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  1. Abdullah Soheimi SS, Abdul Rahman A, Abd Latip N, Ibrahim E, Sheikh Abdul Kadir SH
    PMID: 34444092 DOI: 10.3390/ijerph18168345
    Perfluorinated compounds (PFCs) are non-biodegradable synthetic chemical compounds that are widely used in manufacturing many household products. Many studies have reported the association between PFCs exposure with the risk of developing cardiovascular diseases (CVDs). However, those reports are still debatable, due to their findings. Thus, this review paper aimed to analyse the association of PFCs compound with CVDs and their risk factors in humans by systematic review and meta-analysis. Google Scholar, PubMed and ScienceDirect were searched for PFCs studies on CVDs and their risk from 2009 until present. The association of PFCs exposure with the prevalence of CVDs and their risk factors were assessed by calculating the quality criteria, odds ratios (ORs), and 95% confidence intervals (CIs). CVDs risk factors were divided into serum lipid profile (main risk factor) and other known risk factors. The meta-analysis was then used to derive a combined OR test for heterogeneity in findings between studies. Twenty-nine articles were included. Our meta-analysis indicated that PFCs exposure could be associated with CVDs (Test for overall effect: z = 2.2, p = 0.02; Test for heterogeneity: I2 = 91.6%, CI = 0.92-1.58, p < 0.0001) and their risk factors (Test for overall effect: z = 4.03, p < 0.0001; Test for heterogeneity: I2 = 85.8%, CI = 1.00-1.14, p < 0.0001). In serum lipids, total cholesterol levels are frequently reported associated with the exposure of PFCs. Among PFCs, perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) exposure increased the risk of CVDs than other types of PFCs. Although the risk of PFOA and PFOS were positively associated with CVDs and their risk factors, more observational studies shall be carried out to identify the long-term effects of these contaminants in premature CVDs development in patients.
    Matched MeSH terms: Humans
  2. Chan KH, Muhamad A, Hayati F, Azizan N, Andee DZ
    ANZ J Surg, 2021 Jul;91(7-8):1620-1622.
    PMID: 33351236 DOI: 10.1111/ans.16508
    Matched MeSH terms: Humans
  3. Ramu AG, Umar A, Ibrahim AA, Algadi H, Ibrahim YSA, Wang Y, et al.
    Environ Res, 2021 09;200:111366.
    PMID: 34029547 DOI: 10.1016/j.envres.2021.111366
    In the present research work, 2D-Porous NiO decorated graphene nanocomposite was synthesized by hydrothermal method to monitored the concentration of epinephrine (EPI). The morphology (SEM and TEM) results confirmed 2D-Porous NiO nanoparticles firmly attached over graphene nanosheets. FTIR and XPS analysis confirmed the formation of nickel oxide formation and complete reduction of GO to rGO. The electrochemical activity of the proposed NiO-rGO/GCE modified electrode on epinephrine was analyzed by simple cyclic voltammetry technique. The proposed low cost NiO-rGO/GCE modified electrode showed excellent catalytic activity over GCE and rGO/GCE electrodes. Due to its high conductivity and charge transfer ability of the NiO-rGO/GCE modified electrode exhibited high sensitivity of EPI at optimized conditions. The anodic peak current of the EPI linearly increases with increasing the concertation of EPI. A wide linear range (50 μM-1000 μM) was achieved with high correlation coefficient (R2 = 0.9986) and the limit of detection (LOD) of NiO-rGO/GCE modified electrode was calculated to be 10 μM. NiO-rGO/GCE electrode showed good stability and repeatability towards the EPI oxidation. Mainly, the proposed NiO-rGO/GCE modified electrode showed good sensitivity of EPI in the human biological fluid with high recovery percentage. The low cost, NiO-rGO/GCE electrode could be the promising sensor electrode for the detection of Epinephrine in the real samples.
    Matched MeSH terms: Humans
  4. Ahmed IA, Mikail MA, Zamakshshari N, Abdullah AH
    Biogerontology, 2020 06;21(3):293-310.
    PMID: 32162126 DOI: 10.1007/s10522-020-09865-z
    The deterioration of the skin morphology and physiology is the first and earliest obvious harbinger of the aging process which is progressively manifested with increasing age. Such deterioration affects the vital functions of the skin such as homeodynamic regulation of body temperature, fluid balance, loss of electrolytes and proteins, production of vitamin D, waste removal, immune surveillance, sensory perception, and protection of other organs against deleterious environmental factors. There are, however, harmful chemicals and toxins found in everyday cosmetics that consumers are now aware of. Thus, the natural beauty industry is on the rise with innovative technology and high-performance ingredients as more consumers demand healthier options. Therefore, the aims of this review are to give some critical insights to the effects of both intrinsic and extrinsic factors on excessive or premature skin aging and to elaborate on the relevance of natural beauty and natural anti-aging skincare approaches that will help consumers, scientists and entrepreneurs make the switch. Our recent investigations have shown the potential and relevance of identifying more resources from our rich natural heritage from various plant sources such as leaves, fruits, pomace, seeds, flowers, twigs and so on which can be explored for natural anti-aging skincare product formulations. These trending narratives have started to gain traction among researchers and consumers owing to the sustainability concern and impact of synthetic ingredients on human health and the environment. The natural anti-aging ingredients, which basically follow hormetic pathways, are potentially useful as moisturizing agents; barrier repair agents; antioxidants, vitamins, hydroxy acids, skin lightening agents, anti-inflammatory ingredients, and sunblock ingredients.
    Matched MeSH terms: Humans
  5. Soundirarajan M, Pakniyat N, Sim S, Nathan V, Namazi H
    Technol Health Care, 2021;29(1):99-109.
    PMID: 32568131 DOI: 10.3233/THC-192085
    BACKGROUND: Human facial muscles react differently to different visual stimuli. It is known that the human brain controls and regulates the activity of the muscles.

    OBJECTIVE: In this research, for the first time, we investigate how facial muscle reaction is related to the reaction of the human brain.

    METHODS: Since both electromyography (EMG) and electroencephalography (EEG) signals, as the features of muscle and brain activities, contain information, we benefited from the information theory and computed the Shannon entropy of EMG and EEG signals when subjects were exposed to different static visual stimuli with different Shannon entropies (information content).

    RESULTS: Based on the obtained results, the variations of the information content of the EMG signal are related to the variations of the information content of the EEG signal and the visual stimuli. Statistical analysis also supported the results indicating that the visual stimuli with greater information content have a greater effect on the variation of the information content of both EEG and EMG signals.

    CONCLUSION: This investigation can be further continued to analyze the relationship between facial muscle and brain reactions in case of other types of stimuli.

    Matched MeSH terms: Humans
  6. Niknejad N, Ismail W, Bahari M, Nazari B
    Arch Phys Med Rehabil, 2021 07;102(7):1390-1403.
    PMID: 33484693 DOI: 10.1016/j.apmr.2020.12.014
    OBJECTIVES: To examine the adoption of telerehabilitation services from the stakeholders' perspective and to investigate recent advances and future challenges.

    DATA SOURCES: A systematic review of English articles indexed by PubMed, Thomson Institute of Scientific Information's Web of Science, and Elsevier's Scopus between 1998 and 2020.

    STUDY SELECTION: The first author (N.N.) screened all titles and abstracts based on the eligibility criteria. Experimental and empirical articles such as randomized and nonrandomized controlled trials, pre-experimental studies, case studies, surveys, feasibility studies, qualitative descriptive studies, and cohort studies were all included in this review.

    DATA EXTRACTION: The first, second, and fourth authors (N.N., W.I., B.N.) independently extracted data using data fields predefined by the third author (M.B.). The data extracted through this review included study objective, study design, purpose of telerehabilitation, telerehabilitation equipment, patient/sample, age, disease, data collection methods, theory/framework, and adoption themes.

    DATA SYNTHESIS: A telerehabilitation adoption process model was proposed to highlight the significance of the readiness stage and to classify the primary studies. The articles were classified based on 6 adoption themes, namely users' perception, perspective, and experience; users' satisfaction; users' acceptance and adherence; TeleRehab usability; individual readiness; and users' motivation and awareness.

    RESULTS: A total of 133 of 914 articles met the eligibility criteria. The majority of papers were randomized controlled trials (27%), followed by surveys (15%). Almost 49% of the papers examined the use of telerehabilitation technology in patients with nervous system problems, 23% examined physical disability disorders, 10% examined cardiovascular diseases, and 8% inspected pulmonary diseases.

    CONCLUSION: Research on the adoption of telerehabilitation is still in its infancy and needs further attention from researchers working in health care, especially in resource-limited countries. Indeed, studies on the adoption of telerehabilitation are essential to minimize implementation failure, as these studies will help to inform health care personnel and clients about successful adoption strategies.

    Matched MeSH terms: Humans
  7. Tang MCS, Teoh SS, Ibrahim H, Embong Z
    Sensors (Basel), 2021 Aug 06;21(16).
    PMID: 34450766 DOI: 10.3390/s21165327
    Proliferative Diabetic Retinopathy (PDR) is a severe retinal disease that threatens diabetic patients. It is characterized by neovascularization in the retina and the optic disk. PDR clinical features contain highly intense retinal neovascularization and fibrous spreads, leading to visual distortion if not controlled. Different image processing techniques have been proposed to detect and diagnose neovascularization from fundus images. Recently, deep learning methods are getting popular in neovascularization detection due to artificial intelligence advancement in biomedical image processing. This paper presents a semantic segmentation convolutional neural network architecture for neovascularization detection. First, image pre-processing steps were applied to enhance the fundus images. Then, the images were divided into small patches, forming a training set, a validation set, and a testing set. A semantic segmentation convolutional neural network was designed and trained to detect the neovascularization regions on the images. Finally, the network was tested using the testing set for performance evaluation. The proposed model is entirely automated in detecting and localizing neovascularization lesions, which is not possible with previously published methods. Evaluation results showed that the model could achieve accuracy, sensitivity, specificity, precision, Jaccard similarity, and Dice similarity of 0.9948, 0.8772, 0.9976, 0.8696, 0.7643, and 0.8466, respectively. We demonstrated that this model could outperform other convolutional neural network models in neovascularization detection.
    Matched MeSH terms: Humans
  8. Al-Hiyali MI, Yahya N, Faye I, Hussein AF
    Sensors (Basel), 2021 Aug 04;21(16).
    PMID: 34450699 DOI: 10.3390/s21165256
    The functional connectivity (FC) patterns of resting-state functional magnetic resonance imaging (rs-fMRI) play an essential role in the development of autism spectrum disorders (ASD) classification models. There are available methods in literature that have used FC patterns as inputs for binary classification models, but the results barely reach an accuracy of 80%. Additionally, the generalizability across multiple sites of the models has not been investigated. Due to the lack of ASD subtypes identification model, the multi-class classification is proposed in the present study. This study aims to develop automated identification of autism spectrum disorder (ASD) subtypes using convolutional neural networks (CNN) using dynamic FC as its inputs. The rs-fMRI dataset used in this study consists of 144 individuals from 8 independent sites, labeled based on three ASD subtypes, namely autistic disorder (ASD), Asperger's disorder (APD), and pervasive developmental disorder not otherwise specified (PDD-NOS). The blood-oxygen-level-dependent (BOLD) signals from 116 brain nodes of automated anatomical labeling (AAL) atlas are used, where the top-ranked node is determined based on one-way analysis of variance (ANOVA) of the power spectral density (PSD) values. Based on the statistical analysis of the PSD values of 3-level ASD and normal control (NC), putamen_R is obtained as the top-ranked node and used for the wavelet coherence computation. With good resolution in time and frequency domain, scalograms of wavelet coherence between the top-ranked node and the rest of the nodes are used as dynamic FC feature input to the convolutional neural networks (CNN). The dynamic FC patterns of wavelet coherence scalogram represent phase synchronization between the pairs of BOLD signals. Classification algorithms are developed using CNN and the wavelet coherence scalograms for binary and multi-class identification were trained and tested using cross-validation and leave-one-out techniques. Results of binary classification (ASD vs. NC) and multi-class classification (ASD vs. APD vs. PDD-NOS vs. NC) yielded, respectively, 89.8% accuracy and 82.1% macro-average accuracy, respectively. Findings from this study have illustrated the good potential of wavelet coherence technique in representing dynamic FC between brain nodes and open possibilities for its application in computer aided diagnosis of other neuropsychiatric disorders, such as depression or schizophrenia.
    Matched MeSH terms: Humans
  9. Lai NM, Lee SWH, Wai SX, Teh ZW, Chan MY, Lim YS, et al.
    Neonatology, 2020;117(6):687-693.
    PMID: 33264799 DOI: 10.1159/000511656
    BACKGROUND: Neonates with jaundice are usually managed according to their serum bilirubin despite an unclear overall correlation between bilirubin levels and patient-important outcomes (PIOs) such as kernicterus spectrum disorder (KSD).

    OBJECTIVES: We examined data from Cochrane Neonatal reviews to assess whether conditions that constituted KSD were included as key outcomes and how commonly they occurred in the population studied.

    METHODS: We identified Cochrane reviews, published till November 2017 that evaluated interventions for neonatal jaundice (NNJ). We extracted the following information at the review and study levels: included population, outcomes assessed (in particular, whether PIOs such as KSD were listed as the primary outcomes), as well as their cumulative incidence in the reviews.

    RESULTS: Out of 311 reviews, 11 evaluated interventions for NNJ with 78 randomized controlled trials (RCTs) included. Among the reviews, a total number of 148 outcomes were predefined and 30 (20.3%) were PIOs related to KSD, with 11 (36.7%) listed as primary outcomes. Among the 78 included RCTs (total participants = 8,232), 38 (48.7%) enrolled predominantly high-risk and 40 (51.3%) enrolled predominantly low-risk population. A total number of 431 outcomes were reported, and 40 (9.2%) were PIOs related to KSD (of which 37 were from studies with high-risk infants), with 13 (32.5%) listed as primary outcome. Cumulatively, no infant developed KSD across all studies.

    CONCLUSIONS: There is suboptimal representation of PIOs such as KSD in neonatal trials and Cochrane reviews on NNJ. Over half of the trials included populations with very low risk of KSD, which does not represent judicious use of resources. Amidst our continued search for a more reliable surrogate marker for NNJ, studies should evaluate the whole spectrum KSD alongside serum bilirubin in high-risk populations with sufficiently significant event rates, as this will make the trial methodologically feasible, with findings that will impact the population concerned.

    Matched MeSH terms: Humans
  10. Tay YL, Abdullah Z, Chelladorai K, Low LL, Tong SF
    PMID: 34444527 DOI: 10.3390/ijerph18168778
    Malaysia implemented its first Movement Control Order (MCO) during the early phase of the COVID-19 pandemic to slow the transmission of the virus. This study aimed to explore the public perception of the MCO implementation and people's experiences during this period. The study employed qualitative explorative in-depth interviews conducted with 23 Malaysian adults from various demographic backgrounds. Thematic analysis was performed using NVivo 12. Three main themes were identified: a period of information surge, heterogeneous emotional response, and attempts to adapt. During the MCO, the participants obtained information from multiple platforms. They suggested the need for clear and repeated instructions to avoid confusion and misinformation. They also acknowledged the importance of the MCO in breaking the chain of transmission and safeguarding high-risk groups; however, they also expressed that stricter enforcement from the authorities was warranted. The changes in the participants' work-life routines, lack of physical interaction, and uncertainty about their health and the economy due to the MCO negatively impacted their psychological states. Despite these challenges, the participants attempted to adapt to life under the MCO in different ways. The findings imply that during a crisis, the public tends to seek clear and reliable information, experience emotional turmoil, and adapt to changes. The MCO implementation can be improved through an effective communication strategy and efforts to battle misinformation.
    Matched MeSH terms: Humans
  11. Abduraman MA, Azizan NA, Teoh SH, Tan ML
    Obes Res Clin Pract, 2020 12 25;15(1):10-18.
    PMID: 33371997 DOI: 10.1016/j.orcp.2020.12.001
    Obesity is a serious chronic disease and a public health concern in both developing and developed countries. Managing obesity has been a great challenge for both health care professionals and patients alike. Among the various diet programs aimed at promoting weight loss, the ketogenic diet, a diet high in fat and low in carbohydrates, has been at the forefront recently and its mechanism in weight loss is much debated. Activation of Sirtuin 1 or SIRT1 is able to circumvent various diseases, including metabolic syndrome and obesity and is thought to be a potentially reliable treatment target for both of them. Augmentation of SIRT1 may be carried out using dietary means such as nicotinamide adenine dinucleotide (NAD) supplementation and/or ketogenic diet. Although ketogenic diet may augment SIRT1 activation in people affected by obesity, recent studies have indicated that the relationship between SIRT1 and ketogenesis is unpredictable. The exact circumstances and mechanisms of SIRT1, NAD and ketogenesis in the clinical setting as an intervention tool in managing obesity remained uncertain. Although several recent literatures have documented significant weight-loss following ketogenic diet interventions, there were limitations with regards to duration of trial, choice and the number of trial subjects. Studies investigating the safety of ketogenic diet in the long term, beyond 46 weeks and related mechanism and pathways are still lacking and the sustainability of this diet remains to be determined. This review explores the recent progress on ketogenic diet and its relationships with SIRT1 as a tool in managing obesity and relevant clinical implications.
    Matched MeSH terms: Humans
  12. Balqis-Ali NZ, Fun WH, Ismail M, Ng RJ, Jaaffar FSA, Low LL
    PMID: 34501637 DOI: 10.3390/ijerph18179047
    Strengthening the health systems through gaps identification is necessary to ensure sustainable improvements especially in facing a debilitating outbreak such as COVID-19. This study aims to explore public perspective on health systems' response towards COVID-19, and to identify gaps for health systems strengthening by leveraging on WHO health systems' building blocks. A qualitative study was conducted using open-ended questions survey among public followed by in-depth interviews with key informants. Opinions on Malaysia's health systems response towards COVID-19 were gathered. Data were exported to NVIVO version 12 and analysed using content analysis approach. The study identified various issues on health systems' response towards COVID-19, which were then mapped into health systems' building blocks. The study showed the gaps were embedded among complex interactions between the health systems building blocks. The leadership and governance building block had cross-cutting effects, and all building blocks influenced service deliveries. Understanding the complexities in fostering whole-systems strengthening through a holistic measure in facing an outbreak was paramount. Applying systems thinking in addressing gaps could help addressing the complexity at a macro level, including consideration of how an action implicates other building blocks and approaching the governance effort in a more adaptive manner to develop resilient systems.
    Matched MeSH terms: Humans
  13. Khatiwada AP, Shrestha S, Ozaki A, Shrestha R, Kc B
    Res Social Adm Pharm, 2021 10;17(10):1858-1859.
    PMID: 34052104 DOI: 10.1016/j.sapharm.2021.05.008
    Matched MeSH terms: Humans
  14. Montero-Odasso M, van der Velde N, Alexander NB, Becker C, Blain H, Camicioli R, et al.
    Age Ageing, 2021 09 11;50(5):1499-1507.
    PMID: 34038522 DOI: 10.1093/ageing/afab076
    BACKGROUND: falls and fall-related injuries are common in older adults, have negative effects both on quality of life and functional independence and are associated with increased morbidity, mortality and health care costs. Current clinical approaches and advice from falls guidelines vary substantially between countries and settings, warranting a standardised approach. At the first World Congress on Falls and Postural Instability in Kuala Lumpur, Malaysia, in December 2019, a worldwide task force of experts in falls in older adults, committed to achieving a global consensus on updating clinical practice guidelines for falls prevention and management by incorporating current and emerging evidence in falls research. Moreover, the importance of taking a person-centred approach and including perspectives from patients, caregivers and other stakeholders was recognised as important components of this endeavour. Finally, the need to specifically include recent developments in e-health was acknowledged, as well as the importance of addressing differences between settings and including developing countries.

    METHODS: a steering committee was assembled and 10 working Groups were created to provide preliminary evidence-based recommendations. A cross-cutting theme on patient's perspective was also created. In addition, a worldwide multidisciplinary group of experts and stakeholders, to review the proposed recommendations and to participate in a Delphi process to achieve consensus for the final recommendations, was brought together.

    CONCLUSION: in this New Horizons article, the global challenges in falls prevention are depicted, the goals of the worldwide task force are summarised and the conceptual framework for development of a global falls prevention and management guideline is presented.

    Matched MeSH terms: Humans
  15. Periyasamy P, Ng BH, Ali UK, Rashid ZZ, Kori N
    Infect Control Hosp Epidemiol, 2021 09;42(9):1150-1152.
    PMID: 32928321 DOI: 10.1017/ice.2020.465
    Matched MeSH terms: Humans
  16. Jin J, Akau'ola S, Yip CH, Nthumba P, Ameh EA, de Jonge S, et al.
    World J Surg, 2021 07;45(7):1982-1998.
    PMID: 33835217 DOI: 10.1007/s00268-021-06065-9
    BACKGROUND: Trauma mortality in low- and middle-income countries (LMICs) remains high compared to high-income countries. Quality improvement processes, interventions, and structure are essential in the effort to decrease trauma mortality.

    METHODS: A systematic review and meta-analysis of interventional studies assessing quality improvement processes, interventions, and structure in developing country trauma systems was conducted from November 1989 to August 2020 according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they were conducted in an LMIC population according to World Bank Income Classification, occurred in a trauma setting, and measured the effect of implementation and its impact. The primary outcome was trauma mortality.

    RESULTS: Of 37,575 search results, 30 studies were included from 15 LMICs covering five WHO regions in a qualitative synthesis. Twenty-seven articles were included in a meta-analysis. Implementing a pre-hospital trauma system reduced overall trauma mortality by 45% (risk ratio (RR) 0.55, 95% CI 0.4 to 0.75). Training first responders resulted in an overall decrease in mortality (RR 0.47, 95% CI 0.28 to 0.78). In-hospital trauma training with certified courses resulted in a reduction of mortality (RR 0.71, 95% CI 0.62 to 0.78). Trauma audits and trauma protocols resulted in varying improvements in trauma mortality.

    CONCLUSION: There is evidence that quality improvement processes, interventions, and structure can improve mortality in the trauma systems in LMICs.

    Matched MeSH terms: Humans
  17. Hajissa K, Mussa A
    Hum Vaccin Immunother, 2021 Aug 03;17(8):2445-2447.
    PMID: 33830862 DOI: 10.1080/21645515.2021.1900713
    The unprecedented need to acquire a safe and effective vaccine for the long-term control of coronavirus disease 2019 (COVID-19) is a global imperative. Researchers have been working urgently and collaboratively to develop vaccines against the causative agent of COVID-19. The use of messenger RNA (mRNA) vaccine platform offers new opportunities for the development of effective vaccines. The first use of COVID-19 mRNA vaccines for individuals outside the clinical trials raised concerns over their safety and future efficacy. In social media, particularly in developing countries, widely shared false claims allege that the current mRNA-based COVID-19 vaccines potentially integrate into the host genome and thus may genetically modify humans. These vaccines are also assumed to lack efficacy due to the emergence of new strains. Such misinformation cause people to hesitate about receiving vaccination against COVID-19. This commentary aimed to outline the structure, mechanism of action and the major motive for the use of COVID-19 mRNA vaccine, with a focus on scientifically addressing challenges associated with conspiracy theories and dispelling misinformation around vaccination.
    Matched MeSH terms: Humans
  18. Masngut N, Mohamad E
    J Med Internet Res, 2021 08 04;23(8):e28074.
    PMID: 34156967 DOI: 10.2196/28074
    BACKGROUND: The COVID-19 health crisis has posed an unprecedented challenge for governments worldwide to manage and communicate about the pandemic effectively, while maintaining public trust. Good leadership image in times of a health emergency is paramount to ensure public confidence in governments' abilities to manage the crisis.

    OBJECTIVE: The aim of this study was to identify types of image repair strategies utilized by the Malaysian government in their communication about COVID-19 in the media and analyze public responses to these messages on social media.

    METHODS: Content analysis was employed to analyze 120 media statements and 382 comments retrieved from Facebook pages of 2 mainstream newspapers-Berita Harian and The Star. These media statements and comments were collected within a span of 6 weeks prior to and during the first implementation of Movement Control Order by the Malaysian Government. The media statements were analyzed according to Image Repair Theory to categorize strategies employed in government communications related to COVID-19 crisis. Public opinion responses were measured using modified lexicon-based sentiment analysis to categorize positive, negative, and neutral statements.

    RESULTS: The Malaysian government employed all 5 Image Repair Theory strategies in their communications in both newspapers. The strategy most utilized was reducing offensiveness (75/120, 62.5%), followed by corrective action (30/120, 25.0%), evading responsibilities (10/120, 8.3%), denial (4/120, 3.3%), and mortification (1/120, 0.8%). This study also found multiple substrategies in government media statements including denial, shifting blame, provocation, defeasibility, accident, good intention, bolstering, minimization, differentiation, transcendence, attacking accuser, resolve problem, prevent recurrence, admit wrongdoing, and apologize. This study also found that 64.7% of public opinion was positive in response to media statements made by the Malaysian government and also revealed a significant positive association (P=.04) between image repair strategies utilized by the Malaysian government and public opinion.

    CONCLUSIONS: Communication in the media may assist the government in fostering positive support from the public. Suitable image repair strategies could garner positive public responses and help build trust in times of crisis.

    Matched MeSH terms: Humans
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