MyMedR

Applying the Transtheoretical Model to evaluate the effect of a call-recall program in enhancing Pap smear practice: a cluster randomized trial

Abdullah F, Su TT

Prev Med, 2013;57 Suppl:S83-6.

PMID: 23415623 DOI: 10.1016/j.ypmed.2013.02.001

The objective of this study was to evaluate the effect of a call-recall approach in enhancing Pap smear practice by changes of motivation stage among non-compliant women.

Metabolic syndrome and antipsychotic monotherapy treatment among schizophrenia patients in Malaysia

Said MA, Hatim A, Habil MH, Zafidah W, Haslina MY, Badiah Y, et al.

Prev Med, 2013;57 Suppl:S50-3.

PMID: 23337566 DOI: 10.1016/j.ypmed.2013.01.005

OBJECTIVE: The objective of this study is to determine the prevalence of metabolic syndrome among schizophrenia patients receiving antipsychotic monotherapy in Malaysia.
METHOD: A cross-sectional study was conducted at multiple centres between June 2008 and September 2011. Two hundred and five patients who fulfilled the DSM IV-TR diagnostic criteria for schizophrenia and who had been on antipsychotic medication for at least one year, were screened for metabolic syndrome. Patients receiving a mood stabilizer were excluded from the study. Metabolic syndrome was defined by using the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults Treatment Panel III (ATP III) modified for Asian waist circumference.
RESULTS: In the first-generation antipsychotic (FGA) group, the highest prevalence of metabolic syndrome was among patients treated with trifluoperazine and flupenthixol decanoate (66.7% each). For the second-generation antipsychotic (SGA) group, the highest prevalence of metabolic syndrome was among patients treated with clozapine (66.7%). The component with the highest prevalence in metabolic syndrome was waist circumference in both FGA and SGA groups except for aripiprazole in SGA.
CONCLUSION: The prevalence of metabolic syndrome in schizophrenia patients receiving antipsychotic monotherapy in Malaysia was very high. Intervention measures are urgently needed to combat these problems.
KEYWORDS: Antipsychotics; Metabolic syndrome; Monotherapy; Prevalence; Schizophrenia

Correlates between risk perceptions of cervical cancer and screening practice

Wong YL, Chinna K, Mariapun J, Wong LP, Khoo EM, Low WY, et al.

Prev Med, 2013;57 Suppl:S24-6.

PMID: 23318158 DOI: 10.1016/j.ypmed.2013.01.004

OBJECTIVES: To identify the correlates between risk perceptions and cervical cancer screening among urban Malaysian women.
METHOD: A cross-sectional household survey was conducted among 231 women in Petaling Jaya city in 2007. The association of risk perceptions of cervical cancer and screening practice was analyzed using Poisson regression.
RESULTS: 56% of the respondents ever had a Pap smear test. Knowledge of signs and symptoms (aPR=1.11, 95% CI=1.03-1.19), age (aPR=1.02, 95% CI=1.01-1.03), number of pregnancies (aPR=1.06, 95% CI=1.01-1.11), marital status, education level and religion were found to be significant correlates of Pap smear screening. Respondents who were never married were less likely to have had a Pap smear. Those who had no education or primary education were less likely to have had a Pap smear compared to those with degree qualification. The prevalence of screening was significantly higher among Christians and others (aPR=1.35; 95% CI=1.01-1.81) and Buddhists (aPR=1.38; 95% CI=1.03-1.84), compared to Muslims.
CONCLUSION: Eliminating anecdotal beliefs as risks via targeted knowledge on established risk factors and culturally sensitive screening processes are strategic for increasing and sustaining uptake of Pap smear screening versus current opportunistic screening practices.
KEYWORDS: Cervical cancer; Malaysia; Pap smear; Risk perception; Screening; Targeted knowledge

Behavioural and psychological symptoms of dementia, cognitive impairment and caregiver burden in patients with dementia

Rosdinom R, Zarina MZ, Zanariah MS, Marhani M, Suzaily W

Prev Med, 2013;57 Suppl:S67-9.

PMID: 23313789 DOI: 10.1016/j.ypmed.2012.12.025

OBJECTIVE: This study aims to determine the relationships between behavioural and psychological symptoms of dementia (BPSD), cognitive impairment and burden of care of patients with dementia.
METHOD: A cross-sectional, non-randomised study of 65 elderly patients with dementia and their caregivers was conducted over a 3-month period in January 2007 at the memory clinics of Universiti Kebangsaan Malaysia Medical Centre and Hospital Kuala Lumpur. Patients' cognitive functions were assessed with the Mini Mental State Examination (MMSE). Caregivers were interviewed to determine the severity of BPSD and caregiver burden (CB) using the Neuropsychiatric Inventory (NPI) Questionnaire and Zarit Burden Interview (BI) respectively.
RESULTS: Cognitive impairment did not contribute significantly to CB. Multiple linear regression analysis showed that high BPSD scores contributed 0.27 more in BI score, female patients contributed 0.37 less in BI score and caregivers with higher educational level contribute 0.5 more in BI score.
CONCLUSION: Patients' BPSD and male gender, but not cognitive impairment, were associated with CB. Even though CB was experienced more among caregivers with better education, all caregivers should be screened to ensure their general well-being.
KEYWORDS: BPSD; Caregiver burden; Cognitive impairment
Study site: Memory clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) and Hospital Kuala Lumpur, Kuala Lumpur, Malaysia

Testing the agreement of medical instruments: overestimation of bias in the Bland-Altman analysis

Zaki R, Bulgiba A, Ismail NA

Prev Med, 2013;57 Suppl:S80-2.

PMID: 23313586 DOI: 10.1016/j.ypmed.2013.01.003

The Bland-Altman method is the most popular method used to assess the agreement of medical instruments. The main concern about this method is the presence of proportional bias. The slope of the regression line fitted to the Bland-Altman plot should be tested to exclude proportional bias. The aim of this study was to determine whether the overestimation of bias in the Bland-Altman analysis is still present even when the proportional bias has been excluded.

Concordance between hysteroscopic impression and endometrial histopathological diagnosis

Gan DE, Jawan RA, Moy FM

Prev Med, 2013;57 Suppl:S21-3.

PMID: 23313791 DOI: 10.1016/j.ypmed.2012.12.026

The aim of this study was to evaluate the accuracy of hysteroscopic impression for diagnosing benign and malignant endometrial pathology.

Socioeconomic consequences of the 2004 tsunami: policy implications for natural disaster management

Su TT, Saimy BI, Bulgiba AM

Prev Med, 2013;57 Suppl:S74-6.

PMID: 23313790 DOI: 10.1016/j.ypmed.2012.12.024

The objective of the study is to assess the socioeconomic status of the households affected by the tsunami of 2004 & to determine the factors associated with the recovery of household economic status.

Risk factors of leptospirosis among febrile hospital admissions in northeastern Malaysia

Rafizah AA, Aziah BD, Azwany YN, Imran MK, Rusli AM, Nazri SM, et al.

Prev Med, 2013;57 Suppl:S11-3.

PMID: 23295174 DOI: 10.1016/j.ypmed.2012.12.017

Leptospirosis is a worldwide zoonotic disease. Risk factors for the disease may vary among countries.

Determinants of unsuccessful tuberculosis treatment outcomes in Malaysian HIV-infected patients

Ismail I, Bulgiba A

Prev Med, 2013;57 Suppl:S27-30.

PMID: 23295172 DOI: 10.1016/j.ypmed.2012.12.023

To determine predictors of unsuccessful treatment in HIV-infected tuberculosis (TB) patients.

Stroke incidence in the South West District of the Penang Island, Malaysia: PEARLs: Penang Acute Stroke Research Longitudinal Study

Neelamegam M, Looi I, Cheah WK, Narayanan P, Hamid AM, Ong LM

Prev Med, 2013;57 Suppl:S77-9.

PMID: 23295169 DOI: 10.1016/j.ypmed.2012.12.022

This community based incidence study aims to report the stroke incidence in the south-west region of the Penang Island.

Breast screening and health issues among rural females in Malaysia: how much do they know and practice?

Dahlui M, Gan DE, Taib NA, Lim JN

Prev Med, 2013;57 Suppl:S18-20.

PMID: 23276776 DOI: 10.1016/j.ypmed.2012.12.010

OBJECTIVE:
This study investigated rural women's knowledge of breast cancer and screening methods by ethnicity and examined the predictors of breast screening methods.

METHODS:
A cross-sectional survey was conducted in 2011 in five rural districts of Perak; 959 women were interviewed using a semi-structured questionnaire. ANOVA and regression analysis were used in data analysis.

RESULTS:
Women below 50 years old, of Malay ethnicity and who had secondary education scored better than those older, of Chinese ethnicity and had primary education (p<0.001). The uptake of breast self-examination (BSE), clinical breast examination (CBE) and mammogram was 59%, 51% and 6.8%, respectively. Multivariate analysis revealed knowledge of breast cancer and CBE as top predictors of BSE, being married and knowledge of breast cancer as top predictors for CBE; and CBE as the top predictor of mammography uptake. Support from husbands and family members for breast cancer screening was a predictor for CBE and BSE.

CONCLUSION:
Knowledge of breast cancer and its screening uptake varies by ethnicity, location and the type of support received. Efforts and approaches to improve the women's knowledge of breast cancer and its screening uptake therefore should be customized to address the different influencing factors.

Associations of occupational, transportation, household and leisure-time physical activity patterns with metabolic risk factors among middle-aged adults in a middle-income country

Chu AH, Moy FM

Prev Med, 2013;57 Suppl:S14-7.

PMID: 23276774 DOI: 10.1016/j.ypmed.2012.12.011

This study investigates physical activity in different domains and its association with metabolic risk factors among middle-aged adults.

Are examination findings important in screening for angina in the Malaysian patient?

Bulgiba AM

Prev Med, 2005 Jun;40(6):696-701.

PMID: 15850867

The objective of this study is to look at how well patient history and examination findings can be used in screening for angina.

Dietary patterns in relation to quality-adjusted life years in the EPIC-NL cohort

Fransen HP, Beulens JW, May AM, Struijk EA, Boer JM, de Wit GA, et al.

Prev Med, 2015 Aug;77:119-24.

PMID: 26007298 DOI: 10.1016/j.ypmed.2015.05.014

Dietary patterns have been associated with the incidence or mortality of individual non-communicable diseases, but their association with disease burden has received little attention.

Fulltext Accelerating action on cervical screening in lower- and middle-income countries (LMICs) post COVID-19 era

Woo YL, Gravitt P, Khor SK, Ng CW, Saville M

Prev Med, 2021 03;144:106294.

PMID: 33678225 DOI: 10.1016/j.ypmed.2020.106294

Cervical cancer remains the fourth most common cancer in women, with 85% of deaths occurring in LMICs. Despite the existence of effective vaccine and screening tools, efforts to reduce the burden of cervical cancer must be considered in the context of the social structures within the health systems of LMICs. Compounding this existing challenge is the global COVID-19 pandemic, declared in March 2020. While it is too soon to tell how health systems priorities will change as a result of COVID-19 and its impact on the cervical cancer elimination agenda, there are opportunities to strengthen cervical screening by leveraging on several trends. Many LMICs maximized the strengths of their long established community-based primary care and public health systems with expansion of surveillance systems which incorporated mobile technologies. LMICs can harness the momentum of the measures taken against COVID-19 to consolidate the efforts against cervical cancer. Self-sampling, molecular human papillomavirus (HPV) testing and digital health will shift health systems towards stronger public health and primary care networks and away from expensive hospital-based care investments. While COVID-19 will change health systems priorities in LMICs in ways that may de-prioritize cervical cancer screening, there are significant opportunities for integration into longer-term trends towards universal health coverage, self-care and digital health.

Achieving equity in cervical cancer screening in low- and middle-income countries (LMICs): Strengthening health systems using a systems thinking approach

Gravitt PE, Silver MI, Hussey HM, Arrossi S, Huchko M, Jeronimo J, et al.

Prev Med, 2021 03;144:106322.

PMID: 33678230 DOI: 10.1016/j.ypmed.2020.106322

The World Health Organization (WHO) is leading a call to action to eliminate cervical cancer by the end of the century through global implementation of two effective evidence-based preventive interventions: HPV vaccination and cervical screening and management (CSM). Models estimate that without intervention, over the next 50 years 12.2 million new cases of cervical cancer will occur, nearly 60% of which are preventable only through CSM. Given that more than 80% of the cervical cancer occurs in low- and middle-income countries (LMICs), scaling up sustainable CSM programs in these countries is a top priority for achieving the global elimination goals. Multiple technologies have been developed and validated to meet this need. Now it is critical to identify strategies to implement these technologies into complex, adaptive health care delivery systems. As part of the coordinated cervical cancer elimination effort, we applied a systems thinking lens to reflect on our experiences with implementation of HPV-based CSM programs using the WHO health systems framework. While many common health system barriers were identified, the effectiveness of implementation strategies to address them was context dependent; often reflecting differences in stakeholder's belief in the quality of the evidence supporting a CSM algorithm, the appropriateness of the evidence and algorithm to context, and the 'implementability' of the algorithm under realistic assessments of resource availability and constraints. A structured planning process, with early and broad stakeholder engagement, will ensure that shared-decisions in CSM implementation are appropriately aligned with the culture, values, and resource realities of the setting.

Depressive symptoms mediate the longitudinal association between diabetes and subjective cognitive decline. Findings from a semirural multi-ethnic older population in Malaysia

Johar H, Schaefer A, Su TT

Prev Med, 2023 Feb;167:107390.

PMID: 36528114 DOI: 10.1016/j.ypmed.2022.107390

The potential role of psychological distress as the pathway linking diabetes and subjective cognitive decline (SCD) is still unclear. This study aims to investigate whether depressive symptoms mediate the relationship between diabetes and SCD in older adults. Baseline data from 3428 adults (55-94 years) of the South East Asia Community Observatory (SEACO), Malaysia were utilized. Subjective cognitive complaints (SCC) were recorded at baseline and five years later. Mediation analyses with non-parametric bootstrapping methods were employed. A proportion of 20% of participants without SCC at baseline reported a decline in SCC after 5 years of follow-up. Known diabetes (β = -0.13, SE = 0.05, p = 0.02) and depressive symptoms (ß = -0.18, SE = 0.05, p = 0.001) were independently associated with SCD. Previously diagnosed diabetes was associated with depressive symptoms at baseline (ß = 0.04, SE = 0.02, p = 0.01), and greater SCD at follow-up (β = -0.19, SE = 0.06, p = 0.001). Mediation analyses revealed that 9% of the association between diabetes and SCD was attributable to an indirect effect through depressive symptoms (ß = -0.01, 95% CI 0.02-0.001, p

Cardiovascular health metrics in low and middle-income countries: A scoping review

Garegnani L, Franco JVA, Escobar Liquitay CM, Brant LCC, Lim HM, de Jesus Jessen NP, et al.

Prev Med, 2023 Jul;172:107534.

PMID: 37146731 DOI: 10.1016/j.ypmed.2023.107534

BACKGROUND: In 2010 the American Heart Association defined the concept of ideal cardiovascular health to renew the focus on primordial prevention for cardiovascular disease. Evidence primarily from high-income countries suggests ideal CVH prevalence is low and decreases with age, with vulnerable populations differentially affected. We aimed to identify and characterize the evidence relevant to CVH metrics in low- and middle-income countries (LMICs).

METHODS: We followed the Joanna Briggs Institute guideline for the conduct of this scoping review. We searched MEDLINE, Embase, LILACS and study registers from inception to 14 March 2022. We included cross-sectional and cohort studies in populations representing a geographically-defined unit (urban or rural) in LMICs, and with data on CVH metrics i.e. all health or clinical factors (cholesterol, blood pressure, glycemia and body mass index) and at least one health behavior (smoking, diet or physical activity). We report findings following the PRISMA-Scr extension for scoping reviews.

RESULTS: We included 251 studies; 85% were cross-sectional. Most studies (70.9%) came from just ten countries. Only 6.8% included children younger than 12 years old. Only 34.7% reported seven metrics; 25.1%, six. Health behaviors were mostly self-reported; 45.0% of studies assessed diet, 58.6% physical activity, and 90.0% smoking status.

CONCLUSIONS: We identified a substantial and heterogeneous body of research presenting CVH metrics in LMICs. Few studies assessed all components of CVH, especially in children and in low-income settings. This review will facilitate the design of future studies to bridge the evidence gap. This scoping review protocol was previously registered on OSF: https://osf.io/sajnh.

Electronic nicotine delivery system use and its relation to waterpipe smoking among youth in seven Arab countries

Mohammad MS, Aburezq M, AlSaeed N, Abdullah Z, Fayrouz S, Almunefi K, et al.

Prev Med, 2024 Apr 02;182:107945.

PMID: 38574972 DOI: 10.1016/j.ypmed.2024.107945

OBJECTIVES: Electronic Nicotine Delivery System (ENDS) use and Waterpipe Tobacco Smoking (WTS) are reported to be a growing strain of tobacco epidemic among youth in the Arab world. Therefore, we aimed to: (1) estimate the regional prevalence of ENDS use among youth in 7 Arab countries and, (2) to explore the bidirectional relationship between ENDS use and WTS among Arab adolescents.

METHODS: We analyzed data from the World Health Organization Global Youth Tobacco Survey (GYTS 2014-2018) of 18,536 schoolchildren aged 12-16 from Iraq, Mauritania, Morocco, Oman, Qatar, Tunisia, and Yemen. The weighted prevalence was calculated to generate nationally representative estimates. Adjusted multilevel logistic regression models were conducted to assess the association between ENDS use and WTS.

RESULTS: The pooled weighted prevalence of ENDS use was 9.5%. Higher odds of ENDS use were significantly associated with WTS (AOR: 5.26, 95%CI: 4.28-6.46), smoking conventional cigarettes (AOR: 1.54, 95%CI: 1.23-1.94) and first tobacco use prior to the age of 12 (AOR: 1.40, 95%CI: 1.14-1.72). Females and children who were taught in school the dangers of tobacco had less odds of using ENDS.

CONCLUSION: WTS was associated with increased odds of ENDS use by >5 folds, and vice versa. Tobacco consumption at age younger than 12 years was associated with higher odds of ENDS use, but less odds of WTS. Females and those who were taught in school the dangers of tobacco were less likely to report ENDS use.

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