, practicing in public, school-based programs, to address children's access to care. This delivery model has been demonstrated to improve access to care and oral health outcomes while providing quality care economically. We summarize elements of a recent major review of the global literature on the use of dental therapists, "A Review of the Global Literature on Dental Therapists: In the Context of the Movement to Add Dental Therapists to the Oral Health Workforce in the United States." We contrast the success of a school-based model of caring for children by dental therapists with that of the US model of dentists providing care for children in private practices.
    Matched MeSH terms: Health Services Accessibility
  14. Comparison of the effectiveness of trauma services provided by secondary and tertiary hospitals in Malaysia
    Sethi D, Aljunid S, Saperi SB, Clemens F, Hardy P, Elbourne D, et al.
    Ann Emerg Med, 2007 Jan;49(1):52-61, 61.e1.
    PMID: 17084938
    STUDY OBJECTIVE: The trauma services provided by 6 hospitals operating at 2 levels of care (4 secondary or district general hospitals and 2 tertiary care hospitals) in Malaysia are compared in terms of mortality and disability for direct admissions to emergency departments to test the hypothesis that care at a tertiary care hospital is better than at a district general hospital.
    METHODS: All cases were recruited prospectively for 1 year. The hospitals were purposefully selected as typical for Malaysia. There are 3 primary outcome measures: death, musculoskeletal impairment, and disability at discharge. Adjustment was made for potential covariates and within-hospital clustering by using multivariable random-effects logistic regression analysis.
    RESULTS: For direct admissions, logistic-regression-identified odds of dying were associated with older age (>55 years), odds ratio (OR) 1.9 (95% confidence interval [CI] 1.3 to 2.8); head injury, OR 2.7 (95% CI 1.9 to 3.9); arrival by means other than ambulance, OR 0.6 (95% CI 0.4 to 0.8); severe injuries (Injury Severity Score >15) at a district general hospital, OR 45.2 (95% CI 27.0 to 75.7); severe injuries at a tertiary care hospital, OR 11.2 (95% CI 7.3 to 17.3); and admission to a tertiary care hospital compared to a district general hospital if severely injured (Injury Severity Score >15), OR 0.2 (95% CI 0.1 to 0.4). Admission to a tertiary care hospital was associated with increased odds of disability (OR 1.9; 95% CI 1.5 to 2.3) and musculoskeletal impairment (OR 3.5; 95% CI 2.7 to 4.4) at discharge.
    CONCLUSION: Care at a tertiary care hospital was associated with reduced mortality (by 83% in severe injuries), but with a higher likelihood of disability and impairment, which has implications for improving access to trauma services for the severely injured in Malaysia and other low- and middle-income settings.
    Matched MeSH terms: Health Services Accessibility
  15. Sex inequality in kidney transplantation rates
    Schaubel DE, Stewart DE, Morrison HI, Zimmerman DL, Cameron JI, Jeffery JJ, et al.
    Arch. Intern. Med., 2000 8 6;160(15):2349-54.
    PMID: 10927733 DOI: 10.1001/archinte.160.15.2349
    BACKGROUND: Men in the United States undergoing renal replacement therapy are more likely than women to receive a kidney transplant. However, the ability to pay may, in part, be responsible for this finding.

    OBJECTIVE: To compare adult male and female transplantation rates in a setting in which equal access to medical treatment is assumed.

    METHODS: Using data from the Canadian Organ Replacement Register, the rate of first transplantations was computed for the 20, 131 men and the 13,458 women aged 20 years or older who initiated renal replacement therapy between January 1, 1981, and December 31, 1996. Poisson regression analysis was used to estimate the male-female transplantation rate ratio, adjusting for age, race, province, calendar period, underlying disease leading to renal failure, and dialytic modality. Actuarial survival methods were used to compare transplantation probability for covariable-matched cohorts of men and women.

    RESULTS: Men experienced 20% greater covariable-adjusted kidney transplantation rates relative to women (rate ratio, 1.20; 95% confidence interval, 1.13-1.27). The sex disparity was stronger for cadaveric transplants (rate ratio, 1.23) compared with those from living donors (rate ratio, 1.10). The 5-year probability of receiving a transplant was 47% for men and 39% for women within covariable-matched cohorts (P
    Matched MeSH terms: Health Services Accessibility/statistics & numerical data
  16. Accessibility of breast and cervical cancer services in Malaysia
    Arrows Change, 1997 Dec;3(3):3.
    PMID: 12294552
    Matched MeSH terms: Health Services Accessibility*
  17. A glimpse of public health in China
    Low WY, Binns C
    Asia Pac J Public Health, 2015 Mar;27(2 Suppl):7S-8S.
    PMID: 25712494 DOI: 10.1177/1010539515574405
    Matched MeSH terms: Health Services Accessibility/organization & administration
  18. Access to safe legal abortion in Malaysia: women's insights and health sector response
    Low WY, Tong WT, Wong YL, Jegasothy R, Choong SP
    Asia Pac J Public Health, 2015 Jan;27(1):33-7.
    PMID: 25452590 DOI: 10.1177/1010539514562275
    Malaysia has an abortion law, which permits termination of pregnancy to save a woman's life and to preserve her physical and mental health (Penal Code Section 312, amended in 1989). However, lack of clear interpretation and understanding of the law results in women facing difficulties in accessing abortion information and services. Some health care providers were unaware of the legalities of abortion in Malaysia and influenced by their personal beliefs with regard to provision of abortion services. Accessibility to safer abortion techniques is also an issue. The development of the 2012 Guidelines on Termination of Pregnancy and Guidelines for Management of Sexual and Reproductive Health among Adolescents in Health Clinics by the Ministry of Health, Malaysia, is a step forward toward increasing women's accessibility to safe abortion services in Malaysia. This article provides an account of women's accessibility to abortion in Malaysia and the health sector response in addressing the barriers.
    Matched MeSH terms: Health Services Accessibility*
  19. Sexuality education in Malaysia: perceived issues and barriers by professionals
    Khalaf ZF, Low WY, Merghati-Khoei E, Ghorbani B
    Asia Pac J Public Health, 2014 Jul;26(4):358-66.
    PMID: 24489084 DOI: 10.1177/1010539513517258
    This research explored the perspectives of Malaysian professionals on the issues and barriers affecting the implementation of sexuality education in Malaysia. This qualitative study involved in-depth interviews with 15 key professionals working in the field of sexuality and reproductive health in Malaysia. Thematic analysis was selected to analyze data. Barriers to sexuality education were perceived from 5 aspects: feasibility, acceptability, accountability, strategies, and community unawareness. Respondents believed that implementing national sexuality education is a time-consuming project. They regarded Malaysian multicultural society as a barrier to national sexuality education, and they believed that school-based sexuality education is not easily accomplished in Malaysia; also abstinence-only policy restricts the access of young people to accurate information. Lack of community involvement was perceived as a key concern to sexuality education. Campaigning to promote awareness of families, teachers, community leaders, and policy makers are recommended to help establishing national sexuality education in Malaysia.
    Matched MeSH terms: Health Services Accessibility*
  20. Key quality aspect: a fundamental step for quality improvement in a resource-poor setting
    Su TT, Sax S
    Asia Pac J Public Health, 2009 Oct;21(4):477-86.
    PMID: 19666950 DOI: 10.1177/1010539509342433
    The objective of the study is to identify user's perception of key quality aspects of the hospital and its influence on willingness to pay. The study was conducted in 2001 in Dhading District Hospital, Nepal. This was a descriptive, cross-sectional study design using quantitative and qualitative methods: questionnaire exit interview and focus group discussions with inpatients and outpatients, focus group discussion with service providers, and key informant interviews. The research identified attitude, technical and interpersonal skills of health personnel, availability of drugs and services as important quality aspects to be improved. Users were motivated to use this hospital and were ready to pay if they received proper treatment from skilled and communicative staff. This study highlights the importance of identifying the quality factors important to service users as a first step in improving quality. For the users within this study, this meant improving attitude, interpersonal skills, and technical skills of service personnel.
    Matched MeSH terms: Health Services Accessibility
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