Displaying publications 1 - 20 of 202 in total

  1. Islam R, Ahmad R, Ghailan K, Hoque KE
    J Relig Health, 2020 Jun;59(3):1327-1343.
    PMID: 31134517 DOI: 10.1007/s10943-019-00832-8
    People with HIV/AIDS (PLWHA) commonly pose problems to their family as well as to society because of their vulnerable health and economic conditions. Contrarily, PLWHA encounter social discrimination and adverse realities while finding it difficult to continue in their jobs. These complex phenomena interact to push them into a low economic status. A microfinance program can hopefully assist poor patients to cope with the negative economic consequences of this disease. But the conventional market-oriented microfinance institutions show reluctance to serve this group of people due to the possibilities of having credit risk. In this paper, we propose an alternative microfinancing technique that can provide a better economic life of the PLWHA while absorbing the credit risks. A comprehensive model is designed using specific Islamic financial instruments in conjugation with household economic portfolio theory. Critical realism method was adopted to construct this model. We concluded that the application of Islamic microfinance can enhance income of HIV patients while reducing the productivity-loss. This model can be useful to the microfinance practitioners and policymakers for addressing a different market segment, diversifying products, and formulating policy.
    Matched MeSH terms: Income/statistics & numerical data
  2. Ting CY, Teh GC, Yu KL, Alias H, Tan HM, Wong LP
    Support Care Cancer, 2020 Apr;28(4):1703-1715.
    PMID: 31292755 DOI: 10.1007/s00520-019-04975-y
    PURPOSE: This study examined the prevalence of financial toxicity (FT) and associated factors among urologic cancer patients. The association between FT and health-related quality of life (HRQoL) was also investigated.

    METHODS: A total of 429 respondents diagnosed with urologic cancers (prostate cancer, bladder and renal cancer) from Sarawak General Hospital and Subang Jaya Medical Centre in Malaysia were interviewed using a structured questionnaire. Objective and subjective FT were measured by catastrophic health expenditure (healthcare-cost-to-income ratio greater than 40%) and the Personal Financial Well-being Scale, respectively. HRQoL was measured with the Functional Assessment of Cancer Therapy - General 7 Items scale.

    RESULTS: Objective and subjective FT were experienced by 16.1 and 47.3% of the respondents, respectively. Respondents who sought treatment at a private hospital and had out-of-pocket health expenditures were more likely to experience objective FT, after adjustment for covariates. Respondents who were female and had a monthly household income less than MYR 5000 were more likely to experience average to high subjective FT. Greater objective FT (OR = 2.75, 95% CI 1.09-6.95) and subjective FT (OR = 4.68, 95% CI 2.63-8.30) were associated with poor HRQoL.

    CONCLUSIONS: The significant association between both objective and subjective FT and HRQoL highlights the importance of reducing FT among urologic cancer patients. Subjective FT was found to have a greater negative impact on HRQoL.

    Matched MeSH terms: Income/statistics & numerical data
  3. Yusuf S, Joseph P, Rangarajan S, Islam S, Mente A, Hystad P, et al.
    Lancet, 2020 03 07;395(10226):795-808.
    PMID: 31492503 DOI: 10.1016/S0140-6736(19)32008-2
    BACKGROUND: Global estimates of the effect of common modifiable risk factors on cardiovascular disease and mortality are largely based on data from separate studies, using different methodologies. The Prospective Urban Rural Epidemiology (PURE) study overcomes these limitations by using similar methods to prospectively measure the effect of modifiable risk factors on cardiovascular disease and mortality across 21 countries (spanning five continents) grouped by different economic levels.

    METHODS: In this multinational, prospective cohort study, we examined associations for 14 potentially modifiable risk factors with mortality and cardiovascular disease in 155 722 participants without a prior history of cardiovascular disease from 21 high-income, middle-income, or low-income countries (HICs, MICs, or LICs). The primary outcomes for this paper were composites of cardiovascular disease events (defined as cardiovascular death, myocardial infarction, stroke, and heart failure) and mortality. We describe the prevalence, hazard ratios (HRs), and population-attributable fractions (PAFs) for cardiovascular disease and mortality associated with a cluster of behavioural factors (ie, tobacco use, alcohol, diet, physical activity, and sodium intake), metabolic factors (ie, lipids, blood pressure, diabetes, obesity), socioeconomic and psychosocial factors (ie, education, symptoms of depression), grip strength, and household and ambient pollution. Associations between risk factors and the outcomes were established using multivariable Cox frailty models and using PAFs for the entire cohort, and also by countries grouped by income level. Associations are presented as HRs and PAFs with 95% CIs.

    FINDINGS: Between Jan 6, 2005, and Dec 4, 2016, 155 722 participants were enrolled and followed up for measurement of risk factors. 17 249 (11·1%) participants were from HICs, 102 680 (65·9%) were from MICs, and 35 793 (23·0%) from LICs. Approximately 70% of cardiovascular disease cases and deaths in the overall study population were attributed to modifiable risk factors. Metabolic factors were the predominant risk factors for cardiovascular disease (41·2% of the PAF), with hypertension being the largest (22·3% of the PAF). As a cluster, behavioural risk factors contributed most to deaths (26·3% of the PAF), although the single largest risk factor was a low education level (12·5% of the PAF). Ambient air pollution was associated with 13·9% of the PAF for cardiovascular disease, although different statistical methods were used for this analysis. In MICs and LICs, household air pollution, poor diet, low education, and low grip strength had stronger effects on cardiovascular disease or mortality than in HICs.

    INTERPRETATION: Most cardiovascular disease cases and deaths can be attributed to a small number of common, modifiable risk factors. While some factors have extensive global effects (eg, hypertension and education), others (eg, household air pollution and poor diet) vary by a country's economic level. Health policies should focus on risk factors that have the greatest effects on averting cardiovascular disease and death globally, with additional emphasis on risk factors of greatest importance in specific groups of countries.

    FUNDING: Full funding sources are listed at the end of the paper (see Acknowledgments).

    Matched MeSH terms: Income
  4. Farooq F, Yusop Z, Chaudhry IS, Iram R
    Environ Sci Pollut Res Int, 2020 Mar;27(7):6904-6917.
    PMID: 31879877 DOI: 10.1007/s11356-019-07289-y
    The contemporary debate on globalization and gender equality has a strong impact on economic growth. The present study analyzes the impacts of globalization and gender parity on economic growth in the Organization of Islamic Cooperation (OIC) 47 member countries for the period (1991-2017), using System GMM panel data technique. The results of system GMM have also been empirically estimated by making two groups (viz., low-income and high-income OIC member countries from the World Bank data classification, 2019) to examine the robustness of globalization and gender parity on economic growth. The results reveal that there is a negative impact of globalization on economic growth in the overall sample of OIC countries. When estimated by decomposing low-income countries and high-income countries, globalization has a significantly positive impact on economic growth in the case of high-income OIC countries, whereas globalization slashes GDP in the case of low-income OIC countries. The study finds that there is a positive impact of gender parity (ratio of female to male labor force work participation) on economic growth. Moreover, foreign remittances, government expenditures, capital formation, and human capital are also becoming the causes of a significant increase in economic growth in OIC member countries.
    Matched MeSH terms: Income
  5. Gill AR, Hassan S, Haseeb M
    Environ Sci Pollut Res Int, 2019 Nov;26(33):34468-34478.
    PMID: 31642017 DOI: 10.1007/s11356-019-06565-1
    This research article aims to investigate the moderating role of financial development in Environmental Kuznets Curve (EKC) in the context of Malaysia for the period 1970-2016. As the time series variables are integrated of different order therefore, Auto-Regressive Distributed Lag (ARDL) model has been employed to estimate the long-run equilibrium relationship among the variables. The results indicate that EKC does exist for Malaysia and financial development has negative impact on carbon emission. Moreover, financial development is found to have significant moderating impact on income environment relation. More financial development brings early turning point of the EKC. The results recommend that financial development can be used as one of the policy measures to reduce the environmental cost of economic growth in Malaysia.
    Matched MeSH terms: Income
  6. Kongpakwattana K, Ademi Z, Chaiyasothi T, Nathisuwan S, Zomer E, Liew D, et al.
    Pharmacoeconomics, 2019 Oct;37(10):1277-1286.
    PMID: 31243736 DOI: 10.1007/s40273-019-00820-6
    BACKGROUND: Using non-statin lipid-modifying agents in combination with statin therapy provides additional benefits for cardiovascular disease (CVD) risk reduction, but their value for money has only been evaluated in high-income countries (HICs). Furthermore, studies mainly derive effectiveness data from a single trial or older meta-analyses.

    OBJECTIVES: Our study used data from the most recent network meta-analysis (NMA) and local parameters to assess the cost effectiveness of non-statin agents in statin-treated patients with a history of CVD.

    METHODS: A published Markov model was adopted to investigate lifetime outcomes: (1) number of recurrent CVD events prevented, (2) quality-adjusted life-years (QALYs) gained, (3) costs and (4) incremental cost-effectiveness ratios (ICERs) of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) and ezetimibe added to statin therapy. Event rates and effectiveness inputs were obtained from the NMA. Cost and utility data were gathered from published studies conducted in Thailand. A series of sensitivity analyses were performed.

    RESULTS: Patients receiving PCSK9i and ezetimibe experienced fewer recurrent CVD events (number needed to treat [NNT] 17 and 30) and more QALYs (0.168 and 0.096 QALYs gained per person). However, under the societal perspective and at current acquisition costs in 2018, ICERs of both agents were $US1,223,995 and 27,361 per QALY gained, respectively. Based on threshold analyses, the costs need to be reduced by 97 and 85%, respectively, for PCSK9i and ezetimibe to be cost-effective.

    CONCLUSIONS: Despite the proven effectiveness of PCSK9i and ezetimibe, the costs of these agents need to reduce to a much greater extent than in HICs to be cost-effective in Thailand.

    Matched MeSH terms: Income
  7. Ehigiamusoe KU, Lean HH
    Environ Sci Pollut Res Int, 2019 Aug;26(22):22611-22624.
    PMID: 31165972 DOI: 10.1007/s11356-019-05309-5
    This paper examines the effects of energy consumption, economic growth, and financial development on carbon emissions in a panel of 122 countries. We employ both first-generation and second-generation cointegration and estimation procedures in order to address diverse economic and econometric issues such as heterogeneity, endogeneity, and cross-sectional dependence. We find a cointegration relationship between the variables. Energy consumption, economic growth, and financial development have detrimental effects on carbon emissions in the full sample. When the sample is split into different income groups, we reveal that economic growth and financial development mitigate carbon emissions in high-income group but have the opposite effects in low-income and middle-income groups. The implication of the findings is that energy consumption increases carbon emissions. While high levels of income and financial development decrease carbon emissions, low levels of income and financial development intensify it. Based on the findings, the paper makes some policy recommendations.
    Matched MeSH terms: Income
  8. Liang JB, Paengkoum P
    Asian-australas. J. Anim. Sci., 2019 Aug;32(8):1233-1243.
    PMID: 31357264 DOI: 10.5713/ajas.19.0272
    Asia hosts more than half of the world's 1 billion goats and is also where domestication of wild goats began. Goats, including dairy goats, are adapted to a wide variety of harsh environments and thus play key roles as providers of nutrition, food security and socio-economic status to their human owners in many low-income Asian countries. In many countries in Southeast and East Asia, medium and large scale commercial dairy goat farming can be profitable enterprises because of the high price of goat milk, and good demand due to its health and medicinal properties. In some Asian countries, dairy goats play important roles in non-commercial activities, including use as educational animals in elementary schools in Japan and show animals in Indonesia. Dairy goat farmers in Asia are faced with numerous challenges, such as a shortage of high producing animals adapted to the local environment, lack of quality feeds during a prolonged dry season, many diseases and difficulty getting their product to market, however, the increasing demand for goat milk in the newly developed and developed economies in Asia provides an optimistic future for dairy goat production in this region.
    Matched MeSH terms: Income
  9. Lee HW, Wong VW
    Hepatology, 2019 Jul 12.
    PMID: 31298746 DOI: 10.1002/hep.30848
    In Factfulness, the late Dr. Hans Rosling illustrated how most people grossly underestimated education, income, life expectancy, and vaccination rates in low-income countries.(1) It is natural human psychology to have fixed images about the developing world. Nonetheless, the world is changing. According to the latest World Bank figures, 184 of 218 (84%) countries or regions are now classified as middle-income or high-income economies.(2) Many countries previously labeled as developing countries (such as Armenia, Colombia, Malaysia, and Serbia) are now classified as upper-middle-income economies. Although many problems remain and deserve our attention, Dr. Rosling emphasized that it is equally important to recognize that there is progress and many policies do work. Otherwise, we risk dismissing useful strategies and impeding their implementation. This article is protected by copyright. All rights reserved.
    Matched MeSH terms: Income
  10. Vijayasingham L, Rhule E, Asgari-Jirhandeh N, Allotey P
    Lancet Glob Health, 2019 07;7(7):e843-e844.
    PMID: 31200884 DOI: 10.1016/S2214-109X(19)30196-2
    Matched MeSH terms: Income
  11. Sehreen F, Masud MM, Akhtar R, Masum MRA
    Environ Monit Assess, 2019 Jun 22;191(7):457.
    PMID: 31230139 DOI: 10.1007/s10661-019-7595-9
    The city of Dhaka has been ranked repeatedly as the most polluted, the most populous, and the most unbearable city in the world. More than 19.5 million inhabitants live in Dhaka, and the population growth rate of urban areas in Bangladesh is almost double that of rural areas. Rapid urbanization is one of the leading contributors to water pollution in Dhaka and could prevent the country from achieving sustainable development. Therefore, this study estimates respondents' willingness to pay (WTP) to improve water pollution management systems and identifies factors that influence WTP in Dhaka. This study employed the contingent valuation method (CVM) to estimate WTP of the respondents. Data were collected using a structured questionnaire with CVM questions, which was distributed to households in the study areas. The results revealed that 67% of the respondents are willing to pay for an improved water pollution management system, while 31.8% of households are unwilling to pay. The study also found that socio-economic factors (e.g., income and education) and perception significantly influence WTP. Therefore, this paper will provide directives for policymakers in developing an effective policy framework, as well as sensitize all stakeholders to the management of water pollution in Dhaka. The study suggests that social institutions, financial institutions, banks, non-government organizations (NGOs), insurance companies, and the government could provide effective outreach programs for water pollution management as part of their social responsibility.
    Matched MeSH terms: Income
  12. Poh BK, Lee ST, Yeo GS, Tang KC, Noor Afifah AR, Siti Hanisa A, et al.
    BMC Public Health, 2019 Jun 13;19(Suppl 4):541.
    PMID: 31196019 DOI: 10.1186/s12889-019-6856-4
    BACKGROUND: Socioeconomic factors and nutritional status have been associated with childhood cognitive development. However, previous Malaysian studies had been conducted with small populations and had inconsistent results. Thus, this present study aims to determine the association between socioeconomic and nutritional status with cognitive performance in a nationally representative sample of Malaysian children.

    METHODS: A total of 2406 Malaysian children aged 5 to 12 years, who had participated in the South East Asian Nutrition Surveys (SEANUTS), were included in this study. Cognitive performance [non-verbal intelligence quotient (IQ)] was measured using Raven's Progressive Matrices, while socioeconomic characteristics were determined using parent-report questionnaires. Body mass index (BMI) was calculated using measured weight and height, while BMI-for-age Z-score (BAZ) and height-for-age Z-score (HAZ) were determined using WHO 2007 growth reference.

    RESULTS: Overall, about a third (35.0%) of the children had above average non-verbal IQ (high average: 110-119; superior: ≥120 and above), while only 12.2% were categorized as having low/borderline IQ ( 3SD), children from very low household income families and children whose parents had only up to primary level education had the highest prevalence of low/borderline non-verbal IQ, compared to their non-obese and higher socioeconomic counterparts. Parental lack of education was associated with low/borderline/below average IQ [paternal, OR = 2.38 (95%CI 1.22, 4.62); maternal, OR = 2.64 (95%CI 1.32, 5.30)]. Children from the lowest income group were twice as likely to have low/borderline/below average IQ [OR = 2.01 (95%CI 1.16, 3.49)]. Children with severe obesity were twice as likely to have poor non-verbal IQ than children with normal BMI [OR = 2.28 (95%CI 1.23, 4.24)].

    CONCLUSIONS: Children from disadvantaged backgrounds (that is those from very low income families and those whose parents had primary education or lower) and children with severe obesity are more likely to have poor non-verbal IQ. Further studies to investigate the social and environmental factors linked to cognitive performance will provide deeper insights into the measures that can be taken to improve the cognitive performance of Malaysian children.

    Matched MeSH terms: Income
  13. Hishan SS, Sasmoko, Khan A, Ahmad J, Hassan ZB, Zaman K, et al.
    Environ Sci Pollut Res Int, 2019 Jun;26(16):16503-16518.
    PMID: 30980369 DOI: 10.1007/s11356-019-05056-7
    The Sub-Saharan Africa (SSA) is far lag behind the sustainable targets that set out in the United Nation's Sustainable Development Goals (SDGs), which is highly needed to embark the priorities by their member countries to devise sustainable policies for accessing clean technologies, energy demand, finance, and food production to mitigate high-mass carbon emissions and conserve environmental agenda in the national policy agenda. The study evaluated United Nation's SDGs for environmental conservation and emission reduction in the panel of 35 selected SSA countries, during a period of 1995-2016. The study further analyzed the variable's relationship in inter-temporal forecasting framework for the next 10 years' time period, i.e., 2017-2026. The parameter estimates for the two models, i.e., CO2 model and PM2.5 models are analyzed by Generalized Method of Moment (GMM) estimator that handle possible endogeneity issue from the given models. The results rejected the inverted U-shaped Environmental Kuznets Curve (EKC) for CO2 emissions, while it supported for PM2.5 emissions with a turning point of US$5540 GDP per capita in constant 2010 US$. The results supported the "pollution haven hypothesis" for CO2 emissions, while this hypothesis is not verified for PM2.5 emissions. The major detrimental factors are technologies, FDI inflows, and food deficit that largely increase carbon emissions in a panel of SSA countries. The IPAT hypothesis is not verified in both the emissions; however, population density will largely influenced CO2 emissions in the next 10 years' time period. The PM2.5 emissions will largely be influenced by high per capita income, followed by trade openness, and technologies, over a time horizon. Thus, the United Nation's sustainable development agenda is highly influenced by socio-economic and environmental factors that need sound action plans by their member countries to coordinate and collaborate with each other and work for Africa's green growth agenda.
    Matched MeSH terms: Income
  14. Ozturk I, Al-Mulali U, Solarin SA
    Environ Sci Pollut Res Int, 2019 Jun;26(17):17277-17283.
    PMID: 31012074 DOI: 10.1007/s11356-019-05016-1
    This study aims at exploring the impact of corruption control on energy efficiency in 60 countries categorized by income: lower middle (LMI), upper middle (UMI), and high (HI). Panel methodology was utilized taking the period of 2000-2017. As cross-sectional dependence is confirmed among the tested equations, the Pesaran (J Appl Econ 22(2):265-312, 2007) unit root test and the augmented mean group estimator proposed by Eberhardt and Teal (2010) were utilized to overcome this matter. The results in general indicate that the lower the corruption is, the more the energy efficiency for all income group economies. Moreover, renewable energy reduces energy efficiency in lower-middle income and high-income economies while its effect is positive in middle-income economies. In addition, the environmental Kuznets curve (EKC) found to be present in all income group economies. Lastly, causality relationships among energy efficiency, corruption, and GDP were present mostly in upper-middle income and high-income economies. From the results, it was recommended that the countries from all income groups should increase their corruption control for the purpose of enhancing energy efficiency.
    Matched MeSH terms: Income
  15. Uddin GA, Alam K, Gow J
    Environ Sci Pollut Res Int, 2019 May;26(13):13159-13172.
    PMID: 30903468 DOI: 10.1007/s11356-019-04791-1
    The relationship between national income growth and the environment of 14 Asian economies over a 50 year period is examined using the Environmental Kuznets Curve (EKC) hypothesis. Ecological Footprint (EF) measures environmental impacts and gross domestic product (GDP) measures economic growth. It is hypothesised that increased rates of economic growth come at a cost to the natural environment. The EKC hypothesis has been mainly tested in the literature by cross-sectional or panel data methods. In this study, it is tested using time series analysis through initially examining the relationship between EF and GDP using linear, quadratic and cubic estimating OLS regression functions. In the second stage, the long-run relationship between EF and GDP is investigated using an augmented error correction trend model. There is a statistically significant cointegrated long-run relationship between the variables in most of the countries. The EKC hypothesis is supported in the case of India, Nepal, Malaysia and Pakistan with the other countries exhibiting a positive linear relationship between the two variables. Almost all error correction terms are correct in sign and significance that implies that some percentage of disequilibria in EF in the previous year adjusts back to the long-run equilibrium in the current year. Based on the long-run relationship, it is apparent that rapid economic growth has had an impact on the environment and the ecosystems of these countries over the last 50 years. Despite that, until now, not many of them have taken sufficient steps to reduce their EF or to improve their bioproductive capacity.
    Matched MeSH terms: Income
  16. Zack R, Okunade O, Olson E, Salt M, Amodeo C, Anchala R, et al.
    Hypertension, 2019 05;73(5):990-997.
    PMID: 30929516 DOI: 10.1161/HYPERTENSIONAHA.118.11916
    High blood pressure is the leading modifiable risk factor for mortality, accounting for nearly 1 in 5 deaths worldwide and 1 in 11 in low-income countries. Hypertension control remains a challenge, especially in low-resource settings. One approach to improvement is the prioritization of patient-centered care. However, consensus on the outcomes that matter most to patients is lacking. We aimed to define a standard set of patient-centered outcomes for evaluating hypertension management in low- and middle-income countries. The International Consortium for Health Outcomes Measurement convened a Working Group of 18 experts and patients representing 15 countries. We used a modified Delphi process to reach consensus on a set of outcomes, case-mix variables, and a timeline to guide data collection. Literature reviews, patient interviews, a patient validation survey, and an open review by hypertension experts informed the set. The set contains 18 clinical and patient-reported outcomes that reflect patient priorities and evidence-based hypertension management and case-mix variables to allow comparisons between providers. The domains included are hypertension control, cardiovascular complications, health-related quality of life, financial burden of care, medication burden, satisfaction with care, health literacy, and health behaviors. We present a core list of outcomes for evaluating hypertension care. They account for the unique challenges healthcare providers and patients face in low- and middle-income countries, yet are relevant to all settings. We believe that it is a vital step toward international benchmarking in hypertension care and, ultimately, value-based hypertension management.
    Matched MeSH terms: Income*
  17. Qureshi MI, Yusoff RM, Hishan SS, Alam AF, Zaman K, Rasli AM
    Environ Sci Pollut Res Int, 2019 May;26(15):15496-15509.
    PMID: 30937745 DOI: 10.1007/s11356-019-04866-z
    The natural catastrophic events largely damage the country's sustainability agenda through massive human fatalities and infrastructure destruction. Although it is partially supported the economic growth through the channel of "Schumpeter creative destruction" hypothesis, however, it may not be sustained in the long-run. This study examined the long-run and causal relationships between natural disasters (i.e., floods, storm, and epidemic) and per capita income by controlling FDI inflows and foreign aid in the context of Malaysia, during the period of 1965-2016. The study employed time series cointegration technique, i.e., autoregressive distributed lag (ARDL)-bounds testing approach for robust inferences. The results show that flood, storm, and epidemic disasters substantially decrease the country's per capita income, while FDI inflows and foreign aid largely supported the country's economic growth in the short-run. These results are disappeared in the long-run, where flood and storm disasters exhibit the positive association with the economic growth to support the Schumpeter creative destruction hypothesis. The foreign aid decreases the per capita income and does not maintain the "aid-effectiveness" hypotheses in a given country. The causality estimates confirmed the disaster-led growth hypothesis, as the causality estimates running from (i) storm to per capita income, (ii) epidemic to per capita income, and (iii) storm to foreign aid. The results emphasized for making disaster action plans to reduce human fatalities and infrastructure for sustainable development.
    Matched MeSH terms: Income
  18. Waid JL, Sinharoy SS, Ali M, Stormer AE, Thilsted SH, Gabrysch S
    Curr Dev Nutr, 2019 Apr;3(4):nzy091.
    PMID: 30993255 DOI: 10.1093/cdn/nzy091
    Background: The government of Bangladesh has implemented multiple policies since 1971 to provide the population with more diverse and nutritious diets.

    Objective: The aim of this study was to examine the drivers of dietary change over time and the roles agriculture and economic development have played.

    Methods: We used principal component analysis to derive dietary patterns from 7 cross-sectional rounds of the Bangladesh Household [Income and] Expenditure Survey. We then used linear probability models to estimate associations of adherence to dietary patterns with socio-economic characteristics of households, and with agricultural production on the household and regional level. For dietary patterns that increased or decreased over time, Blinder-Oaxaca decomposition was used to assess factors associated with these changes.

    Results: Seven dietary patterns were identified: modern, traditional, festival, winter, summer, monotonous, and spices. All diets were present in all survey rounds. In 1985, over 40% of households had diets not associated with any identified pattern, which declined to 12% by 2010. The proportion of the population in households adhering to the modern, winter, summer, and monotonous diets increased over time, whereas the proportion adhering to the traditional diet decreased. Although many factors were associated with adherence to dietary patterns in the pooled sample, changes in observed factors only explained a limited proportion of change over time due to variation in coefficients between periods. Increased real per capita expenditure was the largest driver of elevated adherence to dietary patterns over time, whereas changes in the agricultural system increased adherence to less diverse dietary patterns.

    Conclusions: These findings highlight the need for both diversified agricultural production and a continued reduction in poverty in order to drive dietary improvement. This study lays the groundwork for further analysis of the impact of changing diets on health and nutrition.

    Matched MeSH terms: Income
  19. Mohd Nor NA, Taib NA, Saad M, Zaini HS, Ahmad Z, Ahmad Y, et al.
    BMC Bioinformatics, 2019 Feb 04;19(Suppl 13):402.
    PMID: 30717675 DOI: 10.1186/s12859-018-2406-9
    BACKGROUND: Advances in medical domain has led to an increase of clinical data production which offers enhancement opportunities for clinical research sector. In this paper, we propose to expand the scope of Electronic Medical Records in the University Malaya Medical Center (UMMC) using different techniques in establishing interoperability functions between multiple clinical departments involving diagnosis, screening and treatment of breast cancer and building automatic systems for clinical audits as well as for potential data mining to enhance clinical breast cancer research in the future.

    RESULTS: Quality Implementation Framework (QIF) was adopted to develop the breast cancer module as part of the in-house EMR system used at UMMC, called i-Pesakit©. The completion of the i-Pesakit© Breast Cancer Module requires management of clinical data electronically, integration of clinical data from multiple internal clinical departments towards setting up of a research focused patient data governance model. The 14 QIF steps were performed in four main phases involved in this study which are (i) initial considerations regarding host setting, (ii) creating structure for implementation, (iii) ongoing structure once implementation begins, and (iv) improving future applications. The architectural framework of the module incorporates both clinical and research needs that comply to the Personal Data Protection Act.

    CONCLUSION: The completion of the UMMC i-Pesakit© Breast Cancer Module required populating EMR including management of clinical data access, establishing information technology and research focused governance model and integrating clinical data from multiple internal clinical departments. This multidisciplinary collaboration has enhanced the quality of data capture in clinical service, benefited hospital data monitoring, quality assurance, audit reporting and research data management, as well as a framework for implementing a responsive EMR for a clinical and research organization in a typical middle-income country setting. Future applications include establishing integration with external organization such as the National Registration Department for mortality data, reporting of institutional data for national cancer registry as well as data mining for clinical research. We believe that integration of multiple clinical visit data sources provides a more comprehensive, accurate and real-time update of clinical data to be used for epidemiological studies and audits.

    Matched MeSH terms: Income*
  20. Kaur J, Hamajima N, Yamamoto E, Saw YM, Kariya T, Soon GC, et al.
    Complement Ther Med, 2019 Feb;42:422-428.
    PMID: 30670278 DOI: 10.1016/j.ctim.2018.12.013
    BACKGROUND: Traditional and complementary medicine (T&CM) has been integrated into the Malaysian public healthcare system since the establishment of the first T&CM unit at a public hospital in 2007. Assessing patient satisfaction is a vital component of health service evaluation. The main objective of this study is to determine the level of patient satisfaction with the utilization of T&CM services at public hospitals in Malaysia and assess the sociodemographic influence on the overall reporting of satisfaction. This study also aims to analyze the response of the patients towards expansion of T&CM services in the public sector in Malaysia.

    MATERIALS AND METHODS: A study was conducted to analyze data on the utilization of T&CM services within public hospitals. Secondary data on 822 patients' satisfaction with services offered at 15 T&CM units was analyzed to examine the overall levels of satisfaction with T&CM services in public hospitals in Malaysia.

    RESULTS: Overall, 99.4% of patients were satisfied with T&CM services and most patients (91.8%) felt that T&CM treatment positively impacted their health. Overall satisfaction was not affected by lower levels of satisfaction with subcategories of service, such as the number of treatment sessions received (90.7% satisfied), date to the next appointment (90.7% satisfied), and the absence of adverse effects of treatment received (87.1% satisfied). There were no significant associations between the socioeconomic status of the respondents and the level of satisfaction reported; however, respondents with a monthly salary of Ringgit Malaysia (RM) 1000 to RM 3000 were more than twice as likely to be strongly satisfied with services received (adjusted odds ratios [AOR]: 2.12, 95% CI: 1.19-3.78).

    CONCLUSION: This study revealed a high level of satisfaction among patients who had received T&CM treatment at public hospitals in Malaysia. High satisfaction with T&CM treatment validates the integrative management approach adopted in patient care within the public hospitals in Malaysia.

    Matched MeSH terms: Income
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