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  1. Su TT, Azzani M, Tan FL, Loh SY
    Support Care Cancer, 2018 May;26(5):1617-1624.
    PMID: 29209834 DOI: 10.1007/s00520-017-3987-y
    PURPOSE: This study aimed, firstly, to assess the determinants of return to work (RTW), secondly, to explore the amount of annual wage loss, and finally, to discover the determinants of wage loss among breast cancer (BC) survivors.

    METHODS: A cross-sectional study design was used in this research. The data was collected via interview using a validated questionnaire. Logistic regression models were developed to discover the significant determinants of RTW and of wage loss among BC survivors.

    RESULTS: A total of 256 BC survivors were included in this study. The analysis showed that there was a 21% loss of or reduction in mean income within 1 year after diagnosis. The significant predictors of RTW are being a government employee, having reduced wages or wage loss, and if the case had been diagnosed 1 year or more ago. Being a private sector employee and having a late stage of cancer was a barrier to RTW. The main risk factors for reduced wages or wage loss were belonging to the age group of 40-59 years, being of Chinese or Indian ethnicity, having low educational status, and not returning to work. However, belonging to the higher monthly income group (earning > RM 2000) is a protective factor against the risk of reduced wages or wage loss.

    CONCLUSIONS: Non-RTW and wage loss after diagnosis of BC may result in the survivors experiencing a significant financial burden. Assessment of these patients is becoming more crucial because more women participate in the workforce in Malaysia nowadays and because BC is managed using multiple treatment modalities with their consequences could lead to long absences from work.

    Matched MeSH terms: Young Adult
  2. Bakri NN, Ferguson CA, Majeed S, Thomson WM, Oda K, Bartlett S, et al.
    Community Dent Oral Epidemiol, 2024 Aug;52(4):389-397.
    PMID: 37950336 DOI: 10.1111/cdoe.12924
    BACKGROUND: The workplace is an ideal-and priority-setting for health promotion activities. Developing and implementing workplace health promotion interventions, including oral health promotion activities, can help create health-supporting workplace environments.

    OBJECTIVE: To pilot workplace oral health promotion activities among staff working in the aged care sector, report their impact and explore participants' views on the factors that contribute to participation and effectiveness.

    METHODS: This study comprised three phases: (i) the development and face validation of the resources, (ii) a 3-h educational session and (iii) five interview sessions with participants 4-6 weeks following the education session. The recorded interviews were transcribed verbatim and analysed thematically.

    RESULTS: Eleven community-aged care workforce were invited to five feedback sessions. Ten participants were female and ranged in age from 18 to 64. All participants gave favourable comments about the content and delivery of the training session and accompanying resources. The participants felt that the benefits of WOHP include improved staff knowledge, awareness and oral care routine, the ability to share (and put into practice) the gained knowledge and information with their dependants, a lower risk of having poor oral health that adversely affects their well-being and work tasks, and potentially beneficial impacts on the organization's staff roster. Their attendance in the WOHP was facilitated by being paid to attend and scheduling the sessions during work time. Future WOHP suggestions include the possibility of a one-stop dental check-up at the workplace or staff dental care discounts from local dental practitioners and combining oral health with other health promotion activities.

    CONCLUSIONS: Planning and implementing WOHP was deemed acceptable and feasible in this study context and successfully achieved short-term impacts among community-aged care workers. Appropriate times and locations, organizational arrangements and a variety of delivery options contributed to successful programme planning and implementation.

    Matched MeSH terms: Young Adult
  3. Wong YP, Vincent James EP, Mohammad Azhar MAA, Krishnamoorthy Y, Zainudin NA, Zamara F, et al.
    Diagn Cytopathol, 2021 Jun;49(6):718-726.
    PMID: 33629823 DOI: 10.1002/dc.24731
    BACKGROUND: The International Academy of Cytology (IAC) Yokohama reporting system was recently proposed to serve as a standardized diagnostic platform for the cytological interpretation of breast fine needle aspiration biopsy (FNAB). Five cytological categories were suggested, linked to a certain risk of malignancy (ROM). The aim of this study was to assess the potency of this newly proposed reporting guideline, with a review of literatures.

    METHODS: This is a retrospective study over 8-year duration in which all the breast FNABs performed in our institution were recategorized in accordance to the IAC Yokohama reporting system. Kappa coefficient was used to evaluate the agreement between the proposed cytological category and corresponding histological diagnosis, with the level of significance set at 5%. Cyto-histopathological correlation and its diagnostic performance were also assessed.

    RESULTS: A total of 1136 breast FNABs were analyzed, including 31 repeat FNABs. Of these, 521 (47.1%) cases had matched histopathological results. Respective ROM for each category was: "insufficient" 13.6%, "benign" 0.4%, "atypical" 25.0%, "suspicious" 85.7%, and "malignant" 100%. There was substantial agreement (κ=0.757) between cytology and histopathological results. Our data revealed a high-diagnostic specificity, sensitivity, positive and negative predictive value of 99.3% (95% CI: 97.6%-99.9%), 94.2% (95% CI: 87.9%-97.9%), 98.0% (95% CI: 92.5%-99.5%), 98.0% (95% CI: 96.1%-99.1%) respectively when both the "suspicious" and "malignant" cases were considered as positive tests, with area under the curve of 0.993.

    CONCLUSIONS: The IAC Yokohama system is a reliable, evidence-based, and standardized reporting system that helps to facilitate communication among cytopathologists, radiologists, and surgeons toward individualized patient management.

    Matched MeSH terms: Young Adult
  4. Kamaruddin MNSB, Hashim NAB, Mohamed SB, Azhari ZIB
    East Asian Arch Psychiatry, 2023 Dec;33(4):114-119.
    PMID: 38955783 DOI: 10.12809/eaap2342
    BACKGROUND: Suicidal behaviour can be influenced by attitudes towards suicide and psychological distress. This study aimed to investigate the associations between psychological distress, attitudes towards suicide, and suicidal behaviour and to determine the prevalence of suicidal behaviour among students of a public university in East Malaysia.

    METHODS: A total of 521 students from a public university in East Malaysia were asked to complete the Malay versions of the Suicidal Behaviour Questionnaire-Revised (SBQ-R), the Attitudes Towards Suicide Scale, and the Depression Anxiety Stress Scale.

    RESULTS: 197 women and 290 men (mean age, 19.13 years) completed the questionnaires, giving a response rate of 93.4%. The prevalence of high-risk suicidal behaviour (SBQ-R score ≥7) was 23.8%. Suicidal behaviour was positively associated with psychological distress and favourable attitudes towards suicide, and negatively associated with unfavourable attitudes towards suicide. Predictors for suicidal behaviour were psychological distress and favourable attitudes towards suicide ('the ability to understand and accept suicide').

    CONCLUSION: The prevalence of suicidal behaviour is high among students in a public university in East Malaysia. Services and education for mental health awareness and screening for early detection and intervention of psychological distress should be provided to university students. Implementation of suicide awareness policies and suicide prevention training is crucial.

    Matched MeSH terms: Young Adult
  5. Abubakar HA, Shahril MR, Mat S
    BMC Public Health, 2024 Jul 02;24(1):1764.
    PMID: 38956547 DOI: 10.1186/s12889-024-19219-w
    INTRODUCTION: The prevailing nutritional conditions and the triple challenge of malnutrition faced by adolescents have adverse consequences for both the present and future generations' health and nutrition. Summarizing the available research on the nutritional status and dietary habits of adolescents in Nigeria is crucial.

    OBJECTIVE: This study aims to systematically evaluate available literature on the nutritional status of adolescent aged 10 to 19years in Nigeria.

    METHODOLOGY: A systematic search using PRISMA guideline was conducted. Three electronic databases were searched i.e., PubMed, Web of Science and Scopus using specific terms and keywords for online articles published between 2013 and 2023. After applying specified inclusion and exclusion criteria, 51 articles were selected for data extraction, synthesis and quality assessment.

    RESULTS: Of the 51 included studies, 78.4% were conducted in the Southern Nigeria, 11.8% in the Northern Nigeria and 9.8% included both regions. The prevalence of overweight ranged between 0.8 and 31% and obesity ranged between 0.1 and 14%. The prevalence of thinness, stunting and underweight ranged between 3 and 31%, 0.4 to 41.6%, 0.3 to 73.3% respectively. The review also identified an inadequate intake of essential nutrients including iron, zinc, calcium, vitamin A, C, D, niacin, thiamin, riboflavin, cobalamin, and folate, with vitamin A deficiency prevalence ranges from 44 to 96%. The dietary patterns were characterized by a high consumption of cereals grains and starchy foods, low animal proteins, fast-food with soft drinks, and limited consumption of fruits and vegetables along with meal skipping.

    CONCLUSION: These findings portray a complex picture of the nutritional challenges faced by this demographic group, highlighting both undernutrition and overnutrition, poor eating behaviour and micronutrient deficiency as significant concerns. The review revealed regional disparities in research representation, with a concentration of studies in Southern Nigeria. This highlights the importance of directing research efforts toward the northern regions, where the prevalence of nutritional issues is equally severe, but less studied.

    SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42023481095.

    Matched MeSH terms: Young Adult
  6. Chang AB, Yerkovich ST, Baines KJ, Burr L, Champion A, Chatfield MD, et al.
    BMJ Open Respir Res, 2024 May 07;11(1).
    PMID: 38719503 DOI: 10.1136/bmjresp-2023-002216
    INTRODUCTION: Bronchiectasis is a worldwide chronic lung disorder where exacerbations are common. It affects people of all ages, but especially Indigenous populations in high-income nations. Despite being a major contributor to chronic lung disease, there are no licensed therapies for bronchiectasis and there remain relatively few randomised controlled trials (RCTs) conducted in children and adults. Our RCT will address some of these unmet needs by evaluating whether the novel mucoactive agent, erdosteine, has a therapeutic role in children and adults with bronchiectasis.Our primary aim is to determine in children and adults aged 2-49 years with bronchiectasis whether regular erdosteine over a 12-month period reduces acute respiratory exacerbations compared with placebo. Our primary hypothesis is that people with bronchiectasis who regularly use erdosteine will have fewer exacerbations than those receiving placebo.Our secondary aims are to determine the effect of the trial medications on quality of life (QoL) and other clinical outcomes (exacerbation duration, time-to-next exacerbation, hospitalisations, lung function, adverse events). We will also assess the cost-effectiveness of the intervention.

    METHODS AND ANALYSIS: We are undertaking an international multicentre, double-blind, placebo-RCT to evaluate whether 12 months of erdosteine is beneficial for children and adults with bronchiectasis. We will recruit 194 children and adults with bronchiectasis to a parallel, superiority RCT at eight sites across Australia, Malaysia and Philippines. Our primary endpoint is the rate of exacerbations over 12 months. Our main secondary outcomes are QoL, exacerbation duration, time-to-next exacerbation, hospitalisations and lung function.

    ETHICS AND DISSEMINATION: The Human Research Ethics Committees (HREC) of Children's Health Queensland (for all Australian sites), University of Malaya Medical Centre (Malaysia) and St. Luke's Medical Centre (Philippines) approved the study. We will publish the results and share the outcomes with the academic and medical community, funding and relevant patient organisations.

    TRIAL REGISTRATION NUMBER: ACTRN12621000315819.

    Matched MeSH terms: Young Adult
  7. Azzani M, Muagan GAP, Atroosh WM, Ng IZ
    BMJ Open, 2024 Apr 30;14(4):e084454.
    PMID: 38688667 DOI: 10.1136/bmjopen-2024-084454
    BACKGROUND: Cardiovascular disease (CVD) is the major cause of mortality worldwide. Recent studies showed that there is increasing CVD incidence at younger ages. Therefore, this study aimed to estimate the risk of CVD and its associated factors among young adults.

    METHODS: A cross-sectional study was conducted among university students in Selangor, Malaysia, using a self-administered questionnaire along with anthropometric measurements. The sample size was calculated using a single proportion formula. The CVD risk was calculated using the non-laboratory-based Inter-Heart Modifiable Risk Score (IHMRS). Participants aged 18 years and above, with no CVD history, were recruited using a convenience sampling method between February and May 2022. CVD risk was classified as low (scores between 0 and 9 points), moderate (scores between 10 and 15 points) and high (scores between 16 and 48 points). The factors associated with the CVD risk were identified using χ2 analysis.

    RESULTS: A total of 241 participants were included in this study. The median age was 28 years and the majority were females (75.1%). The IHMRS revealed that 46.5%, 44.4% and 9% of the respondents have low, moderate and high CVD risk, respectively. The CVD risk associated factors were education, the history of heart attacks among parents, feeling sad or depressed for 2 weeks or more in a row, having several episodes/permanent stress, expose to secondhand smoke and consuming meat and poultry more than two times daily.

    CONCLUSIONS: This study found that more than 50% of study participants had moderate to high risk of CVD. Family history and lifestyle factors are the most likely determinants of CVD risk among the young age group. These findings support the development and implementation of targeted prevention programmes as well as provide useful information for action planning and policymaking to curb the disease in the future.

    Matched MeSH terms: Young Adult
  8. Oh AL, Makmor-Bakry M, Islahudin F, Ting CY, Chan SK, Tie ST
    Trop Med Int Health, 2024 May;29(5):434-445.
    PMID: 38470004 DOI: 10.1111/tmi.13987
    OBJECTIVES: Treatment interruption is associated with poor tuberculosis (TB) treatment outcomes and increased drug resistance. To address the issue, we aimed to investigate the characteristics, predictors and consequences of treatment interruption.

    METHODS: We conducted a retrospective cohort study by retrieving 4 years (2018-2021) of TB patients' records at 10 public health clinics in Sarawak, Malaysia. Adult patients (≥18 years) with drug-susceptible TB were selected. Treatment interruption was defined as ≥2 weeks of cumulative interruption during treatment. The Chi-square test, Mann-Whitney U test, Kaplan-Meier and Cox proportional hazards regression were used to analyse the data, with p 

    Matched MeSH terms: Young Adult
  9. Ping FW, Keong CC, Bandyopadhyay A
    Indian J Med Res, 2011 Jan;133:96-102.
    PMID: 21321426
    Athletes in Malaysia need to perform in a hot and humid environment due to the climatic nature of the country. Chronic supplementation of Panax ginseng (PG) (a deciduous perennial plant belonging to the Araliaceae family) enhances physical performance. As the ergogenic effect of acute supplementation of PG on endurance performance has not been explored in the Malaysian population especially in a hot and humid condition this study was taken up.
    Matched MeSH terms: Young Adult
  10. Abdullah N, Kueh YC, Kuan G, Wong MS, Tee V, Tengku Alang TAI, et al.
    PeerJ, 2024;12:e17265.
    PMID: 38708340 DOI: 10.7717/peerj.17265
    BACKGROUND: The objective of this study was to investigate the inter-relationship between psychosocial variables and their impact on symptom severity and quality of life (QoL) concerning abdominal bloating.

    METHODS: The study adopted a cross-sectional design with purposive sampling. Participants who consented and met the criteria for bloating based on the Rome IV classification completed designated questionnaires. Independent variables comprised health beliefs, intentions, health-promoting behaviors, social support, depression, and anxiety, while dependent variables included bloating severity (general and within 24 h) and QoL. Structural Equation Modeling (SEM) was conducted utilizing Mplus 8.0 to analyze the relationships between these factors.

    RESULTS: A total of 323 participants, with a mean age of 27.69 years (SD = 11.50), predominantly females (64.7%), volunteered to participate in the study. The final SEM model exhibited good fit based on various indices (CFI = 0.922, SRMR = 0.064, RMSEA (95% CI) = 0.048 (0.041-0.054), p-value = 0.714), with 15 significant path relationships identified. The model explained 12.0% of the variance in severity within 24 h, 6% in general severity, and 53.8% in QoL.

    CONCLUSION: The findings underscore the significant influence of health beliefs, intentions, behaviors, social support, depression, and anxiety on symptom severity and QoL in individuals experiencing abdominal bloating.

    Matched MeSH terms: Young Adult
  11. Feletti F, Goin J
    BMJ Open, 2014 Aug 28;4(8):e005508.
    PMID: 25168039 DOI: 10.1136/bmjopen-2014-005508
    OBJECTIVES: Powered paragliding (PPG) and paragliding are two totally different sports, mainly because of the use of an engine in powered paragliding. As a consequence, the pattern of injuries caused by each of these two sports may be different.

    SETTING: To test this hypothesis, we analysed 384 incident reports gathered by the US Powered Paragliding Association from 1995 to 2012. The majority of the incidents occurred in the USA, while 26 incidents occurred elsewhere: Canada (8), Mexico (5), Panama (1), China (1), Japan (1), Malaysia (1), Indonesia (Java) (1), Europe (8): of which Spain (1), Belgium (1), UK (3), Italy (1), Romania (1), unknown (1).

    OUTCOME: To identify the most affected body area and the most common type of injury sustained in PPG, and to highlight any differences from paragliding.

    RESULTS: The most affected body areas in PPG were the upper limbs (44.5%), followed by the lower limbs (32%), the back (9.8%), the head (7%), the pelvis (3.1), the chest (2.7%) and the abdomen (0.7%) (p<0.001). The engine caused 43 accidents (11.2%) in our study and was responsible for the majority of injuries to the upper limbs. The number of fatal accidents in PPG is not lower than in paragliding and hang-gliding.

    CONCLUSIONS: To help prevent the specific injuries of PPG, the most appropriate equipment should be identified. The results of this study also suggest that, in the future, this sport should be analysed separately from paragliding.

    Matched MeSH terms: Young Adult
  12. Bandyopadhyay A
    Indian J Med Res, 2011 Nov;134(5):653-7.
    PMID: 22199104 DOI: 10.4103/0971-5916.90990
    BACKGROUND & OBJECTIVES: Pulmonary function tests have been evolved as clinical tools in diagnosis, management and follow up of respiratory diseases as it provides objective information about the status of an individual's respiratory system. The present study was aimed to evaluate pulmonary function among the male and female young Kelantanese Malaysians of Kota Bharu, Malaysia, and to compare the data with other populations.

    METHODS: A total of 128 (64 males, 64 females) non-smoking healthy young subjects were randomly sampled for the study from the Kelantanese students' population of the University Sains Malaysia, Kota Bharu Campus, Kelantan, Malaysia. The study population (20-25 yr age group) had similar socio-economic background. Each subject filled up the ATS (1978) questionnaire to record their personal demographic data, health status and consent to participate in the study. Subjects with any history of pulmonary diseases were excluded from the study.

    RESULTS: The pulmonary function measurements exhibited significantly higher values among males than the females. FEV 1% did not show any significant inter-group variation probably because the parameter expresses FEV 1 as a percentage of FVC. FVC and FEV 1 exhibited significant correlations with body height and body mass among males whereas in the females exhibited significant correlation with body mass, body weight and also with age. FEV 1% exhibited significant correlation with body height and body mass among males and with body height in females. FEF 25-75% did not show any significant correlation except with body height among females. However, PEFR exhibited significant positive correlation with all the physical parameters except with age among the females. On the basis of the existence of significant correlation between different physical parameters and pulmonary function variables, simple and multiple regression norms have been computed.

    INTERPRETATION & CONCLUSIONS: From the present investigation it can be concluded that Kelantanese Malaysian youths have normal range of pulmonary function in both the sexes and the computed regression norms may be used to predict the pulmonary function values in the studied population.

    Matched MeSH terms: Young Adult
  13. Chen X, Zhao Y, Zhang A, Zhou Y, Li M, Cheng X, et al.
    BMC Ophthalmol, 2024 Apr 25;24(1):195.
    PMID: 38664615 DOI: 10.1186/s12886-024-03464-z
    BACKGROUND: Analyzing the glaucoma burden in "Belt and Road" (B&R) countries based on age, gender, and risk factors from 1990 to 2019 in order to provide evidence for future prevention strategies.

    METHODS: We applied global burden of disease(GBD) 2019 to compare glaucoma prevalence and Years lived with disabilities (YLDs) from 1990 to 2019 in the B&R countries. Trends of disease burden between 1990 and 2019 were evaluated using the average annual percent change and the 95% uncertainty interval (UI) were reported.

    RESULTS: From 1990 to 2019, most B&R countries showed a downward trend in age-standardized prevalence and YLDs (all P  85 years), Malaysia(75-84 years), Brunei Darussalam(45-49 years), Afghanistan(70-79 years). Finally, in all Central Asian countries, the age-standardized YLDs due to glaucoma caused by fasting hyperglycemia demonstrated have an increase between 1990 and 2019 (all P 

    Matched MeSH terms: Young Adult
  14. Ng S, Hamontri S, Chua I, Chern B, Siow A
    Fertil Steril, 2009 Aug;92(2):448-52.
    PMID: 18930204 DOI: 10.1016/j.fertnstert.2008.08.072
    To present our experience of laparoscopic management of cornual ectopic pregnancy.
    Matched MeSH terms: Young Adult
  15. McKenzie KJ, Newport R
    J Psychosom Res, 2015 Jan;78(1):88-90.
    PMID: 25466984 DOI: 10.1016/j.jpsychores.2014.11.005
    Medically unexplained symptoms (MUS) are increasingly being thought of as resulting from dysfunctional modulation of interoceptive sensory signals by top-down cognitive processes. The current study investigated whether individuals with a tendency toward MUS would be more susceptible to visual illusions that suggest tactile sensation on the skin in the absence of any actual somatosensory input.
    Matched MeSH terms: Young Adult
  16. Lin Y, Hu Z, Alias H, Wong LP
    J Psychosom Res, 2021 05;144:110420.
    PMID: 33770568 DOI: 10.1016/j.jpsychores.2021.110420
    OBJECTIVE: Wuhan, the epicentre of the coronavirus diseases (COVID-19) outbreak, has been locked down on January 23, 2020. We conducted a study among the lay public in Wuhan to access their support, understanding of, compliance with, and the psychological impacts of the quarantine.

    METHODS: We conducted a cross-sectional, online-based survey study between January 28, 2020, and February 2, 2020 among the adult lay public in Wuhan to access their support, understanding of, compliance with, and the psychological impacts of the quarantine. Multivariable logistic analysis was used to identify factors associated with psychological impacts.

    RESULTS: Among the 4100 participants investigated, a total of 15.9% were compliant with all the five household prevention measures, whereas 74.4% were compliant with all the three community prevention measures investigated. By demographics, participants of younger age, higher income, residing in an urban area, knowing neighbors infected with COVID-19 reported significantly higher psychological impact score. Participants with a lower level of support for quarantine were more likely to have a higher psychological impact score (OR = 1.45, 95% CI 1.07-1.96). Participants with a lower level of compliance with preventive measures (score of 0-19) reported higher psychological impact (OR = 1.40, 95% CI 1.22-1.60 vs. score 20-24). Participants who had been out of house socializing and attended public events expressed higher psychological impact.

    CONCLUSIONS: Support, understanding of the rationale for quarantine are essential in ensuring appropriate psychological well-being during the quarantine. Improvements in compliance with preventive measures are highly warranted and may bring about a reduction in psychological distress.

    Matched MeSH terms: Young Adult
  17. Rasidi WNA, Seluakumaran K
    Int J Audiol, 2024 May;63(5):326-333.
    PMID: 37073634 DOI: 10.1080/14992027.2023.2197146
    OBJECTIVE: The ear's spectral resolution or frequency selectivity (FS) is a fundamental aspect of hearing but is not routinely measured in clinical practice. This study evaluated a simplified FS testing procedure for clinical use by replacing the time-consuming two-interval forced choice (2IFC) method with method of limits (MOL) carried out using a custom-made software and consumer-grade equipment.

    DESIGN AND STUDY SAMPLE: Study 1 compared the FS measure obtained with MOL and 2IFC procedure at two centre frequencies (CFs) (1 and 4 kHz) in 21 normal-hearing listeners. Study 2 determined the FS measure using MOL at five CFs (0.5-8 kHz) in 32 normal-hearing and nine sensorineural hearing loss listeners and compared them with their thresholds in quiet.

    RESULTS: FS measurements with MOL and 2IFC methods were highly correlated and had statistically comparable intra-subject test-retest reliability. FS measures determined with MOL were reduced in the hearing-impaired compared to normal-hearing listeners at the CF corresponding to their hearing loss. Linear regression analysis showed significant relationship between FS deterioration and quiet threshold loss (p 

    Matched MeSH terms: Young Adult
  18. Al-Mekhlafi AM, Al-Mekhlafi HM, Mahdy MA, Azazy AA, Fong MY
    Ann Trop Med Parasitol, 2011 Apr;105(3):187-95.
    PMID: 21801497 DOI: 10.1179/136485911X12987676649421
    Between June 2008 and March 2009, a cross-sectional study of human malaria was carried out in four governorates of Yemen, two (Taiz and Hodiedah) representing the country's highlands and the others (Dhamar and Raymah) the country's coastal plains/foothills. The main aims were to determine the prevalences of Plasmodium infection among 455 febrile patients presenting for care at participating health facilities and to investigate the potential risk factors for such infection. Malarial infection was detected in 78 (17·1%) of the investigated patients and was more likely to be detected among the febrile patients from the highlands than among those presenting in the coastal plains/foothills (22·6% v.13·9%; χ(2)=10·102; P=0·018). Binary logistic-regression models identified low household income [odds ratio (OR)=13·52; 95% confidence interval (CI)=2·62-69·67; P=0·002], living in a household with access to a water pump (OR=4·18; CI=1·60-10·96; P=0·004) and living in a household near a stream (OR=4·43; CI=1·35-14·56; P=0·014) as significant risk factors for malarial infection in the highlands. Low household income was the only significant risk factor identified for such infection in the coastal plains and foothills (OR = 8·20; CI=1·80-37·45; P=0·007). It is unclear why febrile patients in the highlands of Yemen are much more likely to be found to have malarial infection than their counterparts from the coastal plains and foothills. Although it is possible that malarial transmission is relatively intense in the highlands, it seems more likely that, compared with those who live at lower altitudes, those who live in the highlands are less immune to malaria, and therefore more likely to develop febrile illness following malarial infection. Whatever the cause of the symptomatic malarial infection commonly found in the highlands of Yemen, it is a matter of serious concern that should be addressed in the national strategy to control malaria.
    Matched MeSH terms: Young Adult
  19. Liew SM, Khoo EM, Ho BK, Lee YK, Omar M, Ayadurai V, et al.
    PLoS One, 2016;11(6):e0157631.
    PMID: 27336440 DOI: 10.1371/journal.pone.0157631
    BACKGROUND: The increasing incidence and geographical distribution of dengue has had significant impact on global healthcare services and resources. This study aimed to determine the factors associated with dengue-related mortality in a cohort of Malaysian patients.

    METHODS: This was a retrospective cohort study of patients in the Malaysian National Dengue Registry of 2013. The outcome measure was dengue-related mortality. Associations between sociodemographic and clinical variables with the outcome were analysed using multivariate analysis.

    RESULTS: There were 43 347 cases of which 13081 were serologically confirmed. The mean age was 30.0 years (SD 15.7); 60.2% were male. The incidence of dengue increased towards the later part of the calendar year. There were 92 probable dengue mortalities, of which 41 were serologically confirmed. Multivariate analysis in those with positive serology showed that increasing age (OR 1.03; CI:1.01-1.05), persistent vomiting (OR 13.34; CI: 1.92-92.95), bleeding (OR 5.84; CI 2.17-15.70) and severe plasma leakage (OR 66.68; CI: 9.13-487.23) were associated with mortality. Factors associated with probable dengue mortality were increasing age (OR 1.04; CI:1.03-1.06), female gender (OR 1.53; CI:1.01-2.33), nausea and/or vomiting (OR 1.80; CI:1.17-2.77), bleeding (OR 3.01; CI:1.29-7.04), lethargy and/or restlessness (OR 5.97; CI:2.26-15.78), severe plasma leakage (OR 14.72; CI:1.54-140.70), and shock (OR 1805.37; CI:125.44-25982.98), in the overall study population.

    CONCLUSIONS: Older persons and those with persistent vomiting, bleeding or severe plasma leakage, which were associated with mortality, at notification should be monitored closely and referred early if indicated. Doctors and primary care practitioners need to detect patients with dengue early before they develop these severe signs and symptoms.

    Matched MeSH terms: Young Adult
  20. Sweeney LA, Molloy GJ, Byrne M, Murphy AW, Morgan K, Hughes CM, et al.
    PLoS One, 2015;10(12):e0144074.
    PMID: 26633191 DOI: 10.1371/journal.pone.0144074
    BACKGROUND: The oral contraceptive pill (OCP) remains the most popular form of prescription contraception in many countries, despite adherence difficulties for many. Uptake of long acting reversible contraceptives (LARCs), which are less reliant on user adherence, remains low. The aim of this study was to explore the experiences of, and attitudes towards, prescription contraception amongst samples of contraception users, general practitioners (GPs) and pharmacists.

    METHODOLOGY AND FINDINGS: We conducted a qualitative study using semi-structured interviews with 18 contraception users, 18 GPs and 9 pharmacists. The study took place in Galway, Republic of Ireland between June and September 2014. Thematic analysis was used to analyse the data. Overall, contraception users were more familiar with the OCP, and all the women interviewed began their prescription contraception journey using this method. All participants identified episodes of poor adherence throughout the reproductive life course. The identified barriers for use of LARCs were lack of information, misconceptions, lack of access and high cost. In contrast, GPs believed that adherence to the OCP was good and stated they were more likely to prescribe the OCP than other methods, as they were most familiar with this option. Barriers to prescribing LARCSs were time, cost to practice, training and deskilling. Pharmacists also believed that adherence to the OCP was generally good and that their role was limited to dispensing medication and providing information when asked.

    DISCUSSION AND CONCLUSION: There are contrasting perspectives between contraception service providers and contraceptive users. Training for healthcare providers is required to support informed contraceptive choice and adherence. It is necessary to address the practice barriers of cost and lack of time, to promote better communication around adherence issues and prescription contraception options. There is a need for more easily-accessible public health information to promote awareness on all methods of prescription contraception.

    Matched MeSH terms: Young Adult
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