Displaying publications 301 - 320 of 548 in total

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  1. Fulltext Using a patient decision aid for insulin initiation in patients with type 2 diabetes: a qualitative analysis of doctor-patient conversations in primary care consultations in Malaysia
    Syed A, Mohd Don Z, Ng CJ, Lee YK, Khoo EM, Lee PY, et al.
    BMJ Open, 2017 05 09;7(5):e014260.
    PMID: 28490553 DOI: 10.1136/bmjopen-2016-014260
    OBJECTIVE: To investigate whether the use of apatient decision aid (PDA) for insulin initiation fulfils its purpose of facilitating patient-centred decision-making through identifying how doctors and patients interact when using the PDA during primary care consultations.
    DESIGN: Conversation analysis of seven single cases of audio-recorded/video-recorded consultations between doctors and patients with type 2 diabetes, using a PDA on starting insulin.
    SETTING: Primary care in three healthcare settings: (1) one private clinic; (2) two public community clinics and (3) one primary care clinic in a public university hospital, in Negeri Sembilan and the Klang Valley in Malaysia.
    PARTICIPANTS: Clinicians and seven patients with type 2 diabetes to whom insulin had been recommended. Purposive sampling was used to select a sample high in variance across healthcare settings, participant demographics and perspectives on insulin.
    PRIMARY OUTCOME MEASURES: Interaction between doctors and patients in a clinical consultation involving the use of a PDA about starting insulin.
    RESULTS: Doctors brought the PDA into the conversation mainly by asking information-focused 'yes/no' questions, and used the PDA for information exchange only if patients said they had not read it. While their contributions were limited by doctors' questions, some patients disclosed issues or concerns. Although doctors' PDA-related questions acted as a presequence to deliberation on starting insulin, their interactional practices raised questions on whether patients were informed and their preferences prioritised.
    CONCLUSIONS: Interactional practices can hinder effective PDA implementation, with habits from ordinary conversation potentially influencing doctors' practices and complicating their implementation of patient-centred decision-making. Effective interaction should therefore be emphasised in the design and delivery of PDAs and in training clinicians to use them.
    Matched MeSH terms: Communication*
  2. Fulltext Oil palm cultivation critically affects sociality in a threatened Malaysian primate
    Holzner A, Balasubramaniam KN, Weiß BM, Ruppert N, Widdig A
    Sci Rep, 2021 May 14;11(1):10353.
    PMID: 33990658 DOI: 10.1038/s41598-021-89783-3
    Human-induced habitat alterations globally threaten animal populations, often evoking complex behavioural responses in wildlife. This may be particularly dramatic when negatively affecting social behaviour, which fundamentally determines individual fitness and offspring survival in group-living animals. Here, we provide first evidence for significant behavioural modifications in sociality of southern pig-tailed macaques visiting Malaysian oil palm plantations in search of food despite elevated predation risk. Specifically, we found critical reductions of key positive social interactions but higher rates of aggression in the plantation interior compared to the plantation edge (i.e. plantation areas bordering the forest) and the forest. At the plantation edge, affiliation even increased compared to the forest, while central positions in the macaques' social network structure shifted from high-ranking adult females and immatures to low-ranking individuals. Further, plantations also affected mother-infant relationships, with macaque mothers being more protective in the open plantation environment. We suggest that although primates can temporarily persist in human-altered habitats, their ability to permanently adapt requires the presence of close-by forest and comes with a trade-off in sociality, potentially hampering individual fitness and infant survival. Studies like ours remain critical for understanding species' adaptability to anthropogenic landscapes, which may ultimately contribute to facilitating their coexistence with humans and preserving biodiversity.
    Matched MeSH terms: Animal Communication*
  3. University of Malaya dental students' attitudes towards communication skills learning: implications for dental education
    Nor NA, Yusof ZY, Shahidan MN
    J Dent Educ, 2011 Dec;75(12):1611-9.
    PMID: 22184601
    The Ministry of Higher Education in Malaysia has called for the implementation of a soft skills module in all public universities in Malaysia. In response to this and as part of curriculum development efforts for a new integrated program for 2011, a study was undertaken to improve the University of Malaya (UM) Faculty of Dentistry's communication skills course. One of the study objectives was to investigate dental students' attitudes towards communication skills learning and the association between their attitudes and demographic and education-related characteristics. A cross-sectional survey--using a self-administered twenty-four-item adapted Communication Skills Attitude Scale (CSAS) that contained both positive (PAS) and negative (NAS) attitude subscales--was carried out targeting all final-year dental students at the UM and the Universiti Kebangsaan Malaysia (UKM). A total of 148 students completed the survey, yielding a response rate of 88.1 percent. Overall, UKM students had significantly more positive attitudes towards communication skills learning (PAS score: mean=48.69, SD=4.48, p<0.001) than UM students (mean=46.03, SD=4.22). There was no statistically significant difference in negative attitudes between the two groups. UKM students with more positive attitudes tended to be female (p<0.05). UM students with more negative attitudes perceived themselves as poor communicators (p<0.05), and UKM students with more negative attitudes tended to have poor English proficiency (p<0.05). This study found that both UM and UKM final-year dental students have positive and negative attitudes towards learning communication skills. These attitudes were significantly associated with certain background and education-related attributes. Outcomes of this study served as a valuable guide in strengthening the communication skills course for the UM's new, integrated dental curriculum.
    Matched MeSH terms: Communication*
  4. Fulltext Effectiveness of antismoking media messages and education among adolescents in Malaysia and Thailand: findings from the international tobacco control southeast Asia project
    Zawahir S, Omar M, Awang R, Yong HH, Borland R, Sirirassamee B, et al.
    Nicotine Tob Res, 2013 Feb;15(2):482-91.
    PMID: 22949569 DOI: 10.1093/ntr/nts161
    Finding ways to discourage adolescents from taking up smoking is important because those who begin smoking at an earlier age are more likely to become addicted and have greater difficulty in quitting. This article examined whether anti smoking messages and education could help to reduce smoking susceptibility among adolescents in two Southeast Asian countries and to explore the possible moderating effect of country and gender.
    Matched MeSH terms: Persuasive Communication*
  5. Preferences of Malaysian cancer patients in communication of bad news
    Eng TC, Yaakup H, Shah SA, Jaffar A, Omar K
    Asian Pac J Cancer Prev, 2012;13(6):2749-52.
    PMID: 22938453
    BACKGROUND: Breaking bad news to cancer patients is a delicate and challenging task for most doctors. Better understanding of patients' preferences in breaking bad news can guide doctors in performing this task.

    OBJECTIVES: This study aimed to describe the preferences of Malaysian cancer patients regarding the communication of bad news.

    METHODOLOGY: This was a cross-sectional study conducted in the Oncology clinic of a tertiary teaching hospital. Two hundred adult cancer patients were recruited via purposive quota sampling. They were required to complete the Malay language version of the Measure of Patients' Preferences (MPP-BM) with minimal researcher assistance. Their responses were analysed using descriptive statistics. Association between demographic characteristics and domain scores were tested using non-parametric statistical tests.

    RESULTS: Nine items were rated by the patients as essential: "Doctor is honest about the severity of my condition", "Doctor describing my treatment options in detail", "Doctor telling me best treatment options", Doctor letting me know all of the different treatment options", "Doctor being up to date on research on my type of cancer", "Doctor telling me news directly", "Being given detailed info about results of medical tests", "Being told in person", and "Having doctor offer hope about my condition". All these items had median scores of 5/5 (IQR:4-5). The median scores for the three domains were: "Content and Facilitation" 74/85, "Emotional Support" 23/30 and "Structural and Informational Support" 31/40. Ethnicity was found to be significantly associated with scores for "Content and Facilitation" and "Emotional Support". Educational status was significantly associated with scores for "Structural and Informational Support".

    CONCLUSION: Malaysian cancer patients appreciate the ability of the doctor to provide adequate information using good communication skills during the process of breaking bad news. Provision of emotional support, structural support and informational support were also highly appreciated.

    Matched MeSH terms: Health Communication*
  6. Fulltext Medical professionalism from a socio-cultural perspective: evaluating medical residents communicative attitudes during the medical encounter in malaysia
    Ganasegeran K, Al-Dubai SA
    J Postgrad Med, 2014 Jan-Mar;60(1):12-5.
    PMID: 24625933 DOI: 10.4103/0022-3859.128799
    The practice of medicine requires good communication skills to foster excellent rapport in doctor patient relationship. Reports on communication skills learning attitude among medical professionals are key essentials toward improving patient safety and quality of care.
    Matched MeSH terms: Communication*
  7. Utilization of debate as an educational tool to learn health economics for dental students in Malaysia
    Khan SA, Omar H, Babar MG, Toh CG
    J Dent Educ, 2012 Dec;76(12):1675-83.
    PMID: 23225687
    Health economics, a special branch of science applying economic principles to the health delivery system, is a relatively young subdiscipline. The literature is scanty about teaching health economics in the medical and dental fields. Delivery methods of this topic vary from one university to another, with lectures, seminars, and independent learning reported as teaching/learning tools used for the topic. Ideally, debates should foster the development of logical reasoning and communication skills. Health economics in dentistry is taught under the community oral health module that constitutes part of an outcome-based dental curriculum in a private dental school in Kuala Lumpur, Malaysia. For this study, the students were divided into two groups: active participants (active debaters) and supporting participants (nonactive debaters). The debate style chosen for this activity was parliamentary style. Active and nonactive debaters' perceptions were evaluated before and after the activity through a structured questionnaire using a five-point rating scale addressing the topic and perceptions about debate as an educational tool. Cronbach's alpha coefficient was used as a measure of internal consistency for the questionnaire items. Among a total of eighty-two third-year dental students of two successive cohorts (thirty-eight students and forty-four students), seventy-three completed the questionnaire, yielding a response rate of 89 percent. Students' responses to the questionnaire were analyzed with the Kruskal-Wallis analysis of variance test. Results revealed that the students felt that their interest in debate, knowledge of the topic, and reinforcement of the previous knowledge had improved following participation in the debate. Within the limitations of this study, it can be concluded that debate was a useful tool in teaching health economics to dental students.
    Matched MeSH terms: Persuasive Communication*
  8. Communication competencies of oncology nurses in Malaysia
    Maskor NA, Krauss SE, Muhamad M, Nik Mahmood NH
    Asian Pac J Cancer Prev, 2013;14(1):153-8.
    PMID: 23534716
    This paper reports on part of a large study to identify competencies of oncology nurses in Malaysia. It focuses on oncology nurses' communications-related competency. As an important cancer care team member, oncology nurses need to communicate effectively with cancer patients. Literature shows that poor communication can make patients feel anxious, uncertain and generally not satisfied with their nurses' care. This paper deliberates on the importance of effective communication by oncology nurses in the context of a public hospital. Four focus group discussions were used in this study with 17 oncology/cancer care nurses from Malaysian public hospitals. The main inclusion criterion was that the nurses had to have undergone a post-basic course in oncology, or have work experience as a cancer care nurse. The findings indicated that nurses do communicate with their patients, patients' families and doctors to provide information about the disease, cancer treatment, disease recurrence and side effects. Nurses should have good communication skills in order to build relationships as well as to provide quality services to their patients. The paper concludes by recommending how oncology nursing competencies can be improved.
    Matched MeSH terms: Communication*
  9. How IRBs make decisions: should we worry if they disagree?
    Kaur S
    J Med Ethics, 2013 Apr;39(4):230.
    PMID: 23077337 DOI: 10.1136/medethics-2012-100965
    Matched MeSH terms: Persuasive Communication*
  10. Developing a Web 2.0 telemedical education system: the AJAX-Cocoon portal
    Mohammed S, Orabi A, Fiaidhi J, Orabi M, R. Benlamri
    Int J Electron Healthc, 2008;4(1):24-42.
    PMID: 18583294
    Web 2.0 technologies such as wikis, podcasts/vodcasting, blogs and semantic portals could be quite effective tools in e-learning for health professionals. If effectively deployed, such tools can offer a way to enhance students', clinicians' and patients' learning experiences, and deepens levels of learners' engagement and collaboration within medical learning environments. However, Web 2.0 requires simplicity of use as well as integration with modern web technologies. This article presents a Web 2.0 telemedical portal, which provides a social community-learning paradigm from the desk of the physician, the student, the hospital administrator, or the insurer. The presented portal utilises RESTful web services and techniques like content syndication, mushups and Asynchronous JavaScript API and XML (AJAX). The designed portal is based on the Apache Cocoon RESTful framework for sharing Digital Imaging and Communications in Medicine (DICOM) medical case studies. Central to this article is the integration between Cocoon and AJAX. The proposed AJAX-Cocoon portal utilises a JSP portlet architecture, which manages the interaction dynamics and overcomes the shortcomings of the JSR 168 and WSRP 1.0 standards.
    Matched MeSH terms: Computer Communication Networks/organization & administration
  11. Fulltext Evaluating IMU communication skills training programme: assessment tool development
    Yeap R, Beevi Z, Lukman H
    Med J Malaysia, 2008 Aug;63(3):244-6.
    PMID: 19248699
    This article describes the development of four assessment tools designed to evaluate the communication skills training (CST) programme at the International Medical University (IMU). The tools measure pre-clinical students' 1) perceived competency in basic interpersonal skills, 2) attitude towards patient-centred communication, 3) conceptual knowledge on doctor-patient communication, and 4) acceptance of the CST programme.
    Matched MeSH terms: Communication*
  12. Health warning messages on tobacco products: a review
    Hammond D
    Tob Control, 2011 Sep;20(5):327-37.
    PMID: 21606180 DOI: 10.1136/tc.2010.037630
    OBJECTIVE: To review evidence on the impact of health warning messages on tobacco packages.
    DATA SOURCES: Articles were identified through electronic databases of published articles, as well as relevant 'grey' literature using the following keywords: health warning, health message, health communication, label and labelling in conjunction with at least one of the following terms: smoking, tobacco, cigarette, product, package and pack.
    STUDY SELECTION AND DATA EXTRACTION: Relevant articles available prior to January 2011 were screened for six methodological criteria. A total of 94 original original articles met inclusion criteria, including 72 quantitative studies, 16 qualitative studies, 5 studies with both qualitative and qualitative components, and 1 review paper: Canada (n=35), USA (n=29) Australia (n=16), UK (n=13), The Netherlands (n=3), France (n=3), New Zealand (n=3), Mexico (n=3), Brazil (n=2), Belgium (n=1), other European countries (n=10), Norway (n=1), Malaysia (n=1) and China (n=1).
    RESULTS: The evidence indicates that the impact of health warnings depends upon their size and
    DESIGN: whereas obscure text-only warnings appear to have little impact, prominent health warnings on the face of packages serve as a prominent source of health information for smokers and non-smokers, can increase health knowledge and perceptions of risk and can promote smoking cessation. The evidence also indicates that comprehensive warnings are effective among youth and may help to prevent smoking initiation. Pictorial health warnings that elicit strong emotional reactions are significantly more effective.
    CONCLUSIONS: Health warnings on packages are among the most direct and prominent means of communicating with smokers. Larger warnings with pictures are significantly more effective than smaller, text-only messages.
    Matched MeSH terms: Health Communication/methods*
  13. The use of objective structured self-assessment and peer-feedback (OSSP) for learning communication skills: evaluation using a controlled trial
    Perera J, Mohamadou G, Kaur S
    Adv Health Sci Educ Theory Pract, 2010 May;15(2):185-93.
    PMID: 19757129 DOI: 10.1007/s10459-009-9191-1
    Feedback is essential to guide students towards expected performance goals. The usefulness of teacher feedback on improving communication skills (CS) has been well documented. It has been proposed that self-assessment and peer-feedback has an equally important role to play in enhancing learning. This is the focus of this study. Objectively structured self-assessment and peer feedback (OSSP) was incorporated into small group CS teaching sessions of a group of semester one medical students who were learning CS for the first time, to minimise the influence of previous educational interventions. A control group matched for academic performance, gender and age was used to enable parallel evaluation of the innovation. A reflective log containing closed and open ended questions was used for OSSP. Facilitators and simulated patients provided feedback to students in both groups during CS learning as per routine practice. Student perceptions on OSSP and acceptability as a learning method were explored using a questionnaire. CS were assessed in both groups using objective structured clinical examination (OSCE) as per routine practice and assessors were blinded as to which group the student belonged. Mean total score and scores for specific areas of interview skills were significantly higher in the experimental group. Analysis of the questionnaire data showed that students gained fresh insights into specific areas such as empathy, addressing patients' concerns and interview style during OSSP which clearly corroborated the specific differences in scores. The free text comments were highly encouraging as to acceptability of OSSP, in spite of 67% being never exposed to formal self- and peer-assessment during pre-university studies. OSSP promotes effective CS learning and learner acceptability is high.
    Matched MeSH terms: Communication*
  14. Space, repetition and collective interlocution: Psychiatric interviews in a Borneo longhouse
    Barrett RJ
    Commun Med, 2004;1(1):25-34.
    PMID: 16808686
    An analysis is presented of psychiatric research interviews conducted among the Iban, a longhouse dwelling people of Sarawak, Malaysia. It draws on transcripts of interviews recorded in the course of carrying out research into schizophrenia in this group. The article examines three different interview spaces within the longhouse--public, family, and private--in order to explore the interplay between ethnographic context and interview conversation. The public setting is notable for the number of relatives who join in and transform the communication from dyadic to collective interlocution; the role of repetition in recruiting them into the conversation is explored. Indirect contrast is the private space, which allows for a level of confidentiality commensurate with Western psychiatric research practice. Intermediate between the two is the family space. The communicative forms that correspond to these settings influence the way symptoms of schizophrenia are experienced and expressed in the Iban. Implications for the practice of psychiatry cross-culturally are examined.
    Matched MeSH terms: Communication*
  15. Fulltext Patient-physician Communication Barrier: A Pilot Study Evaluating Patient Experiences
    Khan T, Hassali M, Al-Haddad M
    J Young Pharm, 2011 Jul;3(3):250-5.
    PMID: 21897668 DOI: 10.4103/0975-1483.83778
    This study aims to identify the patient-physician communication barriers in the primary healthcare setting in Pulau Penang, Malaysia. A cross-sectional study was designed to attain the objectives of the study. A self-developed 17-item study tool was used to explore respondent's perception about the barriers they have faced while communicating with physician. The reliability scale was applied and internal consistency of the study tool was estimated on the basis of Cronbach's alpha (α = 0.58). The data analysis was conducted using statistical package for social sciences students SPSS 13(®). Chi Square test was used to test the difference between proportions. A total of n = 69 patients responded to this survey. A higher participation was seen by the male respondents, 39 (56.5%). About 52 (76.5%) of the respondents were satisfied with the information provided by the physician. In an effort to identify the patient-physician barriers, a poor understanding among the patients and physician was revealed. 16 (23.5%) respondents disclosed lack of satisfaction from the information provided to them. Overall, it is seen that lack of physician-patient understanding was the main reason that result hindrance in the affective communication. Moreover, there is a possibility that a low level of health literacy among the patients and inability of the physician to affectively listen to patients may be the other factors that result in a deficient communication.
    Matched MeSH terms: Communication; Communication Barriers
  16. A novel strategy for load balancing of distributed medical applications
    Logeswaran R, Chen LC
    J Med Syst, 2012 Apr;36(2):483-90.
    PMID: 20703702 DOI: 10.1007/s10916-010-9493-0
    Current trends in medicine, specifically in the electronic handling of medical applications, ranging from digital imaging, paperless hospital administration and electronic medical records, telemedicine, to computer-aided diagnosis, creates a burden on the network. Distributed Service Architectures, such as Intelligent Network (IN), Telecommunication Information Networking Architecture (TINA) and Open Service Access (OSA), are able to meet this new challenge. Distribution enables computational tasks to be spread among multiple processors; hence, performance is an important issue. This paper proposes a novel approach in load balancing, the Random Sender Initiated Algorithm, for distribution of tasks among several nodes sharing the same computational object (CO) instances in Distributed Service Architectures. Simulations illustrate that the proposed algorithm produces better network performance than the benchmark load balancing algorithms-the Random Node Selection Algorithm and the Shortest Queue Algorithm, especially under medium and heavily loaded conditions.
    Matched MeSH terms: Computer Communication Networks/organization & administration
  17. Role of interleukin-1beta and tumour necrosis factor-alpha on hydroxyapatite-induced phagocytosis by murine macrophages (RAW264.7 cells)
    Gopinath VK, Musa M, Samsudin AR, Sosroseno W
    Br J Biomed Sci, 2006;63(4):176-8.
    PMID: 17201208
    Matched MeSH terms: Autocrine Communication/physiology*
  18. Fulltext A chaotic cryptosystem for images based on Henon and Arnold cat map
    Soleymani A, Nordin MJ, Sundararajan E
    ScientificWorldJournal, 2014;2014:536930.
    PMID: 25258724 DOI: 10.1155/2014/536930
    The rapid evolution of imaging and communication technologies has transformed images into a widespread data type. Different types of data, such as personal medical information, official correspondence, or governmental and military documents, are saved and transmitted in the form of images over public networks. Hence, a fast and secure cryptosystem is needed for high-resolution images. In this paper, a novel encryption scheme is presented for securing images based on Arnold cat and Henon chaotic maps. The scheme uses Arnold cat map for bit- and pixel-level permutations on plain and secret images, while Henon map creates secret images and specific parameters for the permutations. Both the encryption and decryption processes are explained, formulated, and graphically presented. The results of security analysis of five different images demonstrate the strength of the proposed cryptosystem against statistical, brute force and differential attacks. The evaluated running time for both encryption and decryption processes guarantee that the cryptosystem can work effectively in real-time applications.
    Matched MeSH terms: Computer Communication Networks*
  19. Fulltext QOS-aware error recovery in wireless body sensor networks using adaptive network coding
    Razzaque MA, Javadi SS, Coulibaly Y, Hira MT
    Sensors (Basel), 2014 Dec 29;15(1):440-64.
    PMID: 25551485 DOI: 10.3390/s150100440
    Wireless body sensor networks (WBSNs) for healthcare and medical applications are real-time and life-critical infrastructures, which require a strict guarantee of quality of service (QoS), in terms of latency, error rate and reliability. Considering the criticality of healthcare and medical applications, WBSNs need to fulfill users/applications and the corresponding network's QoS requirements. For instance, for a real-time application to support on-time data delivery, a WBSN needs to guarantee a constrained delay at the network level. A network coding-based error recovery mechanism is an emerging mechanism that can be used in these systems to support QoS at very low energy, memory and hardware cost. However, in dynamic network environments and user requirements, the original non-adaptive version of network coding fails to support some of the network and user QoS requirements. This work explores the QoS requirements of WBSNs in both perspectives of QoS. Based on these requirements, this paper proposes an adaptive network coding-based, QoS-aware error recovery mechanism for WBSNs. It utilizes network-level and user-/application-level information to make it adaptive in both contexts. Thus, it provides improved QoS support adaptively in terms of reliability, energy efficiency and delay. Simulation results show the potential of the proposed mechanism in terms of adaptability, reliability, real-time data delivery and network lifetime compared to its counterparts.
    Matched MeSH terms: Computer Communication Networks*
  20. Fulltext Assessing routing strategies for cognitive radio sensor networks
    Zubair S, Fisal N, Baguda YS, Saleem K
    Sensors (Basel), 2013;13(10):13005-38.
    PMID: 24077319 DOI: 10.3390/s131013005
    Interest in the cognitive radio sensor network (CRSN) paradigm has gradually grown among researchers. This concept seeks to fuse the benefits of dynamic spectrum access into the sensor network, making it a potential player in the next generation (NextGen) network, which is characterized by ubiquity. Notwithstanding its massive potential, little research activity has been dedicated to the network layer. By contrast, we find recent research trends focusing on the physical layer, the link layer and the transport layers. The fact that the cross-layer approach is imperative, due to the resource-constrained nature of CRSNs, can make the design of unique solutions non-trivial in this respect. This paper seeks to explore possible design opportunities with wireless sensor networks (WSNs), cognitive radio ad-hoc networks (CRAHNs) and cross-layer considerations for implementing viable CRSN routing solutions. Additionally, a detailed performance evaluation of WSN routing strategies in a cognitive radio environment is performed to expose research gaps. With this work, we intend to lay a foundation for developing CRSN routing solutions and to establish a basis for future work in this area.
    Matched MeSH terms: Computer Communication Networks/instrumentation*
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