Displaying publications 1 - 20 of 57 in total

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  1. Miyasaka M, Akabayashi A, Kai I, Ohi G
    J Med Ethics, 1999 Dec;25(6):514-21.
    PMID: 10635508
    SETTING: Medical ethics education has become common, and the integrated ethics curriculum has been recommended in Western countries. It should be questioned whether there is one, universal method of teaching ethics applicable worldwide to medical schools, especially those in non-Western developing countries.
    OBJECTIVE: To characterise the medical ethics curricula at Asian medical schools.
    DESIGN: Mailed survey of 206 medical schools in China, Hong Kong, Taiwan, Korea, Mongolia, Philippines, Thailand, Malaysia, Singapore, Indonesia, Sri Lanka, Australia and New Zealand.
    PARTICIPANTS: A total of 100 medical schools responded, a response rate of 49%, ranging from 23%-100% by country.
    MAIN OUTCOME MEASURES: The degree of integration of the ethics programme into the formal medical curriculum was measured by lecture time; whether compulsory or elective; whether separate courses or unit of other courses; number of courses; schedule; total length, and diversity of teachers' specialties.
    RESULTS: A total of 89 medical schools (89%) reported offering some courses in which ethical topics were taught. Separate medical ethics courses were mostly offered in all countries, and the structure of vertical integration was divided into four patterns. Most deans reported that physicians' obligations and patients' rights were the most important topics for their students. However, the evaluation was diverse for more concrete topics.
    CONCLUSION: Offering formal medical ethics education is a widespread feature of medical curricula throughout the study area. However, the kinds of programmes, especially with regard to integration into clinical teaching, were greatly diverse.
    Matched MeSH terms: Tissue and Organ Procurement
  2. Gordon CR, Siemionow M
    Ann Plast Surg, 2009 Sep;63(3):262-73.
    PMID: 19692900 DOI: 10.1097/SAP.0b013e31818d45e9
    Since 1998, 42 hand transplants in 30 patients have been performed in countries such as France, United States, China, Austria, Malaysia, Italy, Belgium, Poland, Spain, and Germany. Now, with recent improvements in immunosuppression, the clinical applicability may expand and the ethical obstacles may soon be overcome, allowing multiple US institutions to perform hand allotransplantation. The main purpose of this article is to facilitate access to pertinent details in regards to hand transplantation, such as donor/recipient selection criteria, immunosuppressive therapies, and associated complications. It is a comprehensive literature review compiled from published reports from multiple hand transplant programs throughout the world. Due to its inherent complexity, hand transplantation should only be attempted at institutions within the US capable of orchestrating a specialized multidisciplinary team, and each institution's protocol should be extremely detailed and individualized.
    Matched MeSH terms: Tissue and Organ Procurement/organization & administration
  3. Rozaidi SW, Sukro J, Dan A
    Med J Malaysia, 2000 Dec;55(4):478-85.
    PMID: 11221161
    One of the main reasons for poor response in organ donation is the lack of positive attitudes and knowledge present in health care professionals. Definite legislation, policies and programmes dealing with brain death and cadaveric organ transplantation have shown some favourable results in terms of increasing donor rates. These programmes are mainly Western based; therefore adopting such programmes to be used locally may not be adequate or proper. To address this issue, we decided to carry out a questionnaire in two tertiary hospitals in Malaysia, one with a well establish brain death and cadaveric organ transplantation programme and one with none.
    Matched MeSH terms: Tissue and Organ Procurement
  4. Ariffin AF, Yusof N, Mohd S, Rahman SA, Ramalingam S, Mansor A, et al.
    Cell Tissue Bank, 2019 Dec;20(4):527-534.
    PMID: 31456097 DOI: 10.1007/s10561-019-09785-4
    Calcium contents of demineralised human cortical bone determined by titrimetric assay and atomic absorption spectrophotometry technique were verified by comparing to neutron activation analysis which has high recovery of more than 90%. Conversion factors determined from the comparison is necessary to correct the calcium content for each technique. Femurs from cadaveric donors were cut into cortical rings and demineralised in 0.5 M hydrochloric acid for varying immersion times. Initial calcium content in the cortical bone measured by titration was 4.57%, only 21% of the measurement by neutron activation analysis; while measured by atomic absorption spectrophotometer was 13.4%, only 61% of neutron activation analysis. By comparing more readings with the measurements by neutron activation analysis with 93% recovery, a conversion factor of 4.83 was verified and applied for the readings by titration and 1.45 for atomic absorption spectrophotometer in calculating the correct calcium contents. The residual calcium content started to reduce after the cortical bone was demineralised in hydrochloric acid for 8 h and reduced to 13% after 24 h. Using the linear relationship, the residual calcium content could be reduced to less than 8% after immersion in hydrochloric acid for 40 h. Atomic absorption spectrophotometry technique is the method of choice for calcium content determination as it is more reliable compared to titrimetric assay.
    Matched MeSH terms: Tissue and Organ Procurement
  5. ABM Tofazzal Hossain, Shaila Kabir, Constance Liew Sat Lin, Fairrul Kadir, M Tanvir Hossain Parash, Sadia Choudhury Shimmi, et al.
    MyJurnal
    Introduction: Role of nurses is very important in raising awareness, motivation level and increasing rate of organ donation subsequently. There are many studies on critical care nurses’ roles and education affect organ donation. Methods: A narrative literature review article of published research. Twelve published articles from ten different countries were found using different renowned online search engines. Results: Knowledge about organ donation among nursing students almost all over the world is inadequate than expectation and requirement in respective country. Marlene R et al showed that scores on the knowledge, attitudes, and beliefs subscales were positively cor- related with the number of requests for tissue and organs and consents obtained (0.76); and consents obtained for tissues and consents obtained for organs (0.72). Professional education was indicated in 43% of nurses surpassing family beliefs, religion and mass media. The cognitive part (knowledge) is directly depends on non-cognitive (Aware- ness and Attitude). Findings from almost all articles suggest the need of adding organ donation topic in the nursing and medical curriculum to prepare competent nurses and health care providers for future. Conclusion: This study suggests that there is a need to integrate organ donation aspects into the educational program to prepare nurses for their roles in organ and tissue procurement as well as awareness among policy makers in this regard for the well-be- ing of our patients.
    Matched MeSH terms: Tissue and Organ Procurement
  6. Wong LP
    Singapore Med J, 2010 Oct;51(10):790-5.
    PMID: 21103814
    INTRODUCTION:
    This study assessed the information needs, preferred educational messages and channels of delivery, as well as opinions on strategies to promote organ donation. It aimed to provide insight into a culturally sensitive public education campaign to encourage organ donation in diverse ethnic communities in Asia, namely the Malays, Chinese and Indians.

    METHODS:
    A total of 17 focus group discussions with 105 participants were conducted between September and December 2008. The participants were members of the general public aged 18 to 60 years, who were recruited through convenient sampling in the Klang Valley area of Malaysia.

    RESULTS:
    Across ethnic groups, there was a general concern about the mistreatment of the deceased's body in the organ procurement process. The Chinese and Indian participants wanted assurance that the body would be treated with respect and care. The Muslims wanted assurance that the handling of a Muslim's body would follow the rules and regulations of the Islamic faith. The most important information requested by the Muslim participants was whether cadaveric donation is permissible in Islam. A lack of national public education and promotion of organ donation was noted. All the three ethnic groups, especially the Malays, required community and religious leaders for support, encouragement and involvement, as sociocultural influences play a significant role in the willingness to donate organs.

    CONCLUSION:
    The pronounced ethnic differences in information needs suggest that culturally sensitive public educational messages are required. Organ donation and transplantation organisations should work closely with community and religious organisations to address the sociocultural barriers identified.
    Matched MeSH terms: Tissue and Organ Procurement
  7. Tumin M, Tafran K, Zakaria RH, Satar NM, Ng KP, Lim SK
    Ann. Transplant., 2015 Dec 22;20:752-6.
    PMID: 26690676 DOI: 10.12659/aot.894427
    BACKGROUND: Malaysia, which currently uses the informed consent system (ICS), is suffering from a severe shortage of organs for transplantation. Family members of dialysis patients (FMDPs) are expected to have a positive attitude toward deceased organ donation (DOD) because they have a close relative in need of a kidney donation. This study explores FMDPs' attitude toward DOD under the ICS and the presumed consent system (PCS).

    MATERIAL/METHODS: The attitude of 350 FMDPs toward DOD under the ICS and PCS were sought between June and October 2013 in 3 dialysis institutions in Kuala Lumpur, Malaysia.

    RESULTS: Under the ICS, 6.6% of respondents were registered donors, 6.6% were ready to register at the time of the survey, 38.6% were willing to donate but not ready to register at the time of the survey, and 48.2% were unwilling to donate organs upon death. If the PCS were implemented, 57.7% of respondents (28.7% of the willing donors and 88.7% of the unwilling respondents) stated that they would officially object to organ donation.

    CONCLUSIONS: FMDPs' attitude toward DOD is not more positive or significantly better than that of the general public (based on earlier studies). The PCS may increase the number of donors, but it may also worsen the attitude of FMDPs toward DOD. Strategies aiming to promote DOD in Malaysia should be revised, and should perhaps be focused on enhancing trust of the medical system.
    Matched MeSH terms: Tissue and Organ Procurement/organization & administration*
  8. Tumin M, Noh A, Jajri I, Chong CS, Manikam R, Abdullah N
    Exp Clin Transplant, 2013 Jun;11(3):207-10.
    PMID: 23432623 DOI: 10.6002/ect.2012.0194
    This paper examines factors that influence Malaysian persons with a tertiary level of education on their willingness to donate organs.
    Matched MeSH terms: Tissue and Organ Procurement*
  9. Wong LP
    Clin Transplant, 2011 Jan-Feb;25(1):E22-31.
    PMID: 20718827 DOI: 10.1111/j.1399-0012.2010.01312.x
    Malaysia's organ and tissue donation rates are among the lowest in the world. The study aims to explore the knowledge, attitudes, practices and behaviors regarding deceased organ donation and transplantation in the diverse ethnic communities in the state of Selangor, Malaysia.
    Matched MeSH terms: Tissue and Organ Procurement/statistics & numerical data*
  10. Santibañez S, Boudreaux D, Tseng GF, Konkel K
    J Relig Health, 2016 Oct;55(5):1483-94.
    PMID: 26311054 DOI: 10.1007/s10943-015-0110-x
    The Buddhist Tzu Chi Silent Mentor Program promotes the donation of one's body to science as a selfless act by appealing to the Buddhist ethics of compassion and self-sacrifice. Together, faculty, families, and donors help medical students to learn the technical, spiritual, emotional, and psychological aspects of medicine. Students assigned to each "Silent Mentor" visit the family to learn about the donor's life. They see photos and hear family members' stories. Afterwards, students write a brief biography of the donor which is posted on the program website, in the medical school, and on the dissection table. In this paper, we: (1) summarize the Silent Mentor Program; (2) describe findings from an assessment of medical students who recently completed a new version of the program in Malaysia; and (3) explore how healthcare settings could benefit from this innovative program.
    Matched MeSH terms: Tissue and Organ Procurement/ethics
  11. Chen TP, Teo SM, Tan JC, Koh SN, Ambalavanar N, Tan SY
    Transplant Proc, 2000 Nov;32(7):1809-10.
    PMID: 11119946
    Matched MeSH terms: Tissue and Organ Procurement/organization & administration*
  12. Woo KT
    Ann Acad Med Singap, 1992 May;21(3):421-7.
    PMID: 1416796
    In Asian countries, it is more difficult to obtain cadaver kidneys for renal transplantation because of certain socio-cultural beliefs and customs. The issues affecting living related kidney donation are more social than cultural. This is due to the web of family pressures and personal conflicts for both donor and recipient surrounding the donation. Important misconceptions and fears are: fear of death, the belief that removal of organ violates sanctity of decreased, concern about being cut up after death, desire to be buried whole, dislike of idea of kidneys inside another person, wrong concept of brain death, and the idea of donation being against religious conviction. In Singapore, with the introduction of the Human Organ Transplant Act (HOTA) in 1988, the number of cadaveric transplants have increased, including those from the Medical Therapy Act (MTA). HOTA and education have played pivotal roles in bringing about an increased yield of cadaveric kidneys. With the availability of living unrelated donor (LUD) transplants in India, our living related donor (LRD) transplant programme has suffered, because patients would rather buy a kidney from overseas than get a relative to donate one. Patients are also going to China for overseas cadaveric transplants where the kidneys come from executed convicts. People in countries like Hong Kong, Japan and the Philippines share the same Asian tradition of not parting with their organs after death. Muslim countries like Malaysia require the deceased to have earlier pledged his kidneys for donation prior to death before they can be harvested for transplantation at death.
    Matched MeSH terms: Tissue and Organ Procurement*
  13. Blum JD, Talib N, Carstens P, Nasser M, Tomkin D, McAuley A
    Med Law, 2003;22(3):451-71.
    PMID: 14626880
    Recognition and articulation of patient rights are core issues in the medical jurisprudence of most nations. While the nature of rights in medical care may vary from country to country, reflecting the idiosyncrasies of domestic law and health delivery, there are commonalities in this area of law that cut across borders. This paper presents five case studies in the patient rights area from Malaysia, Ireland, South Africa, Indonesia and the United States, respectively. The case discussions range from ongoing and fundamental concerns over broad patient rights issues, such as access to health care and informed consent, to rights concerns of those suffering from HIV/AIDS, to a novel consideration over ethical and legal issues concerning ownership of infant organs. It is the hope of the authors that individually, and collectively, the cases will provide helpful insights into this core area of medical law.
    Matched MeSH terms: Tissue and Organ Procurement/legislation & jurisprudence
  14. Tumin M, Tafran K, Mohd Satar NH, Peng NK, Manikam R, Yoong TL, et al.
    Exp Clin Transplant, 2019 02;17(1):1-5.
    PMID: 29766774 DOI: 10.6002/ect.2017.0214
    OBJECTIVES: This paper explores health care professionals' potential attitude toward organ donation if the presumed consent system were to be implemented in Malaysia, as well as factors associated with this attitude.

    MATERIALS AND METHODS: We used self-administered questionnaires to investigate the attitude of 382 health care professionals from the University of Malaya Medical Center between January and February 2014. The responses were analyzed using logistic regression.

    RESULTS: Of the 382 respondents, 175 (45.8%) stated that they would officially object to organ donation if the presumed consent system were to be implemented, whereas the remaining 207 (54.2%) stated that they would not object. The logistic regression showed that health care professionals from the Malay ethnic group were more likely to object than those from Chinese (adjusted odds ratio of 0.342; P = .001) and Indian and other (adjusted odds ratio of 0.341; P = .003) ethnic groups. Health care professionals earning 3000 Malaysian Ringgit or below were more likely to object than those earning above 3000 Malaysian Ringgit (adjusted odds ratio of 1.919; P = .006). Moreover, respondents who were initially unwilling to donate organs, regardless of the donation system, were more likely to object under the presumed consent system than those who were initially willing to donate (adjusted odds ratio of 2.765; P < .001).

    CONCLUSIONS: Health care professionals in Malaysia have a relatively negative attitude toward the presumed consent system, which does not encourage the implementation of this system in the country at present. To pave the way for a successful implementation of the presumed consent system, efforts should be initiated to enhance the attitude of health care professionals toward this system. In particular, these efforts should at most target the health care professionals who are Malay, earn a low income, and have a negative default attitude toward deceased donation.

    Matched MeSH terms: Tissue and Organ Procurement*
  15. Foong JW, Ong JS, Oo WL, Hossain MM, Baskaran ND, Haron H, et al.
    Med J Malaysia, 2019 04;74(2):109-115.
    PMID: 31079120
    INTRODUCTION: Organ donation rate in Malaysia is amongst the lowest in the World. Healthcare professionals (HCPs) working in critical care areas play an important role in the deceased organ donation (DOD) process. This study seeks to identify the demographics of HCPs working in the critical care areas and their knowledge and attitudes toward the DOD process.

    METHOD: A cross-sectional survey on the demographics, knowledge and attitudes of the doctors and nurses working in critical care areas was undertaken by the random sampling method, using a validated, structured questionnaire. HCP's knowledge and attitudes towards brain death (BD), DOD, organ transplantation (OT), and possession of organ donor card were compared against their demographics.

    RESULTS: Four hundred and twelve (72.9%) out of the total 565 HCPs in critical care areas responded of whom 163 (39.6%) were doctors and 249 (60.4%) were nurses. After adjusting for other factors, department of work and profession were highly correlated with the overall knowledge score (p<0.001 and p=0.003 respectively) and knowledge about BD (p<0.001 and p=0.013 respectively). HCPs from the neurosurgical intensive care unit (p<0.001) and doctors (p<0.001) had higher mean knowledge scores compared to their counterparts. Profession was most significantly correlated with having a positive attitude towards BD (p<0.001) and OT (p<0.001).

    CONCLUSION: Department, profession and ethnicity were the demographic characteristics that correlated with knowledge and attitudes of HCPs on organ donation. Efforts to improve DOD rates in Malaysia should include targeted interventions to address the knowledge and attitudes of HCPs working in critical care areas.

    Matched MeSH terms: Tissue and Organ Procurement/statistics & numerical data*
  16. Lim KJ, Cheng TTJ, Jeffree MS, Hayati F, Cheah PK, Nee KO, et al.
    Transplant Proc, 2020 Apr;52(3):680-686.
    PMID: 32146022 DOI: 10.1016/j.transproceed.2020.01.007
    INTRODUCTION: Worldwide, the gap between organ supply and demand has widened over the years. Malaysia has one of the lowest deceased organ donation rates. Success rate of organ or tissue procurement depends on not only the approach rate by health care providers but also the awareness among the public, whereby it can be a platform for family initiation of organ donation. The purpose of this study is to assess the knowledge of and determine the factors influencing attitude toward organ and tissue donation among patients in a primary clinic.

    METHODS: A cross-sectional analytical study was carried out. Self-administered questionnaires were given to 400 patients who registered at an outpatient clinic in April 2018. Convenience sampling was applied.

    RESULTS: Monthly income, education level, occupation, and knowledge level are significantly associated with attitude of the respondents toward organ and tissue donation. Occupation influenced attitude toward organ donation. Knowledge of organ donation and brain death both significantly affected attitude toward organ donation.

    CONCLUSION: The greater the knowledge of organ donation and brain death, the more positive impression or attitude toward organ donation. Education level and income are the main predictors that influence attitude toward organ donation. Hence, it is important for public health units to promote and deliver public education on organ donation, change public misconceptions, and work parallel with hospitals to increase organ donation rates in Sabah.

    Matched MeSH terms: Tissue and Organ Procurement*
  17. Abidin ZL, Ming WT, Loch A, Hilmi I, Hautmann O
    Transpl Int, 2013 Feb;26(2):187-94.
    PMID: 23199156 DOI: 10.1111/tri.12019
    The rate of organ donations from deceased donors in Malaysia is among the lowest in the world. This may be because of the passivity among health professionals in approaching families of potential donors. A questionnaire-based study was conducted amongst health professionals in two tertiary hospitals in Kuala Lumpur, Malaysia. Four hundred and sixty-two questionnaires were completed. 93.3% of health professionals acknowledged a need for organ transplantation in Malaysia. 47.8% were willing to donate their organs (with ethnic and religious differences). Factors which may be influencing the shortage of organs from deceased donors include: nonrecognition of brainstem death (38.5%), no knowledge on how to contact the Organ Transplant Coordinator (82.3%), and never approaching families of a potential donor (63.9%). There was a general attitude of passivity in approaching families of potential donors and activating transplant teams among many of the health professionals. A misunderstanding of brainstem death and its definition hinder identification of a potential donor. Continuing medical education and highlighting the role of the Organ Transplant Coordinator, as well as increasing awareness of the public through religion and the media were identified as essential in improving the rate of organ donations from deceased donors in Malaysia.
    Matched MeSH terms: Tissue and Organ Procurement/methods*
  18. Naghavi N, Mubarik MS, Rasiah R, Sharif Nia H
    Int J Gen Med, 2020;13:641-651.
    PMID: 32982381 DOI: 10.2147/IJGM.S253372
    Purpose: The gap between the demand and the supply of human organs for transplantation is on the rise in Malaysia, despite the efforts of governments to promote donor registration. Factors affecting willingness to donate are contextual and vary from country to country. This research mainly focuses on the selection of most suitable organ donation system through factors affecting willingness to donate in Malaysia. The objectives of this study are to prioritize those factors acting as the pillars of the organ donation system and further to select the most suitable organ donation system for Malaysia.

    Patients and Methods: The data were collected from 35 experts by using a bipolar questionnaire. The study applied an analytical hierarchal process (AHP) for prioritization factors contributing to willingness to donate and then selection of a suitable organ donation system based on prioritized factors.

    Results: Based on the AHP results, it is evident that donation perception (0.36) has the highest priority in influencing organ donation rates, followed by socioeconomic status (0.32), demographic factors (0.23), and financial incentives (0.09). Further, our results challenge the existing opt-in donation system in Malaysia and present a presumptive approach as a suitable system for increasing deceased donation rate in Malaysia. Presumptive approach promotes the role of health-care professionals in securing the family consent.

    Conclusion: This approach is a person-oriented rather than process-oriented strategy and it relies on designated requesters' skills to evoke altruism among bereaved families. Based on results, the authors recommended that relevant government agencies focus on training nurses to discuss donation with bereaved families and raising public awareness.

    Matched MeSH terms: Tissue and Organ Procurement
  19. Makmor, T, Raja Noriza, RA, NurulHuda, MS, Sook-Lu, Y, Soo-Kun, L, Kok-Peng, N, et al.
    JUMMEC, 2016;19(1):1-6.
    MyJurnal
    Introduction:
    Living donation is an important source for organs transplantation in Malaysia. This study aims to investigate
    the Malaysian living donors’ follow-up attendance, their preferences on medical-institutional facilities, and
    the financial circumstances pertaining to the follow-up costs
    Materials and Methods:
    Primary data were collected through a survey of 80 living donors who made their donation at the University
    of Malaya Medical Center (UMMC) between 1991 and 2012.
    Results:
    Out total of 178 donors, only 111 were reachable and 80 of them participated in the survey (72%). The findings
    revealed that most of the donors (71.2%) attend the follow-up regularly. Nevertheless, donors seem to neglect
    the importance of follow-up as they consider themselves healthy (28.9%) or consider the follow-up as being
    troublesome (28.9%). Most donors (67.5%) are not in favour of being treated as patients, but prefer to be
    monitored under donor registry (88.8%) and getting their health service in special clinics for donors (80%).
    The majority of the donors fund the follow-up costs themselves (32.4%), while 25% of the donors’ follow-up
    costs were funded by family members. Among those donors without income and those of low-income (84.8%
    of respondents), 60.3% believe that the follow-up costs should be borne by the government.
    Conclusions:
    Based on the findings, it is therefore suggested that the government provides all living donors with proper
    free health service through donor registry and donor clinics. Adequate care has to be given to the donors to
    pre-empt any unforeseen health complications due to the organ donation surgical procedures.
    Matched MeSH terms: Tissue and Organ Procurement
  20. Oo WL, Ong JS, Fong JW, Hossain MM, Baskaran ND, Haron H, et al.
    Singapore Med J, 2019 Jul 22.
    PMID: 31328238 DOI: 10.11622/smedj.2019080
    INTRODUCTION: Healthcare professionals (HCPs) working in critical care areas play an important role in the organ donation (OD) process. We studied HCPs' own willingness to be organ donors and its association with sociodemographic factors as well as their knowledge and attitudes about OD and transplantation.

    METHODS: A cross-sectional survey of HCPs working in four critical care units in a major transplant centre in Malaysia was undertaken using a validated structured questionnaire. Responses were analysed using multivariable analysis with willingness to donate as the dependent variable.

    RESULTS: Of the 412 respondents (response rate 98.1%), the majority were nurses (60.4%), Malay (71.1%) and female (77.2%). Overall, 68.0% were willing to donate. The independent predictors of willingness to donate were profession (p < 0.001) and the Hindu religion (p = 0.001). Ethnicity (p = 0.003), religious belief (p < 0.001), knowledge (p = 0.016), belief in brain death (p = 0.018) and confidence in transplantation (p < 0.001) also independently correlated with willingness to donate, while attitudes to OD did not. Of those willing to donate, only 37.3% were carrying a donor card and only 63.1% had informed their family of their intention to donate.

    CONCLUSION: Although willingness to donate was higher in critical care HCPs than HCPs in general, significant knowledge gaps as well as certain beliefs and perceptions that could pose a barrier to OD were identified in this group. Measures to improve OD rates in Malaysia should include targeted educational programmes for HCPs working in critical care areas.
    Matched MeSH terms: Tissue and Organ Procurement
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