METHODS: The questionnaire (RPDM) was developed based on the Health Belief Model and previous literature. A 59-item question pool was initially developed, reviewed by experts for content validity and pretested on five respondents. Different samples were used for pilot study (n = 100) and subsequent validation study (n = 158). Exploratory factor analysis (EFA) and Confirmatory factor analysis (CFA) were used to evaluate construct validity and construct reliability of the questionnaire.
RESULTS: The EFA yielded five-factors model, including 48 items with good factor loadings of > 0.40. CFA was carried out using item parceling. The final model shows acceptable model fit and had sufficient convergent and discriminant validity. The value of construct reliability ranged between 0.76 and 0.90.
CONCLUSION: This newly developed and validated Malay-language RPDM questionnaire is valid and reliable for measuring the five constructs (perceived self-efficacy, perceived severity, perceived benefit, perceived susceptibility and perceived barrier) of risk perception of type 2 diabetes among Malaysians. This Malay-language questionnaire may contribute to a better understanding of risk perception of type 2 diabetes among Malaysians, as well as enhancement of diabetes prevention communication between healthcare providers and their clients.
Methods: The study consists of six phases which begins with eliciting a conceptual understanding of the subject matter which is then followed by questions development, designing the overall structure and format of the questionnaire, assessing both its content validity and face validity, conducting a pilot study and finally a field test. A sample of study respondents who were permanent hospital staff above 18 years of age had been recruited from three government hospitals in Kuching, Sarawak, Malaysia.
Results: The finalised JS-Q consists of a total of 34 questions that were based on 8 domains. For all these 8 domains, the minimum loading of each item on the factors was calculated to be at least 0.500, its coefficient of Cronbach's alpha was calculated to be at least 0.750 and its corrected item-total correlation was calculated to be at least 0.500. The goodness of fit of the model was determined to be satisfactory with a value of Chi-square/df < 3.0, and a value of root mean square error approximation (RMSEA) < 0.8 and finally with both Tucker Lewis index (TLI) and comparative fit index (CFI) > 0.9.
Conclusion: This newly developed and validated questionnaire (JS-Q) is found to be a valid and reliable study instrument for assessing job satisfaction among health workforce.
MATERIALS AND METHODS: This was a single-centre cross-sectional study of 115 women with American College of Radiology (ACR) Breast Imaging-Reporting and Data System (BIRADS) breast density C and D on DBT with breast lesions who underwent AB-MR from June 2018 to December 2021. AB-MR was performed on a 3 T MRI system with an imaging protocol consisting of three sequences: axial T1 fat-saturated unenhanced; axial first contrast-enhanced; and subtracted first contrast-enhanced with maximum intensity projection (MIP). DBT and AB-MR images were evaluated by two radiologists blinded to the histopathology and patient outcomes. Diagnostic accuracy (sensitivity, specificity, positive predictive value [PPV] and negative predictive value [NPV]) was assessed.
RESULT: Of the 115 women, the mean age was 50.6 years. There were 48 (41.7%) Malay, 54 (47%) Chinese, and 12 (10.4%) Indian women. The majority (n=87, 75.7%) were from the diagnostic population. Sixty-one (53.1%) were premenopausal and 54 (46.9%) postmenopausal. Seventy-eight (72.4%) had an increased risk of developing breast cancer. Ninety-one (79.1%) women had density C and 24 (20.9%) had density D. There were 164 histopathology-proven lesions; 69 (42.1%) were malignant and 95 (57.9%) were benign. There were 62.8% (n=103/164) lesions detected at DBT. All the malignant lesions 100% (n=69) and 35.7% (n=34) of benign lesions were detected. Of the 61 lesions that were not detected, 46 (75.4%) were in density C, and 15 (24.6%) were in density D. The sensitivity, specificity, PPV, and NPV for DBT were 98.5%, 34.6%, 66.3%, and 94.7%, respectively. There were 65.2% (n=107/164) lesions detected on AB-MR, with 98.6% (n=68) malignant and 41.1% (39) benign lesions detected. The sensitivity, specificity, PPV, and NPV for AB-MR were 98.5%, 43.9%, 67.2%, and 96.2%, respectively. One malignant lesion (0.6%), which was a low-grade ductal carcinoma in-situ (DCIS), was missed on AB-MR.
CONCLUSION: The present findings suggest that both DBT and AB-MR have comparable effectiveness as an imaging method for detecting breast cancer and have high NPV for low-risk lesions in women with dense breasts.
METHODS: Ten patients involved in motor vehicle accidents were enrolled in this study, and contusions were diagnosed from plain computed tomography scans of the brain. Subsequent computed tomography perfusion (CTP) was performed to analyse the perfusion of pericontusional hypodense areas, which were divided into 4 regions of interest (ROI).
RESULTS: Most ischaemic perfusion was found in ROI 6 (affecting 60% of patients), although the mean of the perfusion parameters were normal. A significant positive correlation was found between the perfusion status in the pericontusional area nearest to the skull vault (ROI 3) and its distance/thickness to the skull vault (r = 0.698, P = 0.025). Two adjacent pericontusional hypodense areas (ROI 4 and ROI 5) showed a significant positive correlation with each other (r = 0.667, P = 0.035) in terms of perfusion status. The presence of a hypodense pericontusional area is suggestive of oedema and perfusion disturbances.
CONCLUSION: CTP is a useful, fast, and appropriate method in evaluating perfusion of pericontusional hypodensity area that may help the treating physician to provide an appropriate treatment to the patient.
METHODS: Doctors from multiple disciplines in a general hospital were invited to complete a 39-item self-reported questionnaire between November 2020 and December 2020. Each question was based on a 5-point Likert scale (1 = strongly disagree; 5 = strongly agree). 'Agree' and 'strongly agree' were considered correct or positive responses, except for nine questions worded in the opposite direction. Associations between variables were confirmed using Pearson's chi-squared and Fisher's exact tests.
RESULTS: Most respondents were house officers (206/321; 64.2%) with less than two years of service, followed by medical officers (68/321; 21.2%) and specialists (47/321; 14.6%). Only 7.2% of the respondents had received formal palliative care training before the study. Of the respondents, 73.5% were aware of the World Health Organization (WHO) analgaesic ladder, 60.7% were correct on oral morphine as the first line for moderate to severe cancer pain treatment and 91.9% knew the need to add rescue morphine for breakthrough pain. Additionally, 34.0% (P < 0.001) perceived morphine use caused addiction, 57.9% (n = 186) expressed fear of respiratory depression and 18.3% of medical officers and specialists perceived limited access and a maximum dose to prescribe. There was a significant difference in knowledge and perception between junior doctors and senior clinicians. The majority strongly agreed and agreed that there were inadequate training opportunities in cancer pain management.
CONCLUSION: Inconsistent knowledge and negative perceptions of cancer pain management among doctors were demonstrated in this study.
METHODS: A randomised controlled trial in a parallel, single-blinded study involving 60 OAG patients was conducted. The patients were randomised into FCDT or NFDT based on a block randomisation technique. A pre-study run-in with Gutt timolol was administered for two weeks. IOP was assessed at baseline, month 1 and month 3, with a bottle weight measurement at month 3.
RESULTS: Only 55 OAG patients were analysed, with 8.4% dropping out. A statistically significant mean IOP reduction was observed in each group from baseline to month 1 (FCDT: mean difference [MD] = 4.93, 95% confidence interval [CI] = 4.00, 5.86); NFDT: MD = 4.92, 95% CI = 4.024, 5.82) and from baseline to month 3 (FCDT: MD 5.17, 95% CI = 4.19, 6.15; NFDT: MD = 4.85, 95% CI = 3.874, 5.82). The overall FCDT mean IOP was significantly lower by 1.02 mmHg (95% CI = -2.01, -0.02) than NFDT (F(1, 53) = 4.19; P = 0.046). A significant interaction was observed between time and treatment at month 3, with the mean IOP for FCDT being lower by 1.22 mg than for NFDT (P = 0.037). The mean adherence score was significantly higher in the FCDT group than in the NFDT group (t stat (df) = 3.88 (53); P < 0.001). The reduction in IOP between the groups became non-significant after adherence was adjusted (F(1, 52) = 2.45; P = 0.124).
CONCLUSION: Both drugs showed a decrease in IOP but more so in FCDT. However, no difference was found in terms of medication adherence. An emphasis on treatment compliance is needed.
METHODS: CD117 (c-KIT) antibodies were used to stain 160 formalin-fixed and paraffin-embedded invasive breast carcinoma tissues to demonstrate the presence of mast cells. Then the labelled mast cells were counted in 10 fields at 400× magnification and the mean value was used to represent the mast cell density.
RESULTS: The demographic distribution revealed that most patients were 40 years old or older (92.5%) and of Malay ethnicity (66.3%). With regard to prognostic factors, the most prevalent subtype was invasive carcinoma of no special type (80.6%), followed by tumour grade 3 (41.3%), T2 tumour size (63.1%), N0 lymph node stage (51.3%), presence of lymphovascular invasion (59.4%), positive oestrogen (64.4%) and progesterone receptors (53.1%), and negative human epidermal growth factor receptor 2 (HER2) expression (75.0%). However, there was no significant difference in stromal mast cell density among the different demographic and prognostic factor groups in invasive breast carcinoma.
CONCLUSION: The findings from this study suggest that stromal mast cells do not play a significant role in preventing or promoting tumour growth in invasive breast carcinoma.
Methods: We performed diffusion magnetic resonance imaging with probabilistic tractography on four Malay males to parcellate the hippocampus according to its relative connection probability to the six subdivisions of the PFC.
Results: Our findings revealed that each hippocampus showed putative connectivity to all the subdivisions of PFC, with the highest connectivity to the orbitofrontal cortex (OFC). Parcellation of the hippocampus according to its connection probability to the six PFC subdivisions showed variability in the pattern of the connection distribution and no clear distinction between the hippocampal subregions.
Conclusion: Hippocampus displayed highest connectivity to the OFC as compared to other PFC subdivisions. We did not find a unifying pattern of distribution based on the connectivity-based parcellation of the hippocampus.