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  1. Ibrahim MD, Amran SNA, Yunos YS, Rahman MRA, Mohtar MZ, Wong LK, et al.
    Appl Bionics Biomech, 2018;2018:7854321.
    PMID: 29853998 DOI: 10.1155/2018/7854321
    The skin of a fast swimming shark reveals riblet structures that help reduce the shark's skin friction drag, enhancing its efficiency and speed while moving in the water. Inspired by the structure of the shark skin denticles, our team has carried out a study as an effort in improving the hydrodynamic design of marine vessels through hull design modification which was inspired by this riblet structure of shark skin denticle. Our study covers on macroscaled design modification. This is an attempt to propose an alternative for a better economical and practical modification to obtain a more optimum cruising characteristics for marine vessels. The models used for this study are constructed using computer-aided design (CAD) software, and computational fluid dynamic (CFD) simulations are then carried out to predict the effectiveness of the hydrodynamic effects of the biomimetic shark skins on those models. Interestingly, the numerical calculated results obtained show that the presence of biomimetic shark skin implemented on the vessels give about 3.75% reduction of drag coefficient as well as reducing up to 3.89% in drag force experienced by the vessels. Theoretically, as force drag can be reduced, it can lead to a more efficient vessel with a better cruising speed. This will give better impact to shipping or marine industries around the world. However, it can be suggested that an experimental procedure is best to be conducted to verify the numerical result that has been obtained for further improvement on this research.
    Matched MeSH terms: Industry
  2. Loo HS, Yeow PH
    Appl Ergon, 2015 Nov;51:383-91.
    PMID: 26154237 DOI: 10.1016/j.apergo.2015.06.007
    The research aims to address the physically loading task and quality and productivity problems in the brazing of coils of air-handler units. Eight operators participated in two intervention studies conducted in a factory in Malaysia to compare the status quo brazing with (1) the use of a new twin-brazing torch that replaced the single-brazing gun and (2) brazing in a sitting position. The outcome measures are related to quality, productivity, monetary costs, body postures and symptoms. After baseline, Interventions I and II were applied for 3 months respectively. The results show a 58.9% quality improvement, 140% productivity increase and 113 times ROI. There was also a reduction in poor work postures e.g. in the raising of the arms and shoulders; bending, twisting and extending of the neck; and bending of left and right wrists, and the back. This research can be replicated in other factories that share similar processes.
    Matched MeSH terms: Manufacturing Industry/economics; Manufacturing Industry/methods*; Manufacturing Industry/standards
  3. Swamy MK, Sinniah UR, Ghasemzadeh A
    Appl Microbiol Biotechnol, 2018 Sep;102(18):7775-7793.
    PMID: 30022261 DOI: 10.1007/s00253-018-9223-y
    Rosmarinic acid (RA) is a highly valued natural phenolic compound that is very commonly found in plants of the families Lamiaceae and Boraginaceae, including Coleus blumei, Heliotropium foertherianum, Rosmarinus officinalis, Perilla frutescens, and Salvia officinalis. RA is also found in other members of higher plant families and in some fern and horned liverwort species. The biosynthesis of RA is catalyzed by the enzymes phenylalanine ammonia lyase and cytochrome P450-dependent hydroxylase using the amino acids tyrosine and phenylalanine. Chemically, RA can be produced via methods involving the esterification of 3,4-dihydroxyphenyllactic acid and caffeic acid. Some of the derivatives of RA include melitric acid, salvianolic acid, lithospermic acid, and yunnaneic acid. In plants, RA is known to have growth-promoting and defensive roles. Studies have elucidated the varied pharmacological potential of RA and its derived molecules, including anticancer, antiangiogenic, anti-inflammatory, antioxidant, and antimicrobial activities. The demand for RA is therefore, very high in the pharmaceutical industry, but this demand cannot be met by plants alone because RA content in plant organs is very low. Further, many plants that synthesize RA are under threat and near extinction owing to biodiversity loss caused by unscientific harvesting, over-collection, environmental changes, and other inherent features. Moreover, the chemical synthesis of RA is complicated and expensive. Alternative approaches using biotechnological methodologies could overcome these problems. This review provides the state of the art information on the chemistry, sources, and biosynthetic pathways of RA, as well as its anticancer properties against different cancer types. Biotechnological methods are also discussed for producing RA using plant cell, tissue, and organ cultures and hairy-root cultures using flasks and bioreactors. The recent developments and applications of the functional genomics approach and heterologous production of RA in microbes are also highlighted. This chapter will be of benefit to readers aiming to design studies on RA and its applicability as an anticancer agent.
    Matched MeSH terms: Drug Industry
  4. Chan SK, Lim TS
    Appl Microbiol Biotechnol, 2019 Apr;103(7):2973-2984.
    PMID: 30805670 DOI: 10.1007/s00253-019-09669-3
    Microbial transglutaminase (mTGase) is commonly known in the food industry as meat glue due to its incredible ability to "glue" meat proteins together. Aside from being widely exploited in the meat processing industries, mTGase is also widely applied in other food and textile industries by catalysing the formation of isopeptide bonds between peptides or protein substrates. The advancement of technology has opened up new avenues for mTGase in the field of biomedical engineering. Efforts have been made to study the structural properties of mTGase in order to gain an in-depth understanding of the structure-function relationship. This review highlights the developments in mTGase engineering together with its role in biomedical applications including biomaterial fabrication for tissue engineering and biotherapeutics.
    Matched MeSH terms: Food Industry
  5. Hasan NM, Zain RM, Abdul Rahman MF, Mustapha I
    Appl Radiat Isot, 2009 Jul-Aug;67(7-8):1239-43.
    PMID: 19303310 DOI: 10.1016/j.apradiso.2009.02.020
    A bulk of used paper supplied to recycling industry may contain water in their internal voids. This is because the price of the used paper is currently based on their weight and it has a huge potential of suppliers to add with water in order to increase the price. Currently used methods for detecting moisture content in a paper are restricted to a sheet of paper only. This paper presents a non-intrusive method for quick and in-situ measurement of water content in a bulk of used paper. The proposed method extends the capability of common paper moisture gauge, by using a neutron device. A fast neutron source (Am-Be 241) and a portable backscattering neutron detector are used for water measurement. It theoretically indicates that the slow neutron counts can be correlated to the hydrogen or water level in a paper. The method has the potential of being used by the paper-recycling industry for rapid and non-destructive measurement of water in a bulk of used paper.
    Matched MeSH terms: Industry
  6. Omar M, Ali HM, Abu MP, Kontol KM, Ahmad Z, Ahmad SH, et al.
    Appl Radiat Isot, 2004 May;60(5):779-82.
    PMID: 15082059
    Radium concentrations in 470 samples of the various types of waste from oil and gas industries were analysed using gamma spectrometers. The results showed that the radium concentration varied within a wide range. The highest mean 226Ra and 228Ra concentrations of 114,300 and 130,120 Bq/kg, respectively, were measured in scales. Overall, 75% of the waste, mostly sludge and extraction residue lies within the normal range of radium concentration in soils of Malaysia. However, some platform sludge can have radium concentration up to 560 Bq/kg.
    Matched MeSH terms: Industry
  7. Praveena SM
    Arch Environ Contam Toxicol, 2018 Oct;75(3):415-423.
    PMID: 29802419 DOI: 10.1007/s00244-018-0537-7
    This study was designed to determine the particle size distribution and develop road dust index combining source and transport factors involving road dust for dust pollution quantification in Rawang. Principal component analysis (PCA) was applied to identify possible sources of potentially toxic elements and spot major pollution areas in Rawang. The health risks (carcinogenic and noncarcinogenic) to adults and children were assessed using the hazard index and total lifetime cancer Risk, respectively. A total of 75 road dust samples were collected and particle sizes (1000, 500, 250, 160, 125 and 63 µm) were determined. Concentrations of potentially toxic elements (Cu, Cd, Co, Cr, Pb, Ni, Zn and As) in particle size of 63 µm were analyzed. The results demonstrated that the highest grain size of 250 µm has contributed almost more than 25% of atmospheric particulate pollution. The highest potentially toxic element concentration was Pb (593.3 mg/kg), whereas the lowest was Co (5.6 mg/kg). Road dust index output indicated that pollution risk fell into moderate levels in eastern and northern areas of Rawang. Similarly, PCA results revealed that potentially toxic elements (Cu, Cd, Pb, Zn, Ni and Cr) were linked with anthropogenic sources (urbanization process, industrial and commercial growth, urban traffic congestion) in northern and southern parts of Rawang. Cobalt and As concentrations were explained mainly from natural sources. Noncarcinogenic risk by hazard index value more than 1.0 was indicated for adults and children. Similarly, carcinogenic risk by total lifetime cancer risk value also showed carcinogenic risks among adults and children.
    Matched MeSH terms: Industry
  8. Karupaiah T, Chinna K, Mee LH, Mei LS, Noor MI
    Asia Pac J Clin Nutr, 2008;17(3):483-91.
    PMID: 18818170
    The Malaysian government recently introduced a ban on fast food advertisements targeting children on television. This study reports on data covering 6 months of television food advertising targeting children. Six out of seven of the Nation's commercial television networks participated (response rate = 85.7%). Based on reported timings of children's programmes, prime time significantly differed ( p <0.05) between weekdays (mean = 1.89 +/- 0.18 hr) and weekends (mean = 4.61 +/- 0.33 hr). The increased trend during weekends, school vacation and Ramadhan was evident. Over the six-month period, the mean number of food advertisements appearing per month varied greatly between television stations (C = 1104; D = 643; F = 407; B = 327; A = 59; E = 47). Food advertising also increased the most in September (n = 3158), followed by July (n = 2770), August (n = 2431), October (n = 2291), November (n = 2245) and June (n = 2211). Content analysis of advertisements indicated snacks were the highest (34.5%), followed by dairy products (20.3%), sugars and candies (13.4%), biscuits (11.2%), fast food (6.7%), breakfast cereal (6.4%), beverages (4.1%), supplements (0.9%), rice (0.6%), noodles (0.5%), bread (0.3%), miscellaneous and processed foods (0.2%). Paradoxically, we found that the frequency of snack food advertised during children's prime time was 5 times more than fast foods. The sodium content (mean = 620 mg per 100g) of these snack foods was found to be highest.
    Matched MeSH terms: Food Industry/organization & administration*
  9. Miskandar MS, Man YC, Yusoff MS, Rahman RA
    Asia Pac J Clin Nutr, 2005;14(4):387-95.
    PMID: 16326646
    Optimum processing conditions on palm oil-based formulations are required to produce the desired quality margarine. As oils and fats contribute to the overall property of the margarine, this paper will review the importance of beta' tending oils and fats in margarine formulation, effects of the processing parameters -- emulsion temperature, flow-rate, product temperature and pin-worker speed -- on palm oil margarines produced and their subsequent behaviour in storage. Palm oil, which contributes the beta' crystal polymorph and the best alternative to hydrogenated liquid fats, and the processing conditions can affect the margarine consistency by influencing the solid fat content (SFC) and the types of crystal polymorph formed during production as well as in storage. Palm oil, or hydrogenated palm oil and olein, in mixture with oils of beta tending, can veer the product to the beta' crystal form. However, merely having beta' crystal tending oils is not sufficient as the processing conditions are also important. The emulsion temperature had no significant effect on the consistency and polymorphic changes of the product during storage, even though differences were observed during processing. The consistency of margarine during storage was high at low emulsion flow-rates and low at high flow rates. The temperature of the scraped-surface tube-cooler is the most important parameter in margarine processing. High temperature will produce a hardened product with formation of beta-crystals during storage. The speed of the pin-worker is responsible for inducing crystallization but, at the same time, destroys the crystal agglomerates, resulting in melting.
    Matched MeSH terms: Food-Processing Industry/methods; Food-Processing Industry/standards*
  10. Kasapila W, Shaarani SM
    Asia Pac J Clin Nutr, 2011;20(1):1-8.
    PMID: 21393103
    In the globalised world of the 21st century, issues of food and nutrition labelling are of pre-eminent importance. Several international bodies, including the World Health Organisation and World Trade Organisation, are encouraging countries to harmonise their food and nutrition regulations with international standards, guidelines and recommendations such as those for Codex Alimentarius. Through harmonisation, these organisations envisage fewer barriers to trade and freer movement of food products between countries, which would open doors to new markets and opportunities for the food industry. In turn, increased food trade would enhance economic development and allow consumers a greater choice of products. Inevitably, however, embracing harmonisation brings along cost implications and challenges that have to be overcome. Moreover, the harmonisation process is complex and sporadic in light of the tasks that countries have to undertake; for example, updating legislation, strengthening administrative capabilities and establishing analytical laboratories. This review discusses the legislation and regulations that govern food and nutrition labelling in Southeast Asia, and highlights the discrepancies that exist in this regard, their origin and consequences. It also gives an account of the current status of harmonising labelling of pre-packaged foodstuffs in the region and explains the subsequent benefits, challenges and implications for governments, the food industry and consumers.
    Matched MeSH terms: Food Industry/economics
  11. Idris NA, Dian NL
    Asia Pac J Clin Nutr, 2005;14(4):396-401.
    PMID: 16326647
    Inter-esterification is one of the processes used to modify the physico-chemical characteristics of oils and fats. Inter-esterification is an acyl-rearrangement reaction on the glycerol molecule. On the other hand, hydrogenation involves addition of hydrogen to the double bonds of unsaturated fatty acids. Due to health implications of trans fatty acids, which are formed during hydrogenation, the industry needs to find alternatives to hydrogenated fats. This paper discusses some applications of inter-esterified fats, with particular reference to inter-esterified palm products, as alternatives to hydrogenation. Some physico-chemical properties of inter-esterified fats used in shortenings are discussed. With inter-esterification, more palm stearin can be incorporated in vanaspati. For confectionary fats and infant formulations, enzymatic inter-esterification has been employed.
    Matched MeSH terms: Food-Processing Industry
  12. Kaewboonchoo O, Isahak M, Susilowati I, Phuong TN, Morioka I, Harncharoen K, et al.
    Asia Pac J Public Health, 2016 Jul;28(5):438-49.
    PMID: 27273897 DOI: 10.1177/1010539516651957
    Work ability is related to many factors that might influence one's capacity to work. This study aimed to examine the work ability and its related factors among small and medium enterprises (SME) workers in 4 Association of Southeast Asian Nations (ASEAN) countries. The participants in this study included 2098 workers from food and textile industries in Indonesia, Malaysia, Thailand, and Vietnam. A cross-sectional survey of anonymous self-administrated questionnaire was designed to collect information on sociodemographic factors, work environment and ergonomic condition, musculoskeletal disorders, and work ability. Bivariate correlation coefficient and multiple linear regression analyses were used to predict the work ability. Results of this study confirm that work ability in 4 ASEAN countries was similar to that in European countries, and that the sociodemographic factors, work environment and ergonomic condition, and musculoskeletal disorder (MSD) were associated with work ability. These factors are important for considering occupational health and safety policy to promote work ability in food, textile, and other SME workers.
    Matched MeSH terms: Textile Industry
  13. Armstrong RW, Rood MJ, Sani S, Mohamed M, Rashid M, Jab AT, et al.
    Asia Pac J Public Health, 2001;13(1):24-9.
    PMID: 12109256 DOI: 10.1177/101053950101300106
    The objective of this study was to establish baseline data about air pollutants potentially related to nasopharyngeal carcinoma (NPC) in the Federal Territory and Selangor, Malaysia. During 1991-1993, ambient air quality was monitored at 42 work sites representing ten industrial sectors: adhesive manufacturing, foundries, latex processing, metalworking, plywood/veneer milling, ricemilling, rubber tire manufacturing, sawmilling, shoemaking, and textile related industries. At each work site, aerosol particle size distributions and concentrations of formaldehyde, benzene, toluene, isopropyl alcohol, and furfural were measured. Mean aerosol particle concentrations ranged from 61 micrograms/m3 in foundries to 5,578 micrograms/m3 in ricemills, with five industries (adhesives, metalworking, ricemilling, sawmilling, and shoemaking) exceeding the US EPA 24-hr ambient air standard for PM-10. Formaldehyde concentrations exceeded the threshold limit value (TLV) in adhesives factories. Other vapours and elements measured were well below TLVs.
    Matched MeSH terms: Industry/classification
  14. Han YW, Mohammad M, Liew SM
    Asian Pac J Cancer Prev, 2014;15(17):7287-90.
    PMID: 25227830
    BACKGROUND: Brief physician counselling has been shown to be effective in improving smokers' behaviour. If the counselling sessions can be given at the workplace, this would benefit a larger number of smokers. This study aimed to determine the effectiveness of a ten-minute physician counseling session at the workplace in improving smoking behaviour.

    MATERIALS AND METHODS: This prospective randomised control trial was conducted on smokers in a factory. A total of 163 participants were recruited and randomised into control and intervention groups using a table of random numbers. The intervention group received a ten-minute brief physician counselling session to quit smoking. Stages of smoking behaviour were measured in both groups using a translated and validated questionnaire at baseline, one month and three months post intervention.

    RESULTS: There was a significant improvement in smoking behaviour at one-month post intervention (p=0.024, intention to treat analysis; OR=2.525; CI=1.109-5.747). This was not significant at three-month post intervention (p=0.946, intention to treat analysis; OR=1.026; 95% CI=0.486-2.168).

    CONCLUSIONS: A session of brief physician counselling was effective in improving smokers' behaviour at workplace, but the effect was not sustained.

    Matched MeSH terms: Manufacturing Industry*
  15. Tan YL, Mackay J, Kolandai MA, Dorotheo EU
    Asian Pac J Cancer Prev, 2020 Jul 01;21(S1):23-25.
    PMID: 32649167 DOI: 10.31557/APJCP.2020.21.S1.23
    OBJECTIVE: This case series describes tobacco industry tactics and strategies used to interfere, derail, delay, and weaken the development of effective health warning regulations in Malaysia, Cambodia, the Philippines, and Hong Kong.

    METHODS: A historical review of official reports, news articles, and gray literature was undertaken to identify tobacco industry tactics and strategies to hamper government efforts in implementing stronger pictorial health warning regulations in four Asian jurisdictions (Cambodia, Hong Kong, Malaysia, and the Philippines).

    RESULTS: Nineteen countries/jurisdictions in the WHO Western Pacific region currently require pictorial health warnings on cigarette packs, including some of the world's largest, in line with the WHO Framework Convention on Tobacco Control Article 11 Guidelines. In the four jurisdictions examined, tobacco industry interference consisted of lobbying and misinformation of high-level government officers and policy-makers, distributing industry-friendly legislative drafts, taking government to court, challenging government timelines for law implementation, and mobilizing third parties. Strong political leadership and strategic advocacy enabled governments to successfully overcome this industry interference.

    CONCLUSION: The tobacco industry uses similar tactics in different jurisdictions to derail, delay, and weaken the implementation of effective health warning policies. Identifying and learning from international experiences can help anticipate and defeat such challenges.

    Matched MeSH terms: Tobacco Industry/legislation & jurisprudence; Tobacco Industry/standards*
  16. Nayagam J
    Asian Pac Migr J, 1992;1(3-4):477-94.
    PMID: 12285766
    The use of migrant workers to ease labor shortages caused by rapid industrialization in Malaysia during the twentieth century is examined. "This paper will focus on: (1) the extent, composition and distribution of migrant workers; (2) the labor shortage and absorption of migrant workers; and (3) the role of migrant workers in the government's economic restructuring process."
    Matched MeSH terms: Industry*
  17. He L, Mao Y, Zhang L, Wang H, Alias SA, Gao B, et al.
    BMC Biotechnol, 2017 02 28;17(1):22.
    PMID: 28245836 DOI: 10.1186/s12896-017-0343-8
    BACKGROUND: α-Amylase plays a pivotal role in a broad range of industrial processes. To meet increasing demands of biocatalytic tasks, considerable efforts have been made to isolate enzymes produced by extremophiles. However, the relevant data of α-amylases from cold-adapted fungi are still insufficient. In addition, bread quality presents a particular interest due to its high consummation. Thus developing amylases to improve textural properties could combine health benefits with good sensory properties. Furthermore, iron oxide nanoparticles provide an economical and convenient method for separation of biomacromolecules. In order to maximize the catalytic efficiency of α-amylase and support further applications, a comprehensive characterization of magnetic immobilization of α-amylase is crucial and needed.

    RESULTS: A novel α-amylase (AmyA1) containing an open reading frame of 1482 bp was cloned from Antarctic psychrotolerant fungus G. pannorum and then expressed in the newly constructed Aspergillus oryzae system. The purified recombinant AmyA1 was approximate 52 kDa. AmyA1 was optimally active at pH 5.0 and 40 °C, and retained over 20% of maximal activity at 0-20 °C. The K m and V max values toward soluble starch were 2.51 mg/mL and 8.24 × 10-2 mg/(mL min) respectively, with specific activity of 12.8 × 103 U/mg. AmyA1 presented broad substrate specificity, and the main hydrolysis products were glucose, maltose, and maltotetraose. The influence of AmyA1 on the quality of bread was further investigated. The application study shows a 26% increase in specific volume, 14.5% increase in cohesiveness and 14.1% decrease in gumminess in comparison with the control. AmyA1 was immobilized on magnetic nanoparticles and characterized. The immobilized enzyme showed improved thermostability and enhanced pH tolerance under neutral conditions. Also, magnetically immobilized AmyA1 can be easily recovered and reused for maximum utilization.

    CONCLUSIONS: A novel α-amylase (AmyA1) from Antarctic psychrotolerant fungus was cloned, heterologous expression in Aspergillus oryzae, and characterized. The detailed report of the enzymatic properties of AmyA1 gives new insights into fungal cold-adapted amylase. Application study showed potential value of AmyA1 in the food and starch fields. In addition, AmyA1 was immobilized on magnetic nanoparticles and characterized. The improved stability and longer service life of AmyA1 could potentially benefit industrial applications.

    Matched MeSH terms: Food Industry/methods
  18. Tahlan S, Kumar S, Ramasamy K, Lim SM, Shah SAA, Mani V, et al.
    BMC Chem, 2019 Dec;13(1):50.
    PMID: 31384798 DOI: 10.1186/s13065-019-0567-x
    Background: Nitrogen containing heterocycles are widely used and investigated by pharmaceutical industry, as they are important in discovery and designing of new drug molecules. Drugs with a benzimidazole nucleus possess exclusive structural features and electron-rich atmosphere, which enable them to bind to a number of biologically important targets and result in a wide range of activities. This has served as the basis of the present study whereby new scaffolds with benzimidazole moiety were designed and synthesized.

    Methods: The structures of synthesized compounds were confirmed by physicochemical and spectral means. The synthesized compounds were screened for their antimicrobial and antiproliferative activities by tube dilution and Sulforhodamine B (SRB) assays, respectively.

    Results and conclusion: The in vitro biological screening results revealed that compound Z24 exhibited promising antimicrobial and anticancer activities which are comparable to standards.

    Matched MeSH terms: Drug Industry
  19. Abbasiliasi S, Tan JS, Bashokouh F, Ibrahim TAT, Mustafa S, Vakhshiteh F, et al.
    BMC Microbiol, 2017 May 23;17(1):121.
    PMID: 28535747 DOI: 10.1186/s12866-017-1000-z
    BACKGROUND: Selection of a microbial strain for the incorporation into food products requires in vitro and in vivo evaluations. A bacteriocin-producing lactic acid bacterium (LAB), Pediococcus acidilactici Kp10, isolated from a traditional dried curd was assessed in vitro for its beneficial properties as a potential probiotic and starter culture. The inhibitory spectra of the bacterial strain against different gram-positive and gram-negative bacteria, its cell surface hydrophobicity and resistance to phenol, its haemolytic, amylolytic and proteolytic activities, ability to produce acid and coagulate milk together with its enzymatic characteristics and adhesion property were all evaluated in vitro.

    RESULTS: P. acidilactici Kp10 was moderately tolerant to phenol and adhere to mammalian epithelial cells (Vero cells and ileal mucosal epithelium). The bacterium also exhibited antimicrobial activity against several gram-positive and gram-negative food-spoilage and food-borne pathogens such as Listeria monocytgenes ATCC 15313, Salmonella enterica ATCC 13311, Shigella sonnei ATCC 9290, Klebsiella oxytoca ATCC 13182, Enterobacter cloaca ATCC 35030 and Streptococcus pyogenes ATCC 12378. The absence of haemolytic activity and proteinase (trypsin) and the presence of a strong peptidase (leucine-arylamidase) and esterase-lipase (C4 and C8) were observed in this LAB strain. P. acidilactici Kp10 also produced acid, coagulated milk and has demonstrated proteolytic and amylolactic activities.

    CONCLUSION: The properties exhibited by P. acidilactici Kp10 suggested its potential application as probiotic and starter culture in the food industry.

    Matched MeSH terms: Food Industry*
  20. Lee PY, Lee YK, Ng CJ
    BMC Public Health, 2012;12:313.
    PMID: 22545648 DOI: 10.1186/1471-2458-12-313
    BACKGROUND: The prevalence of type 2 diabetes is increasing at an alarming rate in developing countries. However, glycaemia control remains suboptimal and insulin use is low. One important barrier is the lack of an efficient and effective insulin initiation delivery approach. This study aimed to document the strategies used and proposed by healthcare professionals to improve insulin initiation in the Malaysian dual-sector (public-private) health system.
    METHODS: In depth interviews and focus group discussions were conducted in Klang Valley and Seremban, Malaysia in 2010-11. Healthcare professionals consisting of general practitioners (n = 11), medical officers (n = 8), diabetes educators (n = 3), government policy makers (n = 4), family medicine specialists (n = 10) and endocrinologists (n = 2) were interviewed. We used a topic guide to facilitate the interviews, which were audio recorded, transcribed verbatim and analysed using a thematic approach.
    RESULTS: Three main themes emerged from the interviews. Firstly, there was a lack of collaboration between the private and public sectors in diabetes care. The general practitioners in the private sector proposed an integrated system for them to refer patients to the public health services for insulin initiation programmes. There could be shared care between the two sectors and this would reduce the disproportionately heavy workload at the public sector. Secondly, besides the support from the government health authority, the healthcare professionals wanted greater involvement of non-government organisations, media and pharmaceutical industry in facilitating insulin initiation in both the public and private sectors. The support included: training of healthcare professionals; developing and disseminating patient education materials; service provision by diabetes education teams; organising programmes for patients' peer group sessions; increasing awareness and demystifying insulin via public campaigns; and subsidising glucose monitoring equipment. Finally, the healthcare professionals proposed the establishment of multidisciplinary teams as a strategy to increase the rate of insulin initiation. Having team members from different ethnic backgrounds would help to overcome language and cultural differences when communicating with patients.
    CONCLUSION: The challenges faced by a dual-sector health system in delivering insulin initiation may be addressed by greater collaborations between the private and public sectors and governmental and non-government organisations, and among different healthcare professionals.
    Study site: Healthcare professionals from three states (Wilayah Federal Territory, Negeri Sembilan and Selangor) and from both urban and semi-rural locations (including Klinik Kesihatan), Malaysia
    Matched MeSH terms: Drug Industry
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