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Fulltext The support for smoke free policy and how it is influenced by tolerance to smoking - experience of a developing country

Rashid A, Manan AA, Yahya N, Ibrahim L

PLoS One, 2014;9(10):e109429.
PMID: 25338116 DOI: 10.1371/journal.pone.0109429

This cross sectional survey was conducted to determine the support in making Penang UNESCO World Heritage Site (GTWHS) smoke free and to determine the influence of tolerance towards smoking on this support. This is the first phase in making Penang, Malaysia a smoke free state. A multistage sampling process was done to select a sample of respondents to represent the population of GTWHS. Attitude towards smoking was assessed using tolerance as a proxy. A total of 3,268 members of the community participated in the survey. A big majority (n = 2969; 90.9%) of the respondents supported the initiative. Support was lowest among the owners and residents/tenants, higher age groups, the Chinese, men, respondents who had poor knowledge of the places gazetted as smoke free, and respondents with poor knowledge of the health effects on smokers and on passive smokers. The odds (both adjusted and unadjusted) of not supporting the initiative was high among those tolerant to smoking in public areas. Tolerance towards smoking was associated with 80.3% risk of non-support in the respondents who were tolerant to smoking and a 57.2% risk in the population. Health promotion and education concerning the harm of tobacco smoke in Malaysia, which has mainly targeted smokers, must change. Health education concerning the risks of second hand smoke must also be given to non-smokers and efforts should be made to denormalize smoking.

Matched MeSH terms: Smoke-Free Policy*
Environmental management for dredging sediments - the requirement of developing nations

Manap N, Voulvoulis N

J Environ Manage, 2015 Jan 1;147:338-48.
PMID: 25304520 DOI: 10.1016/j.jenvman.2014.09.024

Scientific research has characterized the effects of dredging, an underwater excavation process for navigational purposes or material extraction, and has shown its association with a number of chemical, physical and biological impacts. Due to this, much environmental management has been applied in the dredging industry in order to manage its detrimental effects. However, developing nations may have different approaches towards their dredging environmental management to compare to their companions with higher economic strength. Moreover, scientific evidence to make an informed decision is often lacking, hence affecting the number of research executed at these nations, limiting their efforts to preserve the environment. This paper reviews the dredging environmental impacts and its two important factors, dredging technology and sediment characteristic, that determine the magnitude of impacts through literature review, and discusses the need for a more integrated dredging environmental management to be developed for developing nations.

Matched MeSH terms: Environmental Policy*
[Socio-anthropological perspective of the under nutrition care of cancer patients]

Fontas M, Poulain JP, Souquet PJ, Laville M, Giboreau A, Bensafi M, et al.

Bull Cancer, 2014 Mar;101(3):258-65.
PMID: 24691190 DOI: 10.1684/bdc.2014.1905

The diet of the cancer patient is a major focus of prevention and treatment strategy of the recent plans that fight against cancer. It is sometimes reduced to a rapid series of more or less general advice, often interfered by other sources of information, more or less conventional. In this pathological situation where the nutritional status of the patient is paramount, it seems crucial to understand the different modalities of how the food behavior is implemented. This article describes the construction modalities of the cancer eater decisions. The goal of the socio-anthropological analysis proposed in this article is to initiate a reflection on the under nutrition problem by focusing on the approach of the eater diagnosed with cancer. The aim is to help identify ways of action to fight against under nutrition and improve the quality of life of the patient.

Matched MeSH terms: Nutrition Policy*
Fulltext Analysis of newspaper coverage of active aging through the lens of the 2002 World Health Organization Active Ageing Report: A Policy Framework and the 2010 Toronto Charter for Physical Activity: A Global Call for Action

Abdullah B, Wolbring G

Int J Environ Res Public Health, 2013 Dec;10(12):6799-819.
PMID: 24317386 DOI: 10.3390/ijerph10126799

As populations continue to grow older, efforts to support the process of aging well are important goals. Various synonyms are used to cover aging well, such as active aging. The World Health Organization published in 2002 the report Active Ageing: A Policy Framework that according to the call for papers, has brought active ageing to the forefront of international public health awareness. The 2010 Toronto Charter for Physical Activity: A Global Call for Action was singled out in the call for papers as a key document promoting physical activity one goal of the 2002 WHO active aging policy framework. Media are to report to the public topics of importance to them. We investigated the newspaper coverage of aging well and synonymous terms such as active aging through the lens of the 2002 WHO active aging policy framework and the 2010 Toronto Charter for Physical Activity. As sources we used the following newspapers: China Daily, The Star (Malaysia), two UK newspapers (The Guardian, The Times), a database of 300 Canadian newspapers (Canadian Newsstand) and a US newspaper (The New York Times). The study generated data answering the following four research questions: (1) how often are the 2002 WHO active aging policy framework and the 2010 Toronto Charter for Physical Activity mentioned; (2) how often is the topic of active aging and terms conveying similar content (aging well, healthy aging, natural aging and successful aging) discussed; (3) which of the issues flagged as important in the 2002 WHO active aging policy framework and the 2010 Toronto Charter for Physical Activity are covered in the newspaper coverage of active aging and synonymous terms; (4) which social groups were mentioned in the newspapers covered. The study found a total absence of mentioning of the two key documents and a low level of coverage of "active aging" and terms conveying similar content. It found further a lack of engagement with the issues raised in the two key documents and a low level of mentioning of socially disadvantages groups. We posit that reading the newspapers we covered will not expose the reader to the two key documents and the issues linked to aging well including the need to increase physical activity.

Matched MeSH terms: Health Policy*
Predictors of sustained six months quitting success: efforts of smoking cessation in low intensity smoke-free workplaces

Yasin SM, Retneswari M, Moy FM, Taib KM, Ismail N

Ann Acad Med Singap, 2013 Aug;42(8):401-7.
PMID: 24045376

INTRODUCTION: This study aims to identify the predictors of a 6-month quitting success among employees involved in workplace smoking cessation with low-intensity smoke-free policy.
MATERIALS AND METHODS: A multicentre prospective cohort study was conducted among employees from 2 different public universities in Malaysia. Interventions include at least 2 sessions of behavioural therapy combined with free nicotine replacement therapy (NRT) for 8 weeks. Participants were followed up for 6 months. Independent variables assessed were on sociodemographic and environmental tobacco smoke. Their quit status were determined at 1 week, 3 months and 6 months.
RESULTS: One hundred and eighty- five smokers volunteered to participate. Among the participants, 15% and 13% sustained quit at 3 months and 6 months respectively. Multivariate analysis revealed that at 6 months, attending all 3 behavioural sessions predicted success. None of the environmental tobacco exposure variables were predictive of sustained cessation.
CONCLUSION: Individual predictors of success in intra-workplace smoking cessation programmes do not differ from the conventional clinic-based smoking cessation. Furthermore, environmental tobacco exposure in low intensity smoke-free workplaces has limited influence on smokers who succeeded in maintaining 6 months quitting.

Matched MeSH terms: Smoke-Free Policy*
Dietary changes during pregnancy and the postpartum period in Singaporean Chinese, Malay and Indian women: the GUSTO birth cohort study

Chen LW, Low YL, Fok D, Han WM, Chong YS, Gluckman P, et al.

Public Health Nutr, 2014 Sep;17(9):1930-8.
PMID: 23806144 DOI: 10.1017/S1368980013001730

OBJECTIVE: To examine changes in food consumption during pregnancy and the postpartum period in women of major Asian ethnic groups.
DESIGN: Using interviewer-administered questionnaires, we assessed changes in food consumption during pregnancy (26-28 weeks' gestation) and the postpartum period (3 weeks after delivery) as compared with the usual pre-pregnancy diet.
SETTING: Singapore.
SUBJECTS: Pregnant women (n 1027) of Chinese, Malay and Indian ethnicity (mean age 30·4 (SD 5·2) years) who participated in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study.
RESULTS: During pregnancy, participants tended to increase their consumption of milk, fruit and vegetables and decrease their consumption of tea, coffee, soft drinks and seafood (all P < 0·001). Most participants reported adherence to traditional restrictions ('confinement') during the early postpartum period (Chinese: 94·8 %, Malay: 91·6 %, Indian: 79·6 %). During the postpartum period, participants tended to increase their consumption of fish and milk-based drinks and decrease their consumption of noodles, seafood, and chocolates and sweets (all P < 0·001). Ethnic differences in food consumption were pronounced during the postpartum period. For example, most Chinese participants (87·2 %) increased their ginger consumption during the postpartum period as compared with smaller percentages of Malays (31·8 %) and Indians (40·8 %; P for ethnic difference <0·001). Similar ethnic differences were observed for cooking wine/alcohol, herbs and spices, and herbal tea consumption.
CONCLUSIONS: Marked changes in food consumption that reflect both modern dietary recommendations and the persistence of traditional beliefs were observed in Singaporean women during pregnancy and the postpartum period. Traditional beliefs should be considered in interventions to improve dietary intakes during these periods.

Matched MeSH terms: Nutrition Policy*
Fulltext Interview: Health technology assessment in Asia: an emerging trend

Yang BM

J Comp Eff Res, 2012 May;1(3):221-4.
PMID: 24237405 DOI: 10.2217/cer.12.20

Bong-min Yang, PhD (in economics), is Professor and former Dean of the School of Public Health at the Seoul National University, South Korea. Professor Yang has led research and written many papers in health economics and healthcare systems in Korea and Asia. His recent research and publications focus on the field of economic evaluation and outcomes research. He played a key role in the introduction of a formal health technology assessment system within Korean healthcare. He is currently serving as Executive Director, Institute of Health and Environment, Seoul National University. In addition to his research and publications, Professor Yang is Associate Editor for Journal of Comparative Effectiveness Research, is co-editor-in-chief for Value in Health Regional Issues, and is currently chair of the Management Advisory Board of Value in Health and a member of the editorial board of the Journal of Medical Economics. He has been a policy consultant to China, Japan, Indonesia, Hong Kong, Malaysia, Taiwan, Thailand and India. He has also worked as a short-term consultant at the WHO, ADB, UNDP and the World Bank. For the Korean government, he served as Chairperson of the Health Insurance Reform Committee, and Chairperson of the Drug Pricing and Reimbursement Committee. He is currently serving as Chair of the International Society of Pharmacoeconomics and Outcomes Research-Asia Consortium, and a member of the Board of Directors of the International Society of Pharmacoeconomics and Outcomes Research.

Matched MeSH terms: Health Policy*
Fulltext Breast cancer prevention and control programs in Malaysia

Dahlui M, Ramli S, Bulgiba AM

Asian Pac J Cancer Prev, 2011;12(6):1631-4.
PMID: 22126511

Breast cancer is the most common cancer in Malaysian females. The National Cancer Registry in 2003 and 2006 reported that the age standardized incidence of breast cancer was 46.2 and 39.3 per 100,000 populations, respectively. With the cumulative risk at 5.0; a woman in Malaysia had a 1 in 20 chance of developing breast cancer in her lifetime. The incidence of cancer in general, and for breast cancer specifically was highest in the Chinese, followed by Indians and Malays. Most of the patients with breast cancers presented at late stages (stage I: 15.45%, stage II: 46.9%, stage III: 22.2% and stage IV: 15.5%). The Healthy Lifestyles Campaign which started in the early nineties had created awareness on breast cancer and after a decade the effort was enhanced with the Breast Health Awareness program to promote breast self examination (BSE) to all women, to perform annual clinical breast examination (CBE) on women above 40 and mammogram on women above 50. The National Health Morbidity Survey in 2006 showed that the prevalence rate of 70.35% by any of three methods of breast screening; 57.1% by BSE, 51.8% by CBE and 7.6% by mammogram. The current screening policy for breast cancer focuses on CBE whereby all women at the age of 20 years and above must undergo breast examination by trained health care providers every 3 years for age between 20-39 years, and annually for age 40 and above. Several breast cancer preventive programs had been developed by various ministries in Malaysia; among which are the RM50 subsidy for mammogram by the Ministry of Women, Family and Community Development and the SIPPS program (a call-recall system for women to do PAP smear and CBE) by the Ministry of Health. Measures to increase uptake of breast cancer screening and factors as to why women with breast cancer present late should be studied to assist in more development of policy on the prevention of breast cancer in Malaysia.

Matched MeSH terms: Health Policy/legislation & jurisprudence*
Policy trends of extended producer responsibility in Malaysia

Agamuthu P, Victor D

Waste Manag Res, 2011 Sep;29(9):945-53.
PMID: 21771873 DOI: 10.1177/0734242X11413332

This paper seeks to examine the provisions for extended producer responsibility (EPR) within the Malaysian environmental and waste management policies and to determine its existing practice and future prospects in Malaysia. Malaysian waste generation has been increasing drastically where solid waste generation was estimated to increase from about 9.0 million tonnes in 2000 to about 10.9 million tonnes in 2010, to about 12.8 million tonnes in 2015 and finally to about 15.6 million tonnes in 2020. Malaysian e-waste was estimated to be about 652 909 tonnes in 2006 and was estimated to increase to about 706 000 tonnes in 2010 and finally to about 1.2 million tonnes in 2020. The projected increasing generation of both solid waste and scheduled wastes is expected to burden the country's resources and environment in managing these wastes in a sustainable manner. The concept of EPR is provided for in the Malaysia waste management system via the Environmental Quality Act 1974 and the Solid Waste and Public Cleansing Management Act 2007. However, these provisions in the policy are generic in nature without relevant regulations to enable its enforcement and as such the concept of EPR still remains on paper whereas the existing practice of EPR in Malaysia is limited through voluntary participation. In conclusion, policy trends of EPR in Malaysia seem to indicate that Malaysia may be embarking on the path towards EPR through the enactment of an EPR regulation.

Matched MeSH terms: Environmental Policy/economics*
The Heath government and British defence policy in Southeast Asia at the end of empire (1970-71)

Andrea B

20 Century Br Hist, 2009;20(1):53-73.
PMID: 19569309

This article examines the rationale behind the Heath government's 1970 decision to negotiate a Five Power Defence agreement with Australia, New Zealand, Singapore and Malaysia and to maintain a small British military contingent in Southeast Asia as a part of this new politico-military framework. It argues that while its overriding foreign policy concern was to end Britain's problematic relationship with the European Economic Community and to make membership of this grouping the cornerstone of its foreign policy, the Heath government was careful not to cast Britain's post-imperial future in purely European terms. The successful negotiation of the Five Power Defence Arrangements in 1970-71 was instrumental in achieving this by ensuring that London would maintain close links with key Commonwealth partners in the Asian region. In what was not only an attempt to neutralize potential domestic opposition to Britain's entry into the EEC, but also a lingering reluctance to do away with the rhetoric of Britain as a leading power with extra-European interests, Heath was eager to show that by making a contribution to the stability of Southeast Asia, Britain still had a role to play outside Europe.

Matched MeSH terms: Public Policy*
Fulltext National Cancer Patient Registry--a patient registry/clinical database to evaluate the health outcomes of patients undergoing treatment for cancers in Malaysia

Lim GC, Azura D

Med J Malaysia, 2008 Sep;63 Suppl C:55-6.
PMID: 19230247

Cancer burden in Malaysia is increasing. Although there have been improvements in cancer treatment, these new therapies may potentially cause an exponential increase in the cost of cancer treatment. Therefore, justification for the use of these treatments is mandated. Availability of local data will enable us to evaluate and compare the outcome of our patients. This will help to support our clinical decision making and local policy, improve access to treatment and improve the provision and delivery of oncology services in Malaysia. The National Cancer Patient Registry was proposed as a database for cancer patients who seek treatment in Malaysia. It will be a valuable tool to provide timely and robust data on the actual setting in oncology practice, safety and cost effectiveness of treatment and most importantly the outcome of these patients.

Matched MeSH terms: Health Policy/trends
Fulltext Patterns of smoking among adolescents in Malaysia and Thailand: findings from the International Tobacco Control Southeast Asia survey

Hammond D, Kin F, Prohmmo A, Kungskulniti N, Lian TY, Sharma SK, et al.

Asia Pac J Public Health, 2008;20(3):193-203.
PMID: 19124313 DOI: 10.1177/1010539508317572

At present, 70% of the world's 1.1 billion smokers are in developing countries, with over 50% in Asia alone. The current study examined patterns of youth smoking in Thailand and Malaysia. Respondents were 2002 youths between the ages of 13 and 17 from Thailand (n = 1000) and Malaysia (n = 1002). Respondents were selected using a multistage cluster sampling design and surveyed between January 2005 and March 2005. Approximately 3% of youth between the ages of 13 and 17 were current smokers, with an additional 10% to 12% reporting experimental smoking. Males were between 7 and 15 times more likely to report smoking behavior than females. Less than 1% of females respondents in either country met the criteria for current smoking, and less than 5% met the criteria for experimental smoking. In contrast, more than 50% Thai males and approximately one-third of Malaysian males aged 17 met the criteria for either experimental or current smoking.

Matched MeSH terms: Public Policy*
Protecting breastfeeding in West and Central Africa: over 25 years of implementation of the International Code of Marketing of Breastmilk Substitutes

Sokol E, Clark D, Aguayo VM

Food Nutr Bull, 2008 Sep;29(3):159-62.
PMID: 18947028

In 1981 the World Health Assembly (WHA) adopted the International Code of Marketing of Breastmilk Substitutes out of concern that inappropriate marketing of breastmilk substitutes was contributing to the alarming decline in breastfeeding worldwide and the increase in child malnutrition and mortality, particularly in developing countries.

Matched MeSH terms: Nutrition Policy/legislation & jurisprudence*
Increased utilization of peritoneal dialysis to cope with mounting demand for renal replacement therapy--perspectives from Asian countries

Li PK, Lui SL, Leung CB, Yu AW, Lee E, Just PM, et al.

Perit Dial Int, 2007 Jun;27 Suppl 2:S59-61.
PMID: 17556331

With the number of end-stage renal disease (ESRD) patients growing, one of the crucial questions facing health care professionals and funding agencies in Asia is whether funding for dialysis will be sufficient to keep up with demand. During the ISPD's 2006 Congress, academic nephrologists and government officials from China, Hong Kong, India, Indonesia, Japan, Macau, Malaysia, Philippines, Singapore, Taiwan, Thailand, and Vietnam participated in a roundtable discussion on dialysis economics in Asia. The focus was policy and health care financing. The roundtable addressed ESRD growth in Asia and how to obtain enough funding to keep up with the growth in patient numbers. Various models were presented: the "peritoneal dialysis (PD) first" policy model, incentive programs, nongovernmental organizations providing PD, and PD reimbursement in a developing economy. This article summarizes the views of the participant nephrologists on how to increase the utilization of PD to improve on clinical and financial management of patients with ESRD.

Matched MeSH terms: Health Policy/economics
The continuing risk of nuclear war

McCoy R

Med Confl Surviv, 2007 Oct-Dec;23(4):259-66.
PMID: 17987978 DOI: 10.1080/13623690701596668

Climate change and nuclear war are currently the most dangerous challenges to human civilisation and survival. The effects of climate change are now sufficient to persuade many governments to take effective measures to reduce greenhouse gas emissions. Today there are about 27,000 nuclear warheads, many at least ten times more powerful than the Hiroshima and Nagasaki bombs, and a meaningful medical response to a nuclear attack is impossible. Nevertheless, the threat of nuclear war does not raise public concern, and indeed the nuclear-weapon states are upgrading their capability. The only effective preventive measure is the abolition of nuclear weapons. Steps towards this include: a Fissile Material Cut-off Treaty, for the nuclear weapon states to observe their obligations under the Nuclear Non-Proliferation Treaty, and for the Comprehensive Test Ban Treaty to enter into force. The ultimate need is for a Nuclear Weapons Convention; International Physicians for the Prevention of Nuclear War have launched an International Campaign to Abolish Nuclear weapons (ICAN) to promote a NWC.

Matched MeSH terms: Public Policy*
Assessing progressivity of out-of-pocket payment: with illustration to Malaysia

Yu CP, Whynes DK, Sach TH

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

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

Matched MeSH terms: Health Policy/trends*
Fulltext Folic acid in the prevention of neural tube defect--a programme for Malaysia?

Ho JJ

Med J Malaysia, 2004 Mar;59(1):94-9.
PMID: 15535342

There is good evidence that folic acid is safe and efficacious for reducing neural tube defect (NTD). All women capable of becoming pregnant should take 400 microgram daily. This can be given in the form of a daily vitamin supplement, by food fortification, or by increasing natural dietary folates. Compulsory grain fortification has been shown to reduce NTD in a population but supplementation and dietary advice have not. Malaysia should work towards a programme of grain fortification and use alternative strategies to reach sections of the population that would not be covered but several research questions need to be answered before a programme could be implemented in Malaysia.

Matched MeSH terms: Health Policy*
Malaysia tiptoes on the heels of Asian neighbors

Fuyuno I

Nat Biotechnol, 2005 Aug;23(8):908-9.
PMID: 16082349
Matched MeSH terms: Public Policy*
Fulltext Public awareness of HIV/AIDS: how media play a role?

Tham JS, Zanuddin H

Southeast Asian J. Trop. Med. Public Health, 2015 Jul;46(4):669-79.
PMID: 26867387

Abstract. This paper examines the effectiveness of media in public awareness of the HIV/AIDS issue among the public in an area in central Selangor, comprising Kuala Lumpur and its surroundings and suburbs in Malaysia. Cross-sectional survey questionnaires were distributed to 384 respondents about accessing the public awareness of modes of HIV transmission, perceptions and attitudes towards people living with HIV/AIDS, as well as people's understanding about government policies to curb HIV/AIDS. Health care practitioners and newspapers were the preferred sources of information seeking on HIV/AIDS among the public. Most of the respondents were aware of the modes of HIV transmission. However, they were some respondents who still have misconceptions about the modes of transmission. Most of the respondents were not aware about the government's significant policies to address HIV/AIDS in the region. Overall, the respondents had certain knowledge about HIV transmission modes and moderate positive perceptions and attitudes towards people living with HIV/AIDS. Future studies should be conducted to examine about who sets the agenda in the media, and apart from gatekeepers, who are the real decision makers in deciding what is important to inform the public.

Matched MeSH terms: Health Policy*
New Pacific trade deal--good for pharma, bad for public health?

Gornall J

BMJ, 2015;351:h3649.
PMID: 26155990 DOI: 10.1136/bmj.h3649
Matched MeSH terms: Health Policy/economics*

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