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A Model of Aging Perception in Iranian Elders With Effects of Hope, Life Satisfaction, and Socioeconomic Status: A Path Analysis

Yaghoobzadeh A, Gorgulu O, Yee BL, Wibisono AH, Pahlevan Sharif S, Sharif Nia H, et al.

J Am Psychiatr Nurses Assoc, 2018 01 22;24(6):522-530.
PMID: 29357723 DOI: 10.1177/1078390317753676

BACKGROUND: Aging perception plays a central role in the experience of healthy aging by older people. Research identified that factors such as hope, life satisfaction, and socioeconomic status influence the perception of aging in older populations.
OBJECTIVE: This study sought to test a hypothetical model to quantitatively evaluate the relationship between hope, life satisfaction, and socioeconomic status with aging perception.
DESIGN: A cross-sectional design was used with 504 older aged participants who live in Qazvin, Iran. Data were collected using the Barker's Aging Perception Questionnaire, Life Satisfaction Index-Z, and Herth Hope Index.
RESULTS: The results of path analysis showed that hope was the most important factor affecting aging perception. Results drawn from correlation analysis indicated that there was a positive significant correlation ( r = .383, p < .001) between hope and aging perception. Further analysis found that hope had the strongest impact on aging perception compared with the other variables analyzed (e.g., life satisfaction and socioeconomic status).
CONCLUSIONS: A model of aging perception in Iranian elders is presented. The findings suggested that hope had a significant and positive impact on aging perception. Implications for clinical practice and research are discussed.

Matched MeSH terms: Social Class
Fulltext A clustering approach to identify multidimensional poverty indicators for the bottom 40 percent group

Abdul Rahman M, Sani NS, Hamdan R, Ali Othman Z, Abu Bakar A

PLoS One, 2021;16(8):e0255312.
PMID: 34339480 DOI: 10.1371/journal.pone.0255312

The Multidimensional Poverty Index (MPI) is an income-based poverty index which measures multiple deprivations alongside other relevant factors to determine and classify poverty. The implementation of a reliable MPI is one of the significant efforts by the Malaysian government to improve measures in alleviating poverty, in line with the recent policy for Bottom 40 Percent (B40) group. However, using this measurement, only 0.86% of Malaysians are regarded as multidimensionally poor, and this measurement was claimed to be irrelevant for Malaysia as a country that has rapid economic development. Therefore, this study proposes a B40 clustering-based K-Means with cosine similarity architecture to identify the right indicators and dimensions that will provide data driven MPI measurement. In order to evaluate the approach, this study conducted extensive experiments on the Malaysian Census dataset. A series of data preprocessing steps were implemented, including data integration, attribute generation, data filtering, data cleaning, data transformation and attribute selection. The clustering model produced eight clusters of B40 group. The study included a comprehensive clustering analysis to meaningfully understand each of the clusters. The analysis discovered seven indicators of multidimensional poverty from three dimensions encompassing education, living standard and employment. Out of the seven indicators, this study proposed six indicators to be added to the current MPI to establish a more meaningful scenario of the current poverty trend in Malaysia. The outcomes from this study may help the government in properly identifying the B40 group who suffers from financial burden, which could have been currently misclassified.

Matched MeSH terms: Social Class
Fulltext A community child and adolescent guidance clinic in Malaysia

Krahl W, Quek SL, Raman N

Med J Malaysia, 1981 Sep;36(3):171-3.
PMID: 7329374

Study site: Child and Adolescent Guidance Clinic, Hospital Bahagia, Perak, Malaysia

Matched MeSH terms: Social Class
Fulltext A cross sectional assessment of health related quality of life among patients with Hepatitis-B in Pakistan

ul Haq N, Hassali MA, Shafie AA, Saleem F, Aljadhey H

Health Qual Life Outcomes, 2012;10:91.
PMID: 22866752 DOI: 10.1186/1477-7525-10-91

The study aims to assess Health Related Quality of Life (HRQoL) among Hepatitis B (HB) patients and to identify significant predictors of the HRQoL in HB patients of Quetta, Pakistan.

Matched MeSH terms: Social Class
A look at Asia's changing youth population

Xenos P, Kabamalan M, Westley SB

Asia Pac Pop Policy, 1999 Jan.
PMID: 12349008
Matched MeSH terms: Social Class
Fulltext A method of estimating age of undocumented children and young adults of different socioeconomic status in Cambodia

Kar May L, Mei Shian AY, Durward C, Jayaraman J

Heliyon, 2020 Feb;6(2):e03476.
PMID: 32140592 DOI: 10.1016/j.heliyon.2020.e03476

A growing number of Cambodian children without legal documentary evidence of date of birth are vulnerable to exploitation. This study aimed to evaluate the applicability of southern Chinese reference dataset for dental age estimation on Cambodian children and young adults of different socioeconomic status. Dental panoramic tomographs (DPT) of 371 Cambodian children and young adults belonging to lower and higher socioeconomic status (SES) groups were analyzed. All the left maxillary and mandibular permanent teeth including the third molars were scored based on Demirjian's classification of tooth development stages. Chronological age (CA) was calculated from the date of birth and date of exposure of radiograph. The mean age of attainment for each stage of development was obtained from the southern Chinese reference dataset. Dental age (DA) was calculated by averaging the mean age scores for all the teeth. Paired t-test and correlation analysis were conducted to measure associations between the chronological age and the dental age for males and females in the lower and higher socio-economic status groups. Underestimation of age was observed in both SES groups using the southern Chinese reference dataset. For the higher SES group, the difference between the chronological and dental age (CA-DA) was 0.26 years for females and 0.11 years for males. The difference was statistically significant only in females (p < 0.05). In the low SES group, the results showed a difference of 0.07 years in females and 0.01 years in males; the differences were not statistically significant in both sexes (p > 0.05). A strong correlation was observed between the CA and DA in both sex and SES groups ranging from 0.969 to 0.988 (p < 0.05). The southern Chinese dental reference dataset can be used to estimate the age of undocumented Cambodian male and female children and young adults of both higher and lower SES.

Matched MeSH terms: Social Class
Fulltext A national study on the prevalence of obesity among 16,127 Malaysians

Rampal L, Rampal S, Khor GL, Zain AM, Ooyub SB, Rahmat RB, et al.

Asia Pac J Clin Nutr, 2007;16(3):561-6.
PMID: 17704038

A population-based cross-sectional study was conducted in all states of Malaysia with the aim to determine the prevalence of obesity among Malaysians aged fifteen years and above and factors associated. A stratified two-stage cluster sampling design with proportional allocation was used. Trained interviewers using a standardized protocol obtained the weight and height measurements and other relevant information. Subjects with a body mass index >= 30 kg/m2 were labelled as obese. The results show that the overall national prevalence of obesity among Malaysians aged 15 years old and above was 11.7% (95% CI = 11.1 - 12.4%). The prevalence of obesity was significantly higher in females (13.8%) as compared to 9.6% in males (p< 0.0001). Prevalence of obesity was highest amongst the Malays (13.6%) and Indians (13.5%) followed by the indigenous group of "Sarawak Bumiputra" (10.8%) and the Chinese (8.5%). The indigenous group of "Sabah Bumiputra" had the lowest prevalence of 7.3%. These differences are statistically significant (p< 0.0001). Logistic regression analysis results show that there was a significant association between obesity and age, gender, ethnicity urban/rural status and smoking status. The prevalence of obesity amongst those aged >= 18 years old has markedly increased by 280% since the last National Health and Morbidity Survey in 1996.
Study name: National study on Cardio-Vascular Disease Risk Factors 2004

Matched MeSH terms: Social Class
Fulltext A profile of cancer patient outcomes from a tertiary care teaching hospital in Malaysia

Suthahar A, Gurpreet K, Ambigga D, Maniam T, Dhachayani S, Fuad I, et al.

Singapore Med J, 2009 Jul;50(7):720-3.
PMID: 19644630

The aim of this paper was to determine the sociodemographic and cancer characteristics of patients with cancer at a tertiary care centre.

Matched MeSH terms: Social Class
Fulltext A sibling species of Platythyrea clypeata Forel, 1911 in southeast Asia (Hymenoptera, Formicidae, Ponerinae)

Phengsi N, Jaitrong W, Ruangsittichai J, Salinee Khachonpisitsak

Zookeys, 2018.
PMID: 29416393 DOI: 10.3897/zookeys.729.21378

A new species of the rarely collected ant genus Platythyrea Roger, 1863 closely related to Platythyrea clypeata Forel, 1911 is described and illustrated based on the worker caste under the name Platythyrea janyaisp. n. This species is distributed in southern Thailand and western Malaysia, while P. clypeata is distributed in Sri Lanka, Vietnam, Laos, and Thailand in the areas north of the Isthmus of Kra. Platythyrea clypeata is newly recorded from Thailand from dead wood on the forest floor. The type series of P. janyai was also collected from rotten wood on the forest floor.

Matched MeSH terms: Social Class
A study of sudden natural deaths in medico legal autopsies in University Malaya Medical Centre (UMMC), Kuala Lumpur

Kumar V, San KP, Idwan A, Shah N, Hajar S, Norkahfi M

J Forensic Leg Med, 2007 Apr;14(3):151-4.
PMID: 16914354

The main aim of this study is to determine the causes and the epidemiological aspects of sudden natural deaths. Data were collected from 545 sudden natural autopsies in UMMC, Kuala Lumpur over a five-year period, from 1st January 2000 to 31st December 2004. There were 475 males and 70 females. The largest number of sudden natural deaths was in the age group of 41-50 years. 35.8%, 30.5% and 11.7% of the patients were Chinese, Indian and Malay, respectively. A majority of the patients were married (59.8%) and came from the semiskilled-unskilled group (30.6%). The monthly distribution was almost constant. Cardiovascular diseases were the most important cause contributing 64.9% in sudden natural deaths.

Matched MeSH terms: Social Class
A survey in Singapore of low income level housing in relation to health of infants

BROWNE EM

Med J Malaya, 1954 Mar;8(3):222-39.
PMID: 13164693
Matched MeSH terms: Social Class*
Ability to Pay for Future National Health Financing Scheme among Malaysian Households

Aizuddin AN, Aljunid SM

Ann Glob Health, 2017 11 21;83(3-4):654-660.
PMID: 29221542 DOI: 10.1016/j.aogh.2017.10.002

BACKGROUND: Malaysia is no exception to the challenging health care financing phenomenon of globalization.
OBJECTIVES: The objective of the present study was to assess the ability to pay among Malaysian households as preparation for a future national health financing scheme.
METHODS: This was a cross-sectional study involving representative samples of 774 households in Peninsular Malaysia.
FINDINGS: A majority of households were found to have the ability to pay for their health care. Household expenditure on health care per month was between MYR1 and MYR2000 with a mean (standard deviation [SD]) of 73.54 (142.66), or in a percentage of per-month income between 0.05% and 50% with mean (SD) 2.74 (5.20). The final analysis indicated that ability to pay was significantly higher among younger and higher-income households.
CONCLUSIONS: Sociodemographic and socioeconomic statuses are important eligibility factors to be considered in planning the proposed national health care financing scheme to shield the needed group from catastrophic health expenditures.

Matched MeSH terms: Social Class*
Adolescent pregnancy outcomes and risk factors in Malaysia

Omar K, Hasim S, Muhammad NA, Jaffar A, Hashim SM, Siraj HH

Int J Gynaecol Obstet, 2010 Dec;111(3):220-3.
PMID: 20800837 DOI: 10.1016/j.ijgo.2010.06.023

OBJECTIVE: To assess the outcomes and risk factors of adolescent pregnancies in 2 major hospitals in Malaysia.
METHODS: We conducted a case-control study of pregnant girls aged 10 through 19 years. The controls were women aged 20 through 35 years who did not become pregnant in their adolescence. Cases and controls were matched for parity and place of delivery. Data were collected from questionnaires and the hospitals' medical records.
RESULTS: The study included 102 cases and 102 controls. There were significant associations between adolescent pregnancy and low education level, low socioeconomic status, being raised by a single parent, not engaging in extracurricular school activities, engaging in unsupervised activities with peers after school, and substance abuse (P<0.05 for all); being anemic, being unsure of the expected delivery date, and having few antenatal visits and a late delivery booking; and low Apgar scores and perinatal complications.
CONCLUSION: Adolescent pregnancies are high-risk pregnancies. Better sexual health strategies are required to address the associated complications.

Matched MeSH terms: Social Class
Alzheimer's Disease and Related Dementia in Indigenous Populations: A Systematic Review of Risk Factors

Walker JD, Spiro G, Loewen K, Jacklin K

J Alzheimers Dis, 2020;78(4):1439-1451.
PMID: 33185601 DOI: 10.3233/JAD-200704

BACKGROUND: There remains a lack of information and understanding of the prevalence and incidence of Alzheimer's disease and related dementia in Indigenous populations. Little evidence available suggests that Indigenous peoples may have disproportionately high rates of Alzheimer's disease and related dementia (ADRD).
OBJECTIVE: Given this information, this study systematically explores what risk factors may be associated with ADRD in Indigenous populations.
METHODS: A search of all published literature was conducted in October 2016, March 2018, and July 2019 using Medline, Embase, and PsychINFO. Subject headings explored were inclusive of all terms related to Indigenous persons, dementia, and risk. All relevant words, phrases, and combinations were used. To be included in this systematic review, articles had to display an association of a risk factor and ADRD. Only studies that reported a quantifiable measure of risk, involved human subjects, and were published in English were included.
RESULTS: Of 237 articles originally identified through database searches, 45 were duplicates and 179 did not meet a priori inclusion criteria, resulting in 13 studies eligible for inclusion in this systematic review.
CONCLUSION: The large number of potentially modifiable risk factors reported relative to non-modifiable risk factors illustrates the importance of socioeconomic context in the pathogenesis of ADRD in Indigenous populations. The tendency to prioritize genetic over social explanations when encountering disproportionately high disease rates in Indigenous populations can distract from modifiable proximal, intermediate, and distal determinants of health.

Matched MeSH terms: Social Class
An unceasing problem: soil-transmitted helminthiases in rural Malaysian communities

Al-Mekhlafi MS, Atiya AS, Lim YA, Mahdy AK, Ariffin WA, Abdullah HC, et al.

Southeast Asian J. Trop. Med. Public Health, 2007 Nov;38(6):998-1007.
PMID: 18613540

Despite great development in socioeconomic status throughout 50 years of independence, Malaysia is still plagued with soil-transmitted helminthiases (STH). STH continue to have a significant impact on public health particularly in rural communities. In order to determine the prevalence of STH among rural Orang Asli children and to investigate the possible risk factors affecting the pattern of this prevalence, fecal samples were collected from 292 Orang Asli primary schoolchildren (145 males and 147 females) age 7-12 years, from Pos Betau, Kuala Lipis, Pahang. The samples were examined by Kato-Katz and Harada Mori techniques. Socioeconomic data were collected using pre-tested questionnaires. The overall prevalence of ascariasis, trichuriasis, and hookworm infections were 67.8, 95.5 and 13.4%, respectively. Twenty-nine point eight percent of the children had heavy trichuriasis, while 22.3% had heavy ascariasis. Sixty-seven point seven percent of the children had mixed infections. Age > 10 years (p = 0.016), no toilet in the house (p = 0.012), working mother (p = 0.040), low household income (p = 0.033), and large family size (p = 0.028) were identified as risk factors for ascariasis. Logistic regression confirmed low income, no toilet in the house and working mother as significant risk factors for ascariasis. The prevalence of STH is still very high in rural Malaysian communities. STH may also contribute to other health problems such as micronutrient deficiencies, protein-energy malnutrition and poor educational achievement. Public health personnel need to reassess current control measures and identify innovative and integrated ways in order to reduce STH significantly in rural communities.

Matched MeSH terms: Social Class
Fulltext Anemia in pregnancy in Malaysia: a cross-sectional survey

Haniff J, Das A, Onn LT, Sun CW, Nordin NM, Rampal S, et al.

Asia Pac J Clin Nutr, 2007;16(3):527-36.
PMID: 17704035

Anemia is the most prevalent nutritional deficiency during pregnancy. Except for a study conducted 10 years ago in Kelantan, Malaysia's available statistics are based on isolated small urban maternity hospital studies from the 1980s. There was therefore, a need for a large study at national level to estimate the magnitude of the problem in the country as well as to understand its epidemiology. This multi-center, cross-sectional study was conducted from February to March 2005, to assess the prevalence of anemia. Multistage stratified random sampling technique was used and 59 Ministry of Health (MOH) primary health care clinics were selected. Our final dataset consisted of 1,072 antenatal mothers from 56 clinics. The overall prevalence of anemia in this population was 35 % (SE 0.02) if the cut off level is 11 g/dL and 11 % (SE 0.03) if the cut-off level is 10 g/dL. The majority was of the mild type. The prevalence was higher in the teenage group, Indians followed by Malays and Chinese being the least, grandmultiparas, the third trimester and from urban residence. After multiple linear regression analysis, only gestational age remained significant. These findings are useful for our Maternal Health program planners and implementers to target and evaluate interventions. Work is in progress for outcomes and cost-effectiveness studies to best tackle this problem. In conclusion, the prevalence of anemia is 35% and mostly of the mild type and more prevalent in the Indian and Malays.

Matched MeSH terms: Social Class
Anthropometric status and resting metabolic rate in users of the areca nut and smokers of tobacco in rural Sarawak

Strickland SS, Duffield AE

Ann Hum Biol, 1997 Sep-Oct;24(5):453-74.
PMID: 9300122

The areca nut is chewed by many of the world's population, mainly in South and Southeast Asia. Anthropometric data for 458 Sarawaki adults aged over 24 years, measured both in 1990 and in 1996, were examined in relation to use of tobacco and areca nut. Compared to non-smokers, smoking men were significantly taller and slightly (not significantly) thinner in both years, while smoking women were thinner in 1990 and slightly (not significantly) thinner in 1996. In both sexes there was an increase in the mean and range of body mass index (BMI, W/H2) over the 6-year interval. Smoking women showed a significantly smaller increment in BMI after allowing for areca nut use, which was associated with a similar trend, and this finding depended on including areca use in the model. The trend for men was similar. Possible effects of areca use could reflect variation in 'affluence' or conservatism, or appetite suppression. However, resting metabolic rate in 54 men and 70 women aged 24-60 years was associated with areca use. This association appeared to be mediated by the maximum room temperature of the 24 h preceding measurement. In women, a significant curvilinear association of RMR with maximum temperature was found in users of areca nut but not in non-users. In men, RMR was 7% higher (p < 0.05) in users of areca nut than in non-users, after allowing for age, height, weight, the sum of four skinfold thicknesses, and haemoglobin, but the association with maximum temperature was similar in both groups. It is speculated that constituents of areca nut modulate thermoregulatory pathways, resulting in prolonged temperature-dependent and hyperthermic heat production in this population; that males are more responsive to this effect than females; and that by this mechanism, and possibly also through centrally mediated effects on appetite for food, areca use could contribute to long-term variation in energy balance represented by change in BMI.

Matched MeSH terms: Social Class
Fulltext Are the Poor Dying Younger in Malaysia? An Examination of the Socioeconomic Gradient in Mortality

Mariapun J, Hairi NN, Ng CW

PLoS One, 2016;11(6):e0158685.
PMID: 27362581 DOI: 10.1371/journal.pone.0158685

INTRODUCTION: Socioeconomic inequalities in health represent unfairness in the health distribution of a population. Efforts to produce information on mortality distributions in many low and middle income countries (LMICs) are mostly hampered by lack of data disaggregated by socioeconomic groups. In this paper we describe how mortality statistics obtained from multiple data sources were combined to provide an evaluation of the socioeconomic distribution of mortality in Malaysia, a LMIC located in the Asia Pacific region.
METHODS: This study has an ecological design. As a measure of socioeconomic status, we used principal component analysis to construct a socioeconomic index using census data. Districts were ranked according to the standardised median index of households and assigned to each individual in the 5-year mortality data. The mortality indicators of interest were potential years of life lost (PYLL), standardised mortality ratio (SMR), infant mortality rate (IMR) and under-5 mortality rate (U5MR). Both socioeconomic status and mortality outcomes were used compute the concentration index which provided the summary measure of the magnitude of inequality.
RESULTS: Socially disadvantaged districts were found to have worse mortality outcomes compared to more advantaged districts. The values of the concentration index for the overall population of the Peninsula are C = -0.1334 (95% CI: -0.1605 to -0.1063) for the PYLL, C = -0.0685 (95% CI: -0.0928 to -0.0441) for the SMR, C = -0.0997 (95% CI: -0.1343 to -0.0652) for the IMR and C = -0.1207 (95% CI: -0.1523 to -0.0891) for the U5MR. Mortality outcomes within ethnic groups were also found to be less favourable among the poor.
CONCLUSION: The findings of this study suggest that socioeconomic inequalities disfavouring the poor exist in Malaysia.

Matched MeSH terms: Social Class*
Assessing evidence of inequalities in access to medication for diabetic populations in low- and middle-income countries: a systematic review

Christiani Y, Dhippayom T, Chaiyakunapruk N

Glob Health Action, 2016 Dec;9(1):32505.
PMID: 28795917 DOI: 10.3402/gha.v9.32505

Background Inequalities in access to medications among people diagnosed with diabetes in low- and middle-income countries (LMICs) is a public health concern since untreated diabetes can lead to severe complications and premature death. Objective To assess evidence of inequalities in access to medication for diabetes in adult populations of people with diagnosed diabetes in LMICs. Design We conducted a systematic review of the literature using the PRISMA-Equity guidelines. A search of five databases - PubMed, Cochrane, CINAHL, PsycINFO, and EMBASE - was conducted from inception to November 2015. Using deductive content analysis, information extracted from the selected articles was analysed according to the PRISMA-Equity guidelines, based on exposure variables (place of residence, race/ethnicity, occupation, gender, religion, education, socio-economic status, social capital, and others). Results Fifteen articles (seven quantitative and eight qualitative studies) are included in this review. There were inconsistent findings between studies conducted in different countries and regions although financial and geographic barriers generally contributed to inequalities in access to diabetes medications. The poor, those with relatively low education, and people living in remote areas had less access to diabetes medications. Furthermore, we found that the level of government political commitment through primary health care and in the provision of essential medicines was an important factor in promoting access to medications. Conclusions The review indicates that inequalities exist in accessing medication among diabetic populations, although this was not evident in all LMICs. Further research is needed to assess the social determinants of health and medication access for people with diabetes in LMICs.

Matched MeSH terms: Social Class
Assessing progressivity of out-of-pocket payment: with illustration to Malaysia

Yu CP, Whynes DK, Sach TH

Int J Health Plann Manage, 2006 10 19;21(3):193-210.
PMID: 17044546

Throughout the world, policy makers are considering or implementing financing strategies that are likely to have a substantial impact on the equity of health financing. The assessment of the equity implication is clearly important, given the potential impact that alternative finance sources have on households. Households incur out-of-pocket payment directly from their budget, apart from their public or private insurance. Out-of-pocket payment is the primary concern, given their undesirable impact on households. Progressivity measures departures from proportionality in the relationship between out-of-pocket payment and ability to pay. It is the most frequently used yardstick to assess the equity of out-of-pocket payments in empirical studies. This paper provides an evaluation of such progressivity measures, undertaken using four approaches (proportion approach, tabulation approach, concentration curve and Kakwani's index), in order to reveal their usefulness and underlying notion. It is illustrated empirically with data on out-of-pocket payment for health care in Malaysia for 1998/ 1999, based on the nationally representative Household Expenditure Survey. Results indicate that out-of-pocket payments are mildly progressive, whilst the four approaches have their benefits and limitations in assessing equity implications. This analysis is of interest from a policy perspective, given Malaysia's heavy reliance on out-of-pocket payments to finance health care.

Matched MeSH terms: Social Class

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