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.
METHODS: This was a retrospective cohort study of 859 community-dwelling patients aged ≥70 years treated at 15 primary care practices. Patients were asked if they had experienced any of a list of 74 symptoms classified by physiologic system in the previous 6 months and if (1) they believed the symptom to be related to their medication, (2) the symptom had bothered them, (3) they had discussed it with their family physician, and (4) they required hospital care due to the symptom. Self-reported symptoms were independently reviewed by 2 clinicians who determined the likelihood that the symptom was an ADE. Family physician medical records were also reviewed for any report of an ADE.
RESULTS: The ADE instrument had an accuracy of 75% (95% CI, 77%-79%), a sensitivity of 29% (95% CI, 27%-31%), and a specificity of 93% (95% CI, 92%-94%). Older people who reported a symptom had an increased likelihood of an ADE (positive likelihood ratio [LR+]: 4.22; 95% CI, 3.78-4.72). Antithrombotic agents were the drugs most commonly associated with ADEs. Patients were most bothered by muscle pain or weakness (75%), dizziness or lightheadedness (61%), cough (53%), and unsteadiness while standing (52%). On average, patients reported 39% of ADEs to their physician. Twenty-six (3%) patients attended a hospital outpatient clinic, and 32 (4%) attended an emergency department due to ADEs.
CONCLUSION: Older community-dwelling patients were often not correct in recognizing ADEs. The ADE instrument demonstrated good predictive value and could be used to differentiate between symptoms of ADEs and chronic disease in the community setting.
METHODS: This research comprises a longitudinal population-based study that measured the prevalence and 6-month stability of EBD in children aged seven to eight years and thirteen to fourteen years attending public schools in Malaysia based on parents, teachers and children's (aged 13 to 14 years) report of the Strengths and Difficulties Questionnaire (SDQ) at baseline and 6 months later.
FINDINGS: The prevalence of EBD in Malaysian school children was 9.3% for teacher-report, 8.5% for parent-report and 3.9% for child-report. There was no significance difference in the prevalence of emotional and behavioral problems over six-months for all informants, except for teacher-report Emotional and Conduct problems scores which increased significantly and child-report Total Difficulties and Emotional problems scores which decreased significantly (p < 0.05).
CONCLUSIONS: This study shows that the prevalence of EBD among Malaysian children is almost similar to the Western countries and stable over a 6-month period. These findings suggest the need for policy makers in near-developed countries to provide services aimed at preventing EBD and treating children identified as having such problems.
METHODS: Standardised anthropometric measurements were compared against the self-reported values from 5,132 adult residents in a cross-sectional, epidemiological survey. Discrepancies in self-reports from measurements were examined by comparing overall mean differences. Intraclass correlations, Cohen's kappa and Bland-Altman plots with limits of agreement, and sub-analysis by sex and ethnicity were also explored.
RESULTS: Data were obtained from 5,132 respondents. The mean age of respondents was 43.9 years. Overall, the height was overestimated (0.2cm), while there was an underestimation of weight (0.8kg) and derived BMI (0.4kg/m2). Women had a larger discrepancy in height (0.35cm, 95% confidence interval [CI] 0.22 to 0.49), weight (-0.95kg, 95% CI -1.11 to -0.79) and BMI (-0.49kg/m2, 95% CI -0.57 to -0.41) compared with men. Height reporting bias was highest among Indians (0.28cm, 95% CI 0.12 to 0.44) compared with Chinese and Malays, while weight (-1.32kg, 95% CI -1.53 to -1.11) and derived BMI (-0.57kg/m2, 95% CI -0.67 to -0.47) showed higher degrees of underreporting among Malays compared with Chinese and Indians. Substantially high self-reported versus measured values were obtained for intraclass correlations (0.96-0.99, P<0.001) and kappa (0.74). For BMI categories, good to excellent kappa agreement was observed (0.68-0.81, P<0.0001).
CONCLUSION: Self-reported anthropometric estimates can be used, particularly in large epidemiological studies. However, sufficient care is needed when evaluating data from Indians, Malays and women as there is likely an underestimation of obesity prevalence.
MATERIALS AND METHODS: A cross-sectional epidemiological survey was conducted to detect the true prevalence of active smoking pregnant patients and the accuracy of self-reporting, investigate the sociodemographic risk factors and test the knowledge of pregnant patients on adverse effects of smoking. This involved 972 antenatal patients of a maternity hospital where participants completed a sociodemographic data survey and answered a knowledge questionnaire. Urine cotinine testing was carried out after informed consent.
RESULTS: The prevalence of active smokers was 5.2% (n = 50) with 3% (n = 29) being light smokers and 2.2% (n = 21) being heavy smokers. This was significantly higher than self-reported active smoking status of 3.7% (n = 36; P = 0.02). The Malay race, being aged less than 20 years and not having tertiary level qualifications independently increased the likelihood of being an active smoker. Knowledge of the adverse effects of smoking was generally good with a mean total score of 8.18 out of 10 but there were differences amongst the non-smokers, passive smokers, light smokers and active smokers (P = 0.012).
CONCLUSION: While the prevalence of active smoking among pregnant women is low in Singapore compared to other countries, this study substantiated the unreliability of self-reporting of smoking status in the pregnant population which could complicate referral to smoking cessation programmes. The lower awareness of the harms of smoking during pregnancy among smokers highlights a potential area for improvement.
OBJECTIVE: This study aims to develop and validate SafeHIT, an instrument to assess self-reported safe use of HIT among health care practitioners.
METHODS: Systematic literature review and a semistructured interview with 31 experts were adopted to generate SafeHIT instrument items. In total, 450 physicians from various departments at three Malaysian public hospitals participated in the questionnaire survey to validate SafeHIT. Exploratory factor analysis and confirmatory factor analysis (CFA) were undertaken to explore the items that best represent a specific construct and to confirm the reliability and validity of the SafeHIT, respectively.
RESULTS: The final SafeHIT consisted of 14 constructs and 58 items in total. The result of the CFA confirmed that all constructs demonstrated adequate convergent and discriminant validity.
CONCLUSION: A reliable and valid theoretically underpinned measure of determinants of safe HIT use behavior has been developed. Understanding external factors that influence safe HIT use is useful for developing targeted interventions that favor the quality and safety of health care.
PURPOSE: To examine the influence of physical activity (PA) and sedentary time on bone strength, structure, and density in older adolescents.
METHODS: We used peripheral quantitative computed tomography to estimate bone strength at the distal tibia (8% site; bone strength index, BSI) and tibial midshaft (50% site; polar strength strain index, SSIp) in adolescent boys (n = 86; 15.3 ± 0.4 years) and girls (n = 106; 15.3 ± 0.4 years). Using accelerometers (GT1M, Actigraph), we measured moderate-to-vigorous PA (MVPAAccel), vigorous PA (VPAAccel), and sedentary time in addition to self-reported MVPA (MVPAPAQ-A) and impact PA (ImpactPAPAQ-A). We examined relations between PA and sedentary time and bone outcomes, adjusting for ethnicity, maturity, tibial length, and total body lean mass.
RESULTS: At the distal tibia, MVPAAccel and VPAAccel positively predicted BSI (explained 6-7% of the variance, p
Patients and methods: This cross-sectional study included 167 SLE patients (21 males, 146 females; mean age 38.2±9.8 years; range, 20 to 60 years) recruited from the outpatient Rheumatology and Nephrology clinics. Face-to-face interviews were conducted to record patients' socio- demographics (age, sex, ethnicity, marital status, and occupation) and SLE disease characteristics (system involvement, age onset, and presence of organ damage). Disease activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K). Short form 36 (SF-36) was used to determine health-related quality of life (HRQoL) while Work Productivity and Activity Impairment (WPAI) questionnaire was used to assess the four domains of absenteeism, presenteeism, overall work productivity, and non-work related ADL impairment. Univariate analyses and multivariable regression analysis examined the association of demographic variables, SLE disease characteristics, and activity with reduced HRQoL and WPAI scores.
Results: The majority of the patients were Malays (59.3%), followed by Chinese (34.7%) and Indian (3.6%) patients. More than two-thirds of the patients reported some degree of impairment in their work productivity and ADL due to the disease. The absenteeism rate was 10.4% in the past one week and their indirect costs were 2,875.17 Malaysian ringgits (US $701.22) in the past seven days. Significant predictors of higher work productivity and ADL impairment scores were higher disease activity, more frequent SLE flares, lupus nephritis, and hematological involvement of SLE. Patients with higher work productivity and ADL impairment scores were also strongly associated with poor QoL. No ethnic disparities of work productivity and ADL impairment were found.
Conclusion: Systemic lupus erythematosus significantly affected the overall productivity in work and non-work related activity in our Malaysian multi-ethnic cohort and both impairments were significantly associated with poor QoL.
POPULATION AND METHODS: A self-administered questionnaire was used in this multicenter cross-sectional study. It included questions on the socio-demographics, work characteristics, Emotional Exhaustion, Perceived Stress Scale and sources of job stress. Descriptive, univariate and multivariate analysis were conducted using the SPSS software.
RESULTS: A total of 197 doctors working in the Pediatric department in eight hospitals returned complete questionnaire. High and moderate emotional exhaustion was reported by 25.4% and 24.4% doctors, respectively. In bivariate analysis, 29 out of the 38 items of sources of stress showed significant association with emotional exhaustion (p <0.05).The significant predictors of emotional exhaustion in the multivariate analysis were: scoring higher on the Perceived Stress Score, dealing with patient's psychosocial problems, disrespectful interactions with colleagues/ subordinates, lack of appreciation from supervisors, lack of incentives and promotions, time pressures and deadlines to meet, and setting unrealistic goals of having them imposed on oneself (p <0.05). The most common source of stress was dealing with difficult parents (80.2%).
CONCLUSIONS: Emotional exhaustion is associated with sources of stress in the workplace but not with socio-demographic factors.