Displaying publications 21 - 40 of 117 in total

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  1. Fulltext Relation between Conventional and Starch-Assisted ASP Injection and Impact of Crystallinity on Flood Formation
    Al-Jaber HA, Arsad A, Bandyopadhyay S, Jaafar MZ, Tahir M, Nuhma MJ, et al.
    Molecules, 2023 Sep 18;28(18).
    PMID: 37764461 DOI: 10.3390/molecules28186685
    Alkaline-surfactant-polymer (ASP) flooding, a recognized method for oil recovery, encounters limited use due to its expense. In addition, ASP's best composition and injection sequence still remains uncertain today. This study explores conventional ASP flooding using PT SPR Langgak's special surfactants, simulating Langgak oilfield conditions in Sumatra, Indonesia. By comparing the outcomes of this flooding technique with that of starch-assisted ASP performed in another study, the benefits of adding starch nanoparticles to flooding are evident. Nano-starch ASP increased oil recovery by 18.37%, 10.76%, and 10.37% for the three configurations investigated in this study. Water flooding preceded ASP flooding, and flooding operations were carried out at 60 °C. This study employed sodium hydroxide (NaOH), sodium carbonate (Na2CO3), and specialized surfactants from PT SPR. The adopted polymer is solely hydrolyzed polyacrylamide (HPAM) at 2000 ppm. Starch nanoparticles underwent comprehensive characterization and focused more on charge stability. Purple yam nanoparticles (PYNPs) exhibited remarkable stability at -36.33 mV, unlike cassava starch nanoparticles (CSNPs') at -10.68 mV and HPAM's at -27.13 mV. Surface properties affect interactions with fluids and rocks. Crystallinity, a crucial characterization, was assessed using Origin software 2019b. CSNPs showed 24.15% crystallinity, surpassing PYNPs' 20.68%. Higher crystallinity benefits CSNPs' thermal stability. The amorphous behavior found in PYNPs makes them less suitable if applied in harsh reservoirs. This research correlated with prior findings, reinforcing starch nanoparticles' role in enhancing oil recovery. In summary, this study highlighted conventional ASP flooding using HPAM as the sole polymer and compared it with three formations that used two starch nanoparticles included with HPAM, assessing their impact on charge stability, crystallinity, and recovery rate to emphasize their importance in the oil recovery industry. Starch nanoparticles' benefits and limitations guided further investigation in this study.
  2. Synergistic Effect of Nickel Nanoparticles Dispersed on MOF-Derived Defective Co3O4 In Situ Grown over TiO2 Nanowires toward UV and Visible Light Driven Photothermal CO2 Methanation
    Fan WK, Tahir M, Alias H
    ACS Appl Mater Interfaces, 2023 Nov 29;15(47):54353-54372.
    PMID: 37963084 DOI: 10.1021/acsami.3c10022
    Catalytic CO2 hydrogenation is an effective approach to producing clean fuels, but this process is expensive, in addition to the low efficiency of catalysts. Thus, photothermal CO2 hydrogenation can effectively utilize solar energy for CH4 production. Metal-organic framework (MOF) derived materials with a controlled structure and morphology are promising to give a high number of active sites and photostability in thermal catalytic reactions. For the first time, a novel heterostructure catalyst was synthesized using a facile approach to in situ grow MOF-derived 0D Co3O4 over 1D TiO2 nanowires (NWs). The original 3D dodecahedral structure of the MOF is engineered into novel 0D Co3O4 nanospheres, which were uniformly embedded over Ni-dispersed 1D TiO2 NWs. In situ prepared 10Ni-7Co3O4@TiO2 NWs-I achieved an excellent photothermal CH4 evolution rate of 8.28 mmol/h at 250 °C under low-intensity visible light, whereas UV light treatment further increased activity by 1.2-fold. UV irradiations promoted high CH4 production while improving the susceptibility of the catalyst to visible light irradiation. The photothermal effect is prominent at lower temperatures, due to the harmonization of both solar and thermal energy. By paralleling with mechanically assembled 10Ni-7Co3O4/TiO2 NWs-M, the catalytic performance of the in situ approach is far superior, attributing to the morphological transformation of 0D Co3O4, which induced intimate interfacial interactions, formation of oxygen vacancies and boosted photo-to-thermal effects. The co-existence of metallic/metal oxide Ni-Co provided beneficial synergies, enhanced photo-to-thermal effects, and improved charge transfer kinetics of the composite. This work uncovers a facile approach to engineering the morphology of MOF derivatives for efficient photothermal CO2 methanation.
  3. Fulltext Temporal changes in psychobehavioural responses during the early phase of the COVID-19 pandemic in Malaysia
    Wong LP, Alias H
    J Behav Med, 2021 Feb;44(1):18-28.
    PMID: 32757088 DOI: 10.1007/s10865-020-00172-z
    Monitoring public psychological and behavioural responses during the early phase of the coronavirus disease 2019 (COVID-19) outbreak is important for the management and control of infection. This study aims to investigate the temporal trend in (1) avoidance and protective behaviors, (2) fear, (3) socio-economic impact, and (4) anxiety levels during the early phase of the COVID-19 pandemic. As a high level of anxiety may have a detrimental impact during an infectious disease outbreak, factors associated with anxiety were also explored. The survey was carried out for 10 weeks and the responses were divided into three periods of around 3 weeks: 25 January-21 February, 22 February-17 March and 18 March-3 April (the period the Malaysian Government issued Movement Control Order). Findings revealed that most of the pyschobehavioural variables showed small increases during first (25 January-21 February) and second (22 February-17 March) periods, and high psychobehavioral responses were reported during the third period. A total of 72.1% (95%CI = 69.2-75.0) reported moderate to severe anxiety as measured by the State-Trait Anxiety Inventory. Factor influencing moderate to severe anxiety is a high perception of severity (OR = 2.09; 95%CI = 1.48-2.94), high perceived susceptibility (OR = 1.71; 95%CI = 1.17-2.50), high impact score (OR = 1.63; 95%CI = 1.17-2.26) and high fear score (OR = 1.47; 95%CI = 1.01-2.14). In conclusion, the psychological and behavioural responses were found to increase with the progression of the outbreak. High anxiety levels found in this study warrant provision of mental health intervention during the early phase of COVID-19 outbreak.
  4. Fulltext Caring for a child with cancer during COVID-19 pandemic: an assessment of the parents' perception and stress level
    Nawi MA, Lau SCD, Chin ST, Teh KH, Ho LSB, Alias H
    Front Public Health, 2024;12:1223362.
    PMID: 38655523 DOI: 10.3389/fpubh.2024.1223362
    BACKGROUND: The emergence of COVID-19 pandemic has led to heightened fear and uncertainty among parents of children with cancer. This study was conducted to evaluate the parental perceptions toward effects of COVID-19 infection to children with cancer, determine their stress level and factors contributing to high stress level during the pandemic.

    METHODS: This cross-sectional study was conducted in three paediatric oncology centres in Malaysia from September 2020 until December 2022. A total of 167 parents were recruited. Parents completed a set of questionnaires to assess their perception on effect of COVID-19 infection to children with cancer and COVID Stress Scale (CSS) to assess the parents' stress level.

    RESULTS: Patients' mean age at study entry was 8.75 years (SD 4.38). Ninety-one (54.5%) patients were still on active treatment. More than 80% of the parents obtained information regarding COVID-19 infection from mass media and social networking. Fear of their children contracting COVID-19 infection was high especially among patients who were still on treatment. Forty-nine (29.3%) parents were significantly affected by the pandemic leading to loss of job or monthly income. Twenty-nine (17.4%) patients required treatment modification during the pandemic. The median total score for CSS was 78.0 (IQR 25th 64.0; 75th 95.0). Ninety-one (54.5%) respondents were very/extremely stressed based on the CSS scores. Components with high scores were xenophobia (median score 18.0; IQR 25th 13.0, 75th 22.0), fear of danger (median score 17.0; IQR 25th 14.0, 75th 20.0) and contamination fears (median score 16.0; IQR 25th 12.0, 75th 19.0). Lower household income was associated with higher stress level (p = 0.006).

    CONCLUSION: Our study demonstrated high awareness regarding risk of COVID-19 infection among parents of oncology children. Half of the parents had high stress level, with low household income identified as a factor associated with high stress level.

  5. Awareness, perception and barriers to seeking information from online academic databases and medical journals as sources of information
    Wong LP, Mohamad Shakir SM, Tong WT, Alias H, Aghamohammadi N, Arumugam K
    Inform Health Soc Care, 2018 Dec;43(4):335-347.
    PMID: 29035606 DOI: 10.1080/17538157.2017.1364248
    Medical students' use of online medical journals as a source of information is crucial in the learning pathway to become medical doctors. We conducted a cross-sectional survey study among University medical students between December 2012 and March 2013 to assess their awareness, perceived usefulness, practices, and barriers to seeking information from online academic databases and medical journals. The response rate was 67.53%. The majority of the students knew of the availability of online academic databases and medical journals. The mean score for awareness (4.25 of possible 11.0), perceived usefulness (13.95 of possible 33.0), and practice (10.67 of possible 33.0) were low. The mean barrier score toward using online academic databases and medical journals was 25.41 (of possible 45.0). Multivariate findings showed that significant barriers associated with overall usage of online databases and medical journals were 1) not knowing where or how to locate databases and 2) unsureness of using the Boolean operators. Availability of full text subscriptions was found to be an important factor in using online databases. Study findings highlighted the need to increase awareness of academic databases' availability and increase training on ways to search online academic databases and medical journals.
  6. Fulltext Acquired thrombotic thrombocytopenia purpura associated with severe ADAMTS13 deficiency in a 3-year-old boy: a case report and review of the literature
    Alias H, Yong WL, Muttlib FAA, Koo HW, Loh CK, Lau SCD, et al.
    J Med Case Rep, 2018 Sep 17;12(1):276.
    PMID: 30223886 DOI: 10.1186/s13256-018-1806-9
    BACKGROUND: Acquired thrombotic thrombocytopenia purpura is very rarely encountered in children. It is often misdiagnosed initially when the condition is not inherited.

    CASE PRESENTATION: We describe a 3-year-old Malay boy who presented with simple febrile seizure and had no neurological deficit, however, he was found to have microangiopathic hemolytic anemia, thrombocytopenia, and elevated serum lactate dehydrogenase. An ADAMTS13 assay results showed zero activities (0%), and markedly high level of ADAMTS13 inhibitor (93.15 U/mL) confirming the diagnosis of secondary thrombotic thrombocytopenia purpura. He received fresh frozen plasma infusions for 3 days and subsequently his platelet levels normalized. Serial ADAMTS13 assay results showed improvement. He was also given a short course of prednisolone after which the ADAMTS13 activity normalized (> 114%) at the end of prednisolone course.

    CONCLUSIONS: At presentation, acquired thrombotic thrombocytopenia purpura in a very young child is commonly misdiagnosed as other conditions like idiopathic thrombocytopenic purpura, Evans syndrome, atypical hemolytic-uremic syndrome, or malignancy. ADAMTS13 assay should be performed early when thrombotic thrombocytopenia purpura is suspected as this condition is associated with dire consequences.

  7. Fulltext Correction to: Impact of migraine on workplace productivity and monetary loss: a study of employees in banking sector in Malaysia
    Wong LP, Alias H, Bhoo-Pathy N, Chung I, Chong YC, Kalra S, et al.
    J Headache Pain, 2020 Aug 18;21(1):104.
    PMID: 32811428 DOI: 10.1186/s10194-020-01172-9
    An amendment to this paper has been published and can be accessed via the original article.
  8. Spiritual Coping Among Families of Children With Cancer: A Qualitative Study
    Chong ASS, Ahmad MB, Alias H, Iqbal Hussain RB, Lateh AB, Chan CMH
    Asia Pac J Public Health, 2023 Sep;35(6-7):408-412.
    PMID: 37515530 DOI: 10.1177/10105395231190830
    The impact of a childhood cancer diagnosis precipitates caregiver's engagement in spiritual coping. This study aimed to explore spirituality among Malaysian Muslim caregivers of children with acute lymphoblastic leukemia. A total of 13 eligible caregivers participated in this qualitative semi-structured interview via purposive sampling. Each interview was audio recorded, transcribed verbatim, and analyzed using NVivo 12 via thematic analysis. Three main themes revolved around hope through the act of praying and recitation (du'ā' and dhikr), acceptance of God's will (redha), and faith toward God as the Provider of sustenance (rezeki). The findings of this study contribute to a holistic supportive care system in pediatric oncology as it informs health care providers the role of spirituality in mitigating the emotional impact of a cancer diagnosis and promoting psychological adaptation. As a multicultural country, future studies may explore spirituality in other cultures and religion in the country.
  9. Fulltext Predictors of Post-traumatic Stress Symptoms (PTSS), Depression, and Anxiety among Caregivers of Children with Acute Lymphoblastic Leukaemia (ALL)
    Chong ASS, Ahmad M, Mohd Harizan NB, Alias H, Iqbal Hussain R, Lateh A, et al.
    Asian Pac J Cancer Prev, 2023 Jun 01;24(6):1923-1929.
    PMID: 37378920 DOI: 10.31557/APJCP.2023.24.6.1923
    OBJECTIVE: The caregivers of children diagnosed with acute lymphoblastic leukaemia (ALL) are believed to experience post-traumatic stress symptoms (PTSS), depression and anxiety. This present study endeavoured to explore the prevalence and predictors of PTSS, depression, and anxiety among the caregivers of children with ALL.

    METHODS: Purposive sampling was used to select the 73 caregivers of children with ALL who participated in this cross-sectional study. The Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were used to measure psychological distress.

    RESULT: There was a low prevalence (11%) of post-traumatic stress disorder (PTSD) among the participants. Although all the criteria for PTSD were not met, a few post-traumatic symptoms remained, suggesting that PTSS was likely present. Most of the participants reported minimal symptoms of depression (79.5%) and anxiety (65.8%). Anxiety, depression, and ethnicity predicted the PTSS scores (R2 = .77, p =.000). Subsequently, depression predicted the PTSS scores (R2 = 0.42, p =0.000). Participants of 'Other' or 'Indigenous' ethnicity had lower PTSS scores and higher anxiety scores (R2 = 0.75, p =0.000) than participants of Malay ethnicity.

    CONCLUSION: The caregivers of children with ALL experience post-traumatic stress symptoms (PTSS), depression, and anxiety. These variables co-exist and may have different trajectories in different ethnic groups. Therefore, healthcare providers should take ethnicity and psychological distress into consideration when providing paediatric oncology treatment and care.

  10. Fulltext Escalating progression of mental health disorders during the COVID-19 pandemic: Evidence from a nationwide survey
    Wong LP, Alias H, Md Fuzi AA, Omar IS, Mohamad Nor A, Tan MP, et al.
    PLoS One, 2021;16(3):e0248916.
    PMID: 33765039 DOI: 10.1371/journal.pone.0248916
    Since the first nationwide movement control order was implemented on 18 March 2020 in Malaysia to contain the coronavirus disease 2019 (COVID-19) outbreak, to what extent the uncertainty and continuous containment measures have imposed psychological burdens on the population is unknown. This study aimed to measure the level of mental health of the Malaysian public approximately 2 months after the pandemic's onset. Between 12 May and 5 September 2020, an anonymous online survey was conducted. The target group included all members of the Malaysian population aged 18 years and above. The Depression Anxiety Stress Scale (DASS-21) was used to assess mental health. There were increased depressive, anxiety and stress symptoms throughout the study period, with the depression rates showing the greatest increase. During the end of the data collection period (4 August-5 September 2020), there were high percentages of reported depressive (59.2%) and anxiety (55.1%) symptoms compared with stress (30.6%) symptoms. Perceived health status was the strongest significant predictor for depressive and anxiety symptoms. Individuals with a poorer health perception had higher odds of developing depression (odds ratio [OR] = 5.68; 95% confidence interval [CI] 3.81-8.47) and anxiety (OR = 3.50; 95%CI 2.37-5.17) compared with those with a higher health perception. By demographics, young people-particularly students, females and people with poor financial conditions-were more vulnerable to mental health symptoms. These findings provide an urgent call for increased attention to detect and provide intervention strategies to combat the increasing rate of mental health problems in the ongoing COVID-19 pandemic.
  11. Fulltext Insights into the genome structure and copy-number variation of Eimeria tenella
    Lim LS, Tay YL, Alias H, Wan KL, Dear PH
    BMC Genomics, 2012;13:389.
    PMID: 22889016 DOI: 10.1186/1471-2164-13-389
    Eimeria is a genus of parasites in the same phylum (Apicomplexa) as human parasites such as Toxoplasma, Cryptosporidium and the malaria parasite Plasmodium. As an apicomplexan whose life-cycle involves a single host, Eimeria is a convenient model for understanding this group of organisms. Although the genomes of the Apicomplexa are diverse, that of Eimeria is unique in being composed of large alternating blocks of sequence with very different characteristics - an arrangement seen in no other organism. This arrangement has impeded efforts to fully sequence the genome of Eimeria, which remains the last of the major apicomplexans to be fully analyzed. In order to increase the value of the genome sequence data and aid in the effort to gain a better understanding of the Eimeria tenella genome, we constructed a whole genome map for the parasite.
  12. Mechanistic insights into the lignin dissolution behavior in amino acid based deep eutectic solvents
    Zhang Y, Ren H, Li B, Udin SM, Maarof H, Zhou W, et al.
    Int J Biol Macromol, 2023 Jul 01;242(Pt 2):124829.
    PMID: 37210053 DOI: 10.1016/j.ijbiomac.2023.124829
    Deep eutectic solvents (DESs) composed by amino acids (L-arginine, L-proline, L-alanine) as the hydrogen bond acceptors (HBAs) and carboxylic acids (formic acid, acetic acid, lactic acid, levulinic acid) as hydrogen bond donors (HBDs) were prepared and used for the dissolution of dealkaline lignin (DAL). The mechanism of lignin dissolution in DESs was explored at molecular level by combining the analysis of Kamlet-Taft (K-T) solvatochromic parameters, FTIR spectrum and density functional theory (DFT) calculations of DESs. Firstly, it was found that the formation of new hydrogen bonds between lignin and DESs mainly drove the dissolution of lignin, which were accompanied by the erosion of hydrogen bond networks in both lignin and DESs. The nature of hydrogen bond network within DESs was fundamentally determined by the type and number of functional groups in both HBA and HBD, which affected its ability to form hydrogen bond with lignin. One hydroxyl group and carboxyl group in HBDs provided active protons, which facilitated proton-catalyzed cleavage of β-O-4, thus enhancing the dissolution of DESs. The superfluous functional group resulted in more extensive and stronger hydrogen bond network in the DESs, thus decreasing the lignin dissolving ability. Moreover, it was found that lignin solubility had a closed positive correlation with the subtraction value of α and β (net hydrogen donating ability) of DESs. Among all the investigated DESs, L-alanine/formic acid (1:3) with the strong hydrogen-bond donating ability (acidity), weak hydrogen-bond accepting ability (basicity) and small steric-hindrance effect showed the best lignin dissolving ability (23.99 wt%, 60 °C). On top of that, the value of α and β of L-proline/carboxylic acids DESs showed some positive correlation with the global electrostatic potential (ESP) maxima and minima of the corresponding DESs respectively, indicating the analysis of ESP quantitative distributions of DESs could be an effective tool for DESs screening and design for lignin dissolution as well as other applications.
  13. Fulltext Early Surgery Is Feasible for a Very Large Congenital Infantile Fibrosarcoma Associated With Life Threatening Coagulopathy: A Case Report and Literature Review
    Alias H, Abdul Rashid AH, Lau SCD, Loh CK, Sapuan J, Ibrahim S, et al.
    Front Pediatr, 2019;7:529.
    PMID: 31956645 DOI: 10.3389/fped.2019.00529
    Background: Congenital infantile fibrosarcoma (CIF) is a rare malignant soft tissue tumor that predominantly occurs in children under 1 year of age. CIF is frequently misdiagnosed with other conditions like hemangioma of infancy, infantile fibromatosis, or kaposiform hemangioendothelioma. Disseminated intravascular coagulopathy (DIVC) is rarely reported to be associated with CIF. Case presentation: We describe an infant who presented with a large mass over the right arm. She was initially treated conservatively as hemangioma but was later confirmed by tissue histopathological examination to have CIF as the mass rapidly increased in size. She developed massive intra-tumoral bleed with DIVC whilst receiving neoadjuvant chemotherapy requiring multiple blood products transfusion. An urgent near-total resection of the tumor was performed in view of life threatening bleeding despite multiple blood transfusions. Post-operatively, she received further adjuvant chemotherapy. Subsequently, she remained in complete remission 32 months off-treatment and has full function of the affected limb. Conclusions: CIF is an important condition to be considered in infant who has large mass over the extremity. DIVC could be associated with large CIF and when it occurs can be life-threatening. Whenever feasible early surgery should be performed in very young patients with large CIF to prevent mortality from bleeding.
  14. The role of institutional trust in preventive practices and treatment-seeking intention during the coronavirus disease 2019 outbreak among residents in Hubei, China
    Wong LP, Wu Q, Hao Y, Chen X, Chen Z, Alias H, et al.
    Int Health, 2021 May 04.
    PMID: 33945613 DOI: 10.1093/inthealth/ihab023
    BACKGROUND: We aimed to investigate the association between institution trust and public responses to the coronavirus disease 2019 (COVID-19) outbreak.

    METHODS: An Internet-based, cross-sectional survey was administered on 29 January 2020. A total of 4393 adults ≥18 y of age and residing or working in the province of Hubei, central China were included in the study.

    RESULTS: The majority of the participants expressed a great degree of trust in the information and preventive instructions provided by the central government compared with the local government. Being under quarantine (adjusted odds ratio [OR] 2.35 [95% confidence interval {CI} 1.80 to 3.08]) and having a high institutional trust score (OR 2.23 [95% CI 1.96 to 2.53]) were both strong and significant determinants of higher preventive practices scores. The majority of study participants (n=3640 [85.7%]) reported that they would seek hospital treatment if they suspected themselves to have been infected with COVID-19. Few of the participants from Wuhan (n=475 [16.6%]) and those participants who were under quarantine (n=550 [13.8%]) expressed an unwillingness to seek hospital treatment.

    CONCLUSIONS: Institutional trust is an important factor influencing adequate preventive behaviour and seeking formal medical care during an outbreak.

  15. Reasons for using electronic cigarettes and intentions to quit among electronic cigarette users in Malaysia
    Wong LP, Mohamad Shakir SM, Alias H, Aghamohammadi N, Hoe VC
    J Community Health, 2016 Dec;41(6):1101-1109.
    PMID: 27147418 DOI: 10.1007/s10900-016-0196-4
    The rapidly increasing uptake of e-cigarettes in Malaysia as of late demands a study to identify factors leading to its increased popularity and user intentions to quit smoking e-cigarettes. A convenience sample of e-cigarette smokers visiting e-cigarette retail shops in Selangor and Kuala Lumpur was recruited. The majority of e-cigarette smokers were youth in colleges or universities (39 %), and young professionals and managers (36 %). The main reasons for using e-cigarettes were to help the user quit tobacco cigarettes (88 %), the perception that e-cigarettes are not as intrusive as tobacco cigarettes (85 %) and can be used in public areas (70 %), the perception that e-cigarettes are healthier than tobacco cigarettes (85 %), and its relatively lower cost compared to tobacco cigarettes (65 %). A total of 65.3 % of respondents expressed intentions to quit e-cigarettes. In a multivariate analysis, the respondents who earned monthly income of RM1000 or less were significantly more likely to intend to quit smoking e-cigarettes [OR 1.551; 95 % CI 1.022-2.355; p = 0.015] compared to the respondents who earned a monthly income of more than RM2000. The respondents who disagreed with the statement 'Smoking e-cigs is relatively cheaper compared to tobacco cigarettes' were significantly more likely to intend to quit smoking e-cigarettes [OR 1.548; 95 % CI 1.045-2.293; p = 0.027] compared to respondents who did not agree. e-cigarette preventive interventions should target areas related to the identified main reasons for using e-cigarettes, namely as an aid for quitting tobacco cigarettes, the perception that e-cigarettes are not as intrusive as tobacco cigarettes and can be used in public areas, the idea that e-cigarettes are healthier than tobacco cigarettes, and its relatively lower cost compared to tobacco cigarettes.
  16. Fulltext Shisha Smoking Practices, Use Reasons, Attitudes, Health Effects and Intentions to Quit among Shisha Smokers in Malaysia
    Wong LP, Alias H, Aghamohammadi N, Aghazadeh S, Hoe VC
    Int J Environ Res Public Health, 2016 07 19;13(7).
    PMID: 27447655 DOI: 10.3390/ijerph13070726
    Despite its popularity, shisha smoking practices, reasons for its use, attitudes, detrimental health effects and intention to quit among shisha users in Malaysia have never been investigated. A total of 503 shisha users responded to a cross-sectional study conducted between July 2015 and March 2016. The majority of users were young people aged 21-30; a small minority were underage. The reasons for shisha use were its growing popularity as a favourite pastime activity and the perception of shisha use as cool and trendy. Just over half (57.3%) agree that shisha use exposes the smoker to large amounts of smoke and the majority were unsure about the health risks of shisha smoking compared to tobacco smoking. The three most common detrimental health effects reported by the study respondents were dry throat, headache and nausea. Regular shisha users have significantly higher detrimental health effects compared to no-regular shisha users. Shisha users with a duration of smoking of 6-12 months (odds ratio (OR) 3.212; 95% confidence interval (CI) 1.651-6.248) and 6 months and below (OR 2.601; 95% CI 1.475-4.584) were significantly more likely to have a higher proportion who intend quitting smoking than shisha users of more than 12 months duration.
  17. E-cigarette users' attitudes on the banning of sales of nicotine e-liquid, its implication on e-cigarette use behaviours and alternative sources of nicotine e-liquid
    Wong LP, Alias H, Agha Mohammadi N, Ghadimi A, Hoe VCW
    J Community Health, 2017 Dec;42(6):1225-1232.
    PMID: 28589268 DOI: 10.1007/s10900-017-0374-z
    The banning of sales of nicotine e-liquid in e-cigarette shops has been implemented in several states in Malaysia. The distribution of nicotine e-liquid can only be allowed by licensed pharmacies or registered medical practitioners. This study aimed to evaluate e-cigarette users' responses to the control policy in a cross-sectional survey of 851 e-cigarette users by utilizing a self-report questionnaire that assessed (1) attitudes on regulation policy of e-cigarette banning; (2) e-cigarette use behaviors; and (3) sources of e-liquid after the regulation policy has been implemented. Participants from the state of Selangor where the banning policy was implemented were surveyed. The majority (95.8%) opposed the banning and believed e-cigarettes should be sold to anyone aged 18 years or above as with tobacco cigarettes, only a minority believed that nicotine e-liquid should only be available for sale over the counter in pharmacy stores (14.6%) and in clinics with a doctor's prescription (11.8%). The majority (44.2%) reported that they would continue their e-cigarette use as before the banning policy, while 20% plan to completely stop e-cigarette usage without replacing it with any alternatives. The vast majority (87.9%) was still able to obtained nicotine e-liquid from e-cigarette shops in spite of the ban and the second most common source was from online purchase (63.1%). The sales of nicotine e-liquid from black-market were evidenced as many reported obtaining zero nicotine e-liquid from the black market (54.4%). Self- or home-made (30.8%) nicotine e-liquid was also reported. Majority of respondents that self-made e-liquid were from the average monthly income group (below MYR3000). Obtaining nicotine from the pharmacy was least preferred (21.4%). Provision of professional advice to nicotine e-liquid users along with the ban may lessen the likelihood of users switching to tobacco cigarettes or other nicotine alternatives. Banning of sales of nicotine e-liquid in e-cigarette shops resulted in a boom in the black market supplying nicotine e-liquid and, self- or home-made nicotine e-liquid. Enforcing regulations and monitoring black market sales is warranted. Efforts to educate e-cigarette users of the danger of sourcing nicotine e-liquid from the black market and self- or home-made nicotine e-liquid are essential.
  18. Fulltext Assessment of Impact of Containment During the COVID-19 Epidemic and Coping Behaviours Using Newly Developed Assessment Tools
    Wong LP, Alias H, Danaee M, Lee HY, Tan KM, Tok PSK, et al.
    Front Public Health, 2021;9:787672.
    PMID: 35004587 DOI: 10.3389/fpubh.2021.787672
    Background: The confinement measures during COVID-19 had a massive effect on physical and psychological health in public. This study assessed the impact of containment and coping behaviour among the Malaysia public during the COVID-19 pandemic. Questions assessing the impact of containment and coping behaviours were developed and psychometrically tested. Methods: Exploratory factor analysis (EFA) was conducted with the items using principal component analysis extraction and Varimax rotation. Partial least squares structural equation modelling was used to determine the relationship between coping and impact. Results: The 13-item of impact and 10-item coping instruments were developed with three dimensions identified through EFA. Both scales demonstrated excellent composite reliability and good convergent validity. The survey findings revealed that the impact on individual psychological aspects was prominent, followed by well-being and lifestyle. Mindfulness and physical coping strategies were most commonly reported. Coping through seeking help from health professionals and hotlines had a positive direct effect on well-being and lifestyle (b = 0.231, p < 0.001), psychological (B = 0.132, p < 0.001), and employment-related (0.194, p < 0.001) impacts. Coping through mindfulness practise had a negative effect on well-being and lifestyle-related impact (B = -0.180, p < 0.001) and employment-related impact (B = -0.096, p = 0.008). Conclusions: Despite some limitation, the scales for measuring impact and coping behaviours have the potential to be used as a measurement tool in future studies. Findings highlight the enormous impact of the pandemic on psychological well-being and lifestyles. Health authorities should support individual coping as it was found to be an important resilience-related factor to mitigate the impacts of containment during the pandemic.
  19. Fulltext A cross-sectional survey of self-medication with Traditional Chinese Medicine for treatment and prevention of COVID-19
    Lin Y, Cai CZ, Alias H, Wong LP, Hu Z
    Complement Ther Med, 2022 Dec;71:102898.
    PMID: 36372316 DOI: 10.1016/j.ctim.2022.102898
    OBJECTIVE: To investigate user behavioural profiles and the prevalence of self-medication with traditional Chinese medicine (TCM) for COVID-19 among the general public in China.

    DESIGN: Cross-sectional study.

    SETTING: Self-administered online survey was carried out between January and June 2021 in China.

    RESULTS: A total of 1132 complete responses were received from a nationwide sample. A considerable proportion viewed TCM to be more effective than Western medicine for treating COVID-19 (67.1 %) and stated that it is safer to use TCM (63.5 %) and easier to access TCM for treating COVID-19 (63.5 %). A total of 16.4 % (95 %CI 14.3-18.7) reported ever self-medicating with TCM to resolve COVID-19 symptoms and 12.2 % (95 % CI 10.3-14.2) ever using TCM to prevent SARS-CoV-2 infection. Lianhua Qingwen capsule/granule (53.2 %), Ganmao granule (50.5 %) and Banlangen granule (44.6 %) were most commonly used to resolve COVID-19 symptoms whereas Banlangen granule (60.1 %) was commonly used for the prevention of SARS-CoV-2 infection. Older age participants, from rural areas, with chronic diseases, higher socioeconomic status, and a positive attitude towards TCM were more likely to self-medicate using TCM to resolve COVID-19 symptoms.

    CONCLUSION: Self-medication with TCM during the COVID-19 pandemic for symptom control or prevention is prevalent. The findings of the user behavioural profile and types of TMCs commonly used in this study provide beneficial information for the development of strategies to improve public health-seeking behaviour and the performance of the country's healthcare system in the era of the COVID-19 pandemic.

  20. Fulltext Cost-based COVID-19 vaccination and willingness to pay: A post-pandemic review
    Wong LP, Lee HY, Alias H, Zimet G, Liu T, Lin Y, et al.
    Hum Vaccin Immunother, 2024 Dec 31;20(1):2313860.
    PMID: 38359815 DOI: 10.1080/21645515.2024.2313860
    The primary objective of this paper is to serve as a valuable resource for policymakers who are confronted with the evolving landscape of the coronavirus disease 2019 (COVID-19), considering both free and cost-based vaccination approaches. The potential consequences of shifting from free to cost-based vaccination are explored, encompassing its impact on global vaccine equity and prioritization, economic well-being, healthcare systems and delivery, public health policies, and vaccine distribution strategies. Examining past studies on willingness to pay for the initial COVID-19 vaccine dose and booster shots provides insights into how individuals value COVID-19 vaccinations and underscores the significance of addressing issues related to affordability. If COVID-19 vaccinations incur expenses, using effective communication strategies that emphasize the importance of vaccination and personal health benefits can increase willingness to pay. Making COVID-19 vaccines accessible through public health programs or health insurance can help alleviate financial barriers and increase vaccination rates.
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