Displaying publications 1 - 20 of 111 in total

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  1. McCoy D, Roberts S, Daoudi S, Kennedy J
    BMJ Glob Health, 2023 Sep;8(9).
    PMID: 37748796 DOI: 10.1136/bmjgh-2023-013067
    The past four decades have seen a steady rise of references to 'security' by health academics, policy-makers and practitioners, particularly in relation to threats posed by infectious disease pandemics. Yet, despite an increasingly dominant health security discourse, the many different ways in which health and security issues and actors intersect have remained largely unassessed and unpacked in current critical global health scholarship. This paper discusses the emerging and growing health-security nexus in the wake of COVID-19 and the international focus on global health security. In recognising the contested and fluid concept of health security, this paper presents two contrasting approaches to health security: neocolonial health security and universal health security. Building from this analysis, we present a novel heuristic that delineates the multiple intersections and entanglements between health and security actors and agendas to broaden our conceptualisation of global health security configurations and practices and to highlight the potential for harmful unintended consequences, the erosion of global health norms and values, and the risk of health actors being co-opted by the security sector.
    Matched MeSH terms: Politics
  2. Zahra S, Badeeb RA
    Environ Sci Pollut Res Int, 2022 Aug;29(36):54698-54717.
    PMID: 35305216 DOI: 10.1007/s11356-022-19669-y
    The paper explores the short-run and long-run asymmetric impact of fiscal decentralization, green energy, and economic policy uncertainty on environmental sustainability proxied by ecological footprint. Using the Nonlinear Autoregressive Distributed lag (NARDL) approach in selected five OECD countries, we find that ecological footprint responds to positive and negative fiscal decentralization asymmetrically in the long run and short run. However, the nature of the response varies significantly across countries. The result also suggests that green energy is a major factor in reducing the ecological footprint in all countries except Canada. Finally, economic policy uncertainty plays a negative and significant role in the ecological footprint in the UK, USA, and Germany while insignificant in Australia and Canada. Implications for effective environmental policies are discussed.
    Matched MeSH terms: Politics
  3. Jafar U, Aziz MJA, Shukur Z
    Sensors (Basel), 2021 Aug 31;21(17).
    PMID: 34502764 DOI: 10.3390/s21175874
    Online voting is a trend that is gaining momentum in modern society. It has great potential to decrease organizational costs and increase voter turnout. It eliminates the need to print ballot papers or open polling stations-voters can vote from wherever there is an Internet connection. Despite these benefits, online voting solutions are viewed with a great deal of caution because they introduce new threats. A single vulnerability can lead to large-scale manipulations of votes. Electronic voting systems must be legitimate, accurate, safe, and convenient when used for elections. Nonetheless, adoption may be limited by potential problems associated with electronic voting systems. Blockchain technology came into the ground to overcome these issues and offers decentralized nodes for electronic voting and is used to produce electronic voting systems mainly because of their end-to-end verification advantages. This technology is a beautiful replacement for traditional electronic voting solutions with distributed, non-repudiation, and security protection characteristics. The following article gives an overview of electronic voting systems based on blockchain technology. The main goal of this analysis was to examine the current status of blockchain-based voting research and online voting systems and any related difficulties to predict future developments. This study provides a conceptual description of the intended blockchain-based electronic voting application and an introduction to the fundamental structure and characteristics of the blockchain in connection to electronic voting. As a consequence of this study, it was discovered that blockchain systems may help solve some of the issues that now plague election systems. On the other hand, the most often mentioned issues in blockchain applications are privacy protection and transaction speed. For a sustainable blockchain-based electronic voting system, the security of remote participation must be viable, and for scalability, transaction speed must be addressed. Due to these concerns, it was determined that the existing frameworks need to be improved to be utilized in voting systems.
    Matched MeSH terms: Politics
  4. Lim JT, Maung K, Tan ST, Ong SE, Lim JM, Koo JR, et al.
    PLoS Comput Biol, 2021 May;17(5):e1008959.
    PMID: 34043622 DOI: 10.1371/journal.pcbi.1008959
    Mass gathering events have been identified as high-risk environments for community transmission of coronavirus disease 2019 (COVID-19). Empirical estimates of their direct and spill-over effects however remain challenging to identify. In this study, we propose the use of a novel synthetic control framework to obtain causal estimates for direct and spill-over impacts of these events. The Sabah state elections in Malaysia were used as an example for our proposed methodology and we investigate the event's spatial and temporal impacts on COVID-19 transmission. Results indicate an estimated (i) 70.0% of COVID-19 case counts within Sabah post-state election were attributable to the election's direct effect; (ii) 64.4% of COVID-19 cases in the rest of Malaysia post-state election were attributable to the election's spill-over effects. Sensitivity analysis was further conducted by examining epidemiological pre-trends, surveillance efforts, varying synthetic control matching characteristics and spill-over specifications. We demonstrate that our estimates are not due to pre-existing epidemiological trends, surveillance efforts, and/or preventive policies. These estimates highlight the potential of mass gatherings in one region to spill-over into an outbreak of national scale. Relaxations of mass gathering restrictions must therefore be carefully considered, even in the context of low community transmission and enforcement of safe distancing guidelines.
    Matched MeSH terms: Politics*
  5. Rashid NKA, Sulaiman NFC, Anang Z, Possumah BT, Muhamad S, Sa'at NH, et al.
    Data Brief, 2021 Apr;35:106743.
    PMID: 33553520 DOI: 10.1016/j.dib.2021.106743
    Unsustainable consumption promotes discouraging patterns of consumption with negative impacts on society. It also contributes to inequalities and poverty. Unsustainable patterns of production and consumption undermine development goals in terms of inefficiency and overconsumption. This research explores the level of sustainable consumption of Malaysian households from the perspective of income and consumption expenditure. The analysis is based on cross-sectional data obtained from questionnaires distributed to 635 Malaysian households in eight districts in Terengganu (urban and rural areas) using stratified random sampling. The findings show that the level of sustainable consumption expenditure of Muslim households in Terengganu is still low. Achieving sustainable consumption patterns is more technically and politically complex than changing production patterns because it raises important issues such as human values, equity and lifestyle choices.
    Matched MeSH terms: Politics
  6. Tan JWC, Sim D, Ako J, Almahmeed W, Cooper ME, Dalal JJ, et al.
    Eur Cardiol, 2021 Feb;16:e14.
    PMID: 33976709 DOI: 10.15420/ecr.2020.52
    The Asian Pacific Society of Cardiology convened a consensus statement panel for optimising cardiovascular (CV) outcomes in type 2 diabetes, and reviewed the current literature. Relevant articles were appraised using the Grading of Recommendations, Assessment, Development and Evaluation system, and consensus statements were developed in two meetings and were confirmed through online voting. The consensus statements indicated that lifestyle interventions must be emphasised for patients with prediabetes, and optimal glucose control should be encouraged when possible. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are recommended for patients with chronic kidney disease with adequate renal function, and for patients with heart failure with reduced ejection fraction. In addition to SGLT2i, glucagon-like peptide-1 receptor agonists are recommended for patients at high risk of CV events. A blood pressure target below 140/90 mmHg is generally recommended for patients with type 2 diabetes. Antiplatelet therapy is recommended for secondary prevention in patients with atherosclerotic CV disease.
    Matched MeSH terms: Politics
  7. Rampal L, Liew BS
    Med J Malaysia, 2021 01;76(1):1-4.
    PMID: 33510100
    The first case of COVID-19 was reported in Malaysia on the 25 January 2020. By the 20 January 2021, the cumulative numbers reported confirmed cases of COVID-19 had reached 169,379 including 630 deaths. Malaysia has been hit by three waves of COVID-19. This article reports on the three waves, the current situation and some of the possible factors associated. It outlines the need to reassess the overall situation, re-strategize the approach in order to contain the spread. The first COVID-19 wave lasted from 25 January to 16 February 2020, the second wave occurred between the 27 February 2020 and the 30 June 2020. The current third wave began on 8th September 2020.The sudden surge of cases in the third wave was mainly due to the two largest contributors, namely the Benteng Lahad Datu cluster in Sabah state and Kedah's Tembok cluster. The current situation is critical. The daily confirmed cases of COVID-19 continue to soar. The challengers faced by healthcare workers and other front liners is tremendous. Non-communicable diseases such as cardiovascular diseases, diabetes and cancer are the leading cause of death in Malaysia. A paradigm shift in the approach is required to ensure the sustainability of the normal healthcare services provided by the government especially for the lower income groups. There is also a need to expedite the tabling of Tobacco Control Bill in coming parliament session which is long overdue. H.E. the King of Malaysia has called on all Malaysians to put aside political, racial and religious differences and show the spirit of loyalty, humanitarianism and steadfastness in fighting the COVID-19 pandemic.
    Matched MeSH terms: Politics
  8. Lombe D, Sullivan R, Caduff C, Ali Z, Bhoo-Pathy N, Cleary J, et al.
    Ecancermedicalscience, 2021;15:1202.
    PMID: 33889211 DOI: 10.3332/ecancer.2021.1202
    Introduction: Public health emergencies and crises such as the current COVID-19 pandemic can accelerate innovation and place renewed focus on the value of health interventions. Capturing important lessons learnt, both positive and negative, is vital. We aimed to document the perceived positive changes (silver linings) in cancer care that emerged during the COVID-19 pandemic and identify challenges that may limit their long-term adoption.

    Methods: This study employed a qualitative design. Semi-structured interviews (n = 20) were conducted with key opinion leaders from 14 countries. The participants were predominantly members of the International COVID-19 and Cancer Taskforce, who convened in March 2020 to address delivery of cancer care in the context of the pandemic. The Framework Method was employed to analyse the positive changes of the pandemic with corresponding challenges to their maintenance post-pandemic.

    Results: Ten themes of positive changes were identified which included: value in cancer care, digital communication, convenience, inclusivity and cooperation, decentralisation of cancer care, acceleration of policy change, human interactions, hygiene practices, health awareness and promotion and systems improvement. Impediments to the scale-up of these positive changes included resource disparities and variation in legal frameworks across regions. Barriers were largely attributed to behaviours and attitudes of stakeholders.

    Conclusion: The COVID-19 pandemic has led to important value-based innovations and changes for better cancer care across different health systems. The challenges to maintaining/implementing these changes vary by setting. Efforts are needed to implement improved elements of care that evolved during the pandemic.

    Matched MeSH terms: Politics
  9. Stroebe W, vanDellen MR, Abakoumkin G, Lemay EP, Schiavone WM, Agostini M, et al.
    PLoS One, 2021;16(10):e0256740.
    PMID: 34669724 DOI: 10.1371/journal.pone.0256740
    During the initial phase of the COVID-19 pandemic, U.S. conservative politicians and the media downplayed the risk of both contracting COVID-19 and the effectiveness of recommended health behaviors. Health behavior theories suggest perceived vulnerability to a health threat and perceived effectiveness of recommended health-protective behaviors determine motivation to follow recommendations. Accordingly, we predicted that-as a result of politicization of the pandemic-politically conservative Americans would be less likely to enact recommended health-protective behaviors. In two longitudinal studies of U.S. residents, political conservatism was inversely associated with perceived health risk and adoption of health-protective behaviors over time. The effects of political orientation on health-protective behaviors were mediated by perceived risk of infection, perceived severity of infection, and perceived effectiveness of the health-protective behaviors. In a global cross-national analysis, effects were stronger in the U.S. (N = 10,923) than in an international sample (total N = 51,986), highlighting the increased and overt politicization of health behaviors in the U.S.
    Matched MeSH terms: Politics*
  10. Virk A, Croke K, Mohd Yusoff M, Mokhtaruddin K, Abdullah Z, Nadziha Mohd Hanafiah A, et al.
    Health Syst Reform, 2020 12 01;6(1):e1833639.
    PMID: 33314988 DOI: 10.1080/23288604.2020.1833639
    Health system reforms across high- and middle-income countries often involve changes to public hospital governance. Corporatization is one such reform, in which public sector hospitals are granted greater functional independence while remaining publicly owned. In theory, this can improve public hospital efficiency, while retaining a public service ethos. However, the extent to which efficiency gains are realized and public purpose is maintained depends on policy choices about governance and payment systems. We present a case study of Malaysia's National Heart Institute (IJN), which was created in 1992 by corporatization of one department in a large public hospital. The aim of the paper is to examine whether IJN has achieved the goals for which it was created, and if so, whether it provides a potential model for further reforms in Malaysia and other similar health systems. Using a combination of document analysis and key informant interviews, we examine key governance, health financing and payment, and equity issues. For governance, we highlight the choice to have IJN owned by and answerable to a Ministry of Finance (MOF) holding company and MOF-appointed board, rather than the Ministry of Health (MOH). On financing and payment, we analyze the implications of IJN's combined role as fee-for-service provider to MOH as well as provider of care to private patients. For equity, we analyze the targeting of IJN care across publicly-referred and private patients. These issues demonstrate unresolved tensions between IJN's objectives and public service goals. As an institutional innovation that has endured for 28 years and grown dramatically in size and revenue, IJN's trajectory offers critical insights on the relevance of the hybrid public-private models for hospitals in Malaysia as well as in other middle-income countries. While IJN appears to have achieved its goal of establishing itself as a commercially viable, publicly owned center of clinical excellence in Malaysia, the value for money and equity of the services it provides to the Ministry of Health remain unclear. IJN is accountable to a small Ministry of Finance holding company, which means that detailed information required to evaluate these critical questions is not published. The case of IJN highlights that corporatization cannot achieve its stated goals of efficiency, innovation, and equity in isolation; rather it must be supported by broader reforms, including of health financing, payment, governance, and transparency, in order to ensure that autonomous hospitals improve quality and provide efficient care in an equitable way.
    Matched MeSH terms: Politics
  11. Lim SC, Yap YC, Barmania S, Govender V, Danhoundo G, Remme M
    Sex Reprod Health Matters, 2020 Dec;28(2):1842153.
    PMID: 33236973 DOI: 10.1080/26410397.2020.1842153
    Despite increasing calls to integrate and prioritise sexual and reproductive health (SRH) services in universal health coverage (UHC) processes, several SRH services have remained a low priority in countries' UHC plans. This study aims to understand the priority-setting process of SRH interventions in the context of UHC, drawing on the Malaysian experience. A realist evaluation framework was adopted to examine the priority-setting process for three SRH tracer interventions: pregnancy, safe delivery and post-natal care; gender-based violence (GBV) services; and abortion-related services. The study used a qualitative multi-method design, including a literature and document review, and 20 in-depth key informant interviews, to explore the context-mechanism-outcome configurations that influenced and explained the priority-setting process. Four key advocacy strategies were identified for the effective prioritisation of SRH services, namely: (1) generating public demand and social support, (2) linking SRH issues with public agendas or international commitments, (3) engaging champions that are internal and external to the public health sector, and (4) reframing SRH issues as public health issues. While these strategies successfully triggered mechanisms, such as mutual understanding and increased buy-in of policymakers to prioritise SRH services, the level and extent of prioritisation was affected by both inner and outer contextual factors, in particular the socio-cultural and political context. Priority-setting is a political decision-making process that reflects societal values and norms. Efforts to integrate SRH services in UHC processes need both to make technical arguments and to find strategies to overcome barriers related to societal values (including certain socio-cultural and religious norms). This is particularly important for sensitive SRH services, like GBV and safe abortion, and for certain populations.
    Matched MeSH terms: Politics
  12. Ramos AC, Chevallier JM, Mahawar K, Brown W, Kow L, White KP, et al.
    Obes Surg, 2020 May;30(5):1625-1634.
    PMID: 32152841 DOI: 10.1007/s11695-020-04519-y
    BACKGROUND: One-anastomosis gastric bypass (OAGB-MGB) is currently the third performed primary bariatric surgical procedure worldwide. However, the procedure is hampered by numerous controversies and there is considerable variability in surgical technique, patient selection, and pre- and postoperative care among the surgeons performing this procedure. This paper reports the results of a modified Delphi consensus study organized by the International Federation for Surgery of Obesity and Metabolic Disorders (IFSO).

    METHODS: Fifty-two internationally recognized bariatric experts from 28 countries convened for voting on 90 consensus statements over two rounds to identify those on which consensus could be reached. Inter-voter agreement of ≥ 70% was considered consensus, with voting participation ≥ 80% considered a robust vote.

    RESULTS: At least 70% consensus was achieved for 65 of the 90 questions (72.2% of the items), 61 during the first round of voting and an additional four in the second round. Where consensus was reached on a binary agree/disagree or yes/no item, there was agreement with the statement presented in 53 of 56 instances (94.6%). Where consensus was reached on a statement where options favorable versus unfavorable to OAGB-MGB were provided, including statements in which OAGB-MGB was compared to another procedure, the response option favorable to OAGB-MGB was selected in 13 of 23 instances (56.5%).

    CONCLUSION: Although there is general agreement that the OAGB-MGB is an effective and usually safe option for the management of patients with obesity or severe obesity, numerous areas of non-consensus remain in its use. Further empirical data are needed.

    Matched MeSH terms: Politics
  13. Corduff N, Chao YY, Lam SC, Lim J, Lim TS, Lohia K, et al.
    J Clin Aesthet Dermatol, 2020 Apr;13(4):23-34.
    PMID: 33144908
    OBJECTIVE: A group of established aesthetic physicians sought to develop treatment guidelines for assessing Asian face morphologies that reflect accurate and current beauty standards across Asia. DESIGN: Physicians completed surveys, debated, and voted on their clinical strategies and developed an alternative simplified visual tool of assessment (SVAT) that discerns between country variations in genetic and ideal morphotypes. SETTING: Electronic and paper surveys were followed by consensus debates and voting. PARTICIPANTS: Established aesthetic physicians practicing regularly on Asian patients. MEAUSUREMENTS: A clinically applicable SVAT was developed, which considered facial index, mid-face projection, upper and lower face shape, submalar contour, nose length and dorsal height, eye shape and brow shape, proportion of lips-to-lower face and ratio of upper-to-lower lip, and chin shape. RESULTS: For facial shape change, physicians always assessed the horizontal thirds, facial symmetry, and lip-chin complex profile, and also analyzed overall face shapes and Ogee curves. Criteria for creating oval-shaped faces was also defined and included treating indications, such as loss of angularity and bilateral masseter muscle hypertrophy, narrow jawlines, and longer and wider foreheads. Critical differences and similarities in country-specific aesthetic preferences, treatment requests, and considerations or strategies were uncovered, including the inadequacy of assessing overall peripheral facial shapes. CONCLUSION: This consensus establishes the assessment and treatment criteria for achieving ideal shapes for Asian patients. Specific descriptors are affected by variations; therefore, we present the visual criteria for Asian facial morphotypes. We hope that physicians new to treating Asian patients can use this clinical information to improve their practice.
    Matched MeSH terms: Politics
  14. De Castro JA, Kesavelu D, Lahiri KR, Chaijitraruch N, Chongsrisawat V, Jog PP, et al.
    PMID: 33110611 DOI: 10.1186/s40794-020-00120-4
    This paper proposes recommendations for probiotics in pediatric gastrointestinal diseases in the Asia-Pacific region. Evidence-based recommendations and randomized controlled trials in the region are included. Cultural aspects, health management issues and economic factors were also considered. Final recommendations were approved by utilizing a modified Delphi process and applying the Likert scale in an electronic voting process. Bacillus clausii was recommended as an adjunct treatment with oral rehydration solution for acute viral diarrhea. B. clausii may also be considered for prevention of antibiotic-associated diarrhea, Clostridium difficile-induced diarrhea, and as adjunct treatment of Helicobacter pylori. There is insufficient evidence for recommendations in other conditions. Despite a diversity of epidemiological, socioeconomical and health system conditions, similar recommendations currently apply to most Asia-Pacific countries. Ideally, these need to be validated with local randomized-controlled trials.
    Matched MeSH terms: Politics
  15. Ho KY, Cardosa MS, Chaiamnuay S, Hidayat R, Ho HQT, Kamil O, et al.
    J Pain Res, 2020;13:1925-1939.
    PMID: 32821151 DOI: 10.2147/JPR.S247781
    Cyclo-oxygenase (COX)-2 selective and nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) are important in managing acute and chronic pain secondary to inflammation. As a greater understanding of the risks of gastrointestinal (GI), cardiovascular (CV) and renal events with NSAIDs use has emerged, guidelines have evolved to reflect differences in risks among NSAIDs. Updated guidelines have yet to reflect new evidence from recent trials which showed similar CV event rates with celecoxib compared to naproxen and ibuprofen, and significantly better GI tolerability for celecoxib. This practice advisory paper aims to present consensus statements and associated guidance regarding appropriate NSAID use based on a review of current evidence by a multidisciplinary group of expert clinicians. This paper is especially intended to guide primary care practitioners within Asia in the appropriate use of NSAIDs in primary care. Following a literature review, group members used a modified Delphi consensus process to determine agreement with selected recommendations. Agreement with a statement by 75% of total voting members was defined a priori as consensus. For low GI risk patients, any nonselective NSAID plus proton pump inhibitor (PPI) or celecoxib alone is acceptable treatment when CV risk is low; for high CV risk patients, low-dose celecoxib or naproxen plus PPI is appropriate. For high GI risk patients, celecoxib plus PPI is acceptable for low CV risk patients; low-dose celecoxib plus PPI is appropriate for high CV risk patients, with the alternative to avoid NSAIDs and consider opioids instead. Appropriate NSAID prescription assumes that the patient has normal renal function at commencement, with ongoing monitoring recommended. In conclusion, appropriate NSAID use requires consideration of all risks.
    Matched MeSH terms: Politics
  16. Syaza Zainudin, Mohd Amiruddin Mohd Kassim, Nor Nadia Mohamad Ridza
    Borneo Epidemiology Journal, 2020;1(2):145-156.
    MyJurnal
    Background and Objective: Countries all over the world respect the election process as one of the fundamental steps in forming a government. However, the exponential spread of COVID-19 has been deeply alarming, with a high number of positive cases and total deaths, forcing World Health Organization to declare it as a pandemic on 11thMarch 2020. During these unprecedented events, governments have had a tough decision to balance between the constitutional obligation to hold an election and the safety of the people. As such, electoral commissions have implemented numerous approaches to allow election to proceed in a safe and controlled setting during the pandemic.
    Methods: The preventative measures and standard operating procedures in the Sabah state of Malaysia, NewZealand and the United States elections are discussed, as well as COVID-19 post-election situation in respective countries. Innovative approaches and election flexibilities shall be considered to allow voting in the safest way possible, following the new normal.
    Discussion:Nevertheless, countries need to evaluate its strength of public health response when deciding to hold elections due to potential devastating outbreaks following elections despite measures taken.
    Conclusion: The election is a fundamental process in a democracy. Countries are required to be flexible and innovative in their approach to hold a safe election. Nevertheless, it may be prudent for countries with fewer resources and poor pandemic control to postpone election as a rise in cases will be catastrophic, putting many lives at risk.
    Matched MeSH terms: Politics
  17. R.U GOBITHAASAN, NUR FARHANA SYAHIRA CHE HAMID
    MyJurnal
    Sentiment analysis is a field of research that has a significant impact on today’s nations, politics and businesses. It is an algorithmic process to comprehend the opinions of a given subject based on the Natural Language Processing (NLP) methodologies. It has received much attention in recent years and is proven vital in various fields, e.g., online product reviews and social media analysis (Twitter, Facebook, etc.). This paper reports the outcome of sentiment analysis to investigate people’s acceptance of Pakatan Harapan, as the new Malaysian government, spearheaded by Tun Dr. Mahathir Mohamad and Dr. Wan Azizah, with an influence of Dato Seri Anwar Ibrahim. The objective is to classify tweets into three types of sentiments; positive, neutral and negative using Naïve Bayes method which is readily available in Python. The first step is tweets extraction for a month (March to April 2019) using search queries: {Pakatan Harapan, Mahathir, Anwar Ibrahim, Wan Azizah}. It is followed by tweets wrangling using NLP library and lastly output visualization in the form of a word cloud. A word cloud is a visual representation of text data with various font sizes depending on its probabilities. Final results showed that the tweets related to new government consist of neutral sentiment (41%) followed by positive sentiment (30%) and negative sentiment (29%). Malaysians do prefer the new government. However careful mitigation steps must be crafted to overcome controversial issues such as the ‘Rome Statute’ to avoid negative digital footprint, hence winning the Malaysians’ heart.
    Matched MeSH terms: Politics
  18. Wafa SW, Ghazalli R
    PLoS One, 2020;15(4):e0232000.
    PMID: 32330177 DOI: 10.1371/journal.pone.0232000
    With the on-going interest in implementing school policies to address the problem of childhood obesity in Malaysia, there is urgent need for information about the association between school environment and children's weight status. This study aims to investigate the association between school environmental factors (physical, economic, political and sociocultural) with BMI of school children in Terengganu. The school environment factors were assessed using a set of validated whole-school environmental mapping questionnaires, consisting of 76 criteria with four domains; physical environment (41 criteria), economic environment (nine criteria), political environment (nine criteria) and sociocultural environment (17 criteria). This involved face-to-face interview sessions with 32 teachers from 16 schools (eight rural and eight urban). In addition, 400 school children aged between 9 and 11 years of the selected schools were assessed for BMI (WHO 2007 reference chart), dietary intake (food frequency questionnaire (FFQ)) and physical activity level (physical activity questionnaire for children (PAQ-C)). Multiple regression was used to examine the association between school environment factors and BMI of the school children. Seven school environment criteria were found to be associated with BMI of school children when it was adjusted for calorie intake and physical activity level. About 33.4% of the variation in BMI of school children was explained by health professional involvement, simple exercise before class, encouragement to walk/ride bicycle to/from school, no high-calorie food sold, healthy options of foods and drinks at tuck shop, availability of policy on physical activity and training teacher as a role model. Policy makers should make urgent actions to address the obesogenic features of school environments. It should strive towards setting up healthy school environment and improving school curricula to promote healthy behaviours among the school children.
    Matched MeSH terms: Politics
  19. Croke K, Mohd Yusoff MB, Abdullah Z, Mohd Hanafiah AN, Mokhtaruddin K, Ramli ES, et al.
    Health Policy Plan, 2019 Dec 01;34(10):732-739.
    PMID: 31563946 DOI: 10.1093/heapol/czz089
    There is growing evidence that political economy factors are central to whether or not proposed health financing reforms are adopted, but there is little consensus about which political and institutional factors determine the fate of reform proposals. One set of scholars see the relative strength of interest groups in favour of and opposed to reform as the determining factor. An alternative literature identifies aspects of a country's political institutions-specifically the number and strength of formal 'veto gates' in the political decision-making process-as a key predictor of reform's prospects. A third group of scholars highlight path dependence and 'policy feedback' effects, stressing that the sequence in which health policies are implemented determines the set of feasible reform paths, since successive policy regimes bring into existence patterns of public opinion and interest group mobilization which can lock in the status quo. We examine these theories in the context of Malaysia, a successful health system which has experienced several instances of proposed, but ultimately blocked, health financing reforms. We argue that policy feedback effects on public opinion were the most important factor inhibiting changes to Malaysia's health financing system. Interest group opposition was a closely related factor; this opposition was particularly powerful because political leaders perceived that it had strong public support. Institutional veto gates, by contrast, played a minimal role in preventing health financing reform in Malaysia. Malaysia's dramatic early success at achieving near-universal access to public sector healthcare at low cost created public opinion resistant to any change which could threaten the status quo. We conclude by analysing the implications of these dynamics for future attempts at health financing reform in Malaysia.
    Matched MeSH terms: Politics*
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