METHODS: Hundred fifty pre-orthodontic study casts comprised of 52 Malay, 54 Chinese, and 44 Indian patients were selected. Digital calipers (Fowler Pro-Max) linked to Hamilton Tooth Arch Software were used to measure the tooth width and ratios. Statistical analysis was carried out to test for gender differences (independent t-test), to identify the effects of malocclusion and ethnic groups (Two-way ANOVA), and to compare the means of the current study with Bolton's standards (one sample t-test).
RESULTS: This study showed that there was no significant difference between the genders of the sample of each ethnicity. There was no correlation found between ethnic groups and malocclusion classes. There was a significant difference when comparing Bolton values with the Malay sample for both ratios. It was found that more Malay subjects presented with maxillary excess contrary to Chinese and Indians who presented more maxillary deficiency for the anterior and overall ratio.
CONCLUSION: There was a significant difference found between the TSD of the three major ethnicities in Malaysia. The Bolton standards can be applied to Malaysian Chinese and Indians but not to Malays orthodontic populations for both anterior and overall ratios. Subsequently, a specific standard should be used for the Malays orthodontic population. It was found that more Malay subjects presented with maxillary excess contrary to Chinese and Indians who presented more maxillary deficiency for the anterior and overall ratio.
MATERIALS AND METHODS: An exploratory qualitative study was conducted using videoconferencing. Fourteen medical officers working in public primary healthcare clinics from various regions of Malaysia were chosen using purposive sampling process, and participants underwent a total of seven paired in-depth interview (IDI) sessions. IDIs were video recorded, transcribed and subjected to interpretive thematic analysis.
RESULTS: The two main themes which emerged were the benefits and challenges of NCD teleconsultation service. Various categories relating to benefits of teleconsultation for NCD care are as follows: (1) Improved efficiency for patient care delivery (improved effectiveness, convenient, improved safety, better disease monitoring, patient empowerment) and (2) Benefits for Health Care Providers (improved healthcare and service delivery). Main challenges identified were as follows: (1) Challenges for Delivery of Care (Patients' adaptation in using teleconsultation service, Patients abusing the system, Poor digital literacy, No proper disease monitoring record), (2) Challenges for Health Care Providers (Lack of dedicated team and training, Higher workload and time-consuming) and (3) Challenges for Health Care System (Institutional policy, legal and regulatory weakness, Medical record documentation and prescription updates).
CONCLUSION: Optimisation of NCD patient healthcare delivery via teleconsultation is beneficial during and after pandemic. Targeted improvements to address current challenges are crucial to optimise its use beyond the pandemic period in the Malaysian public healthcare system.
MATERIALS AND METHODS: The validated exam developed by the BEST collaborative group was used to assess TM knowledge of doctors, from junior residents up to senior specialists. Scores of 42%, 62%, and 82%, corresponding to basic, intermediate, and expert levels of knowledge, respectively. Convenience sampling was done from eight blood-using departments at University Malaya Medical Centre. The Kruskal-Wallis test was used to compare the candidates' exam scores between different variables.
RESULTS: A total of 184 doctors were assessed. The overall mean score was 40.1% (SD 12.7%). The most senior doctors had a significantly lower mean score compared with resident trainees and specialists. Doctors from haematology, anesthesiology, and internal medicine had significantly higher scores (51%, 47.4%, and 46.4% respectively, p<0.05). No correlations were found between the exam scores and the self-reported amount, or quality of prior TM teaching, nor with the year of postgraduate training. Participants did poorly on questions related to transfusion reactions, especially the question on transfusion-related acute lung injury.
CONCLUSION: Inadequate transfusion medicine knowledge was found across all the departments and levels of appointment. It is concerning that the most senior decision-making doctors had especially poor knowledge. TM training is needed by all residents, and regular updates should be given to established specialists.
METHOD: The DERS-18 underwent forward-backward translation and assessment of face and content validity. Both Malay version of the DERS-18 and DASS-21 were completed by 701 adolescents (44.4% boys) aged 13 and 14 years old. To assess its dependability, a floor and ceiling effect evaluation and Cronbach's analysis were both performed. A series of confirmatory factor analyses (CFA), bivariate correlation, and regression were performed to evaluate the construct and criterion validity, respectively.
RESULTS: The Malay version of DERS-18, after excluding "Awareness", indicated excellent reliability (Cronbach's α = 0.93), and acceptable internal consistency for each subscale (range of α from 0.63 to 0.82). Floor or ceiling effects were observed at item level and subscale level, but not at total level. CFA results revealed that the Malay version of the DERS-18 bifactor model (excluding "Awareness") portrayed the best construct validity (χ2/df = 2.673, RMSEA = 0.049, CFI = 0.977, TLI = 0.968) compared to a single factor, a correlated factor, and a higher-order factor model. The DERS-18 subscales (except "Awareness") and DERS-18 total scores were significantly correlated with stress, anxiety, and depression in a positive direction (r ranged from 0.62 to 0.64, p < 0.01). The general factor of the DERS-18 and its specific factors ("Clarity", "Goals", and "Non-Acceptance") significantly predicted the symptoms of stress, anxiety, and depression (R2 ranged from 0.44 to 0.46, p < 0.001).
CONCLUSION: The Malay version of the DERS-18, excluding "Awareness", possessed good reliability, construct validity, and criterion validity to assess emotion dysregulation among Malaysian adolescents.
AIMS: To describe the national state of advance care planning development in Malaysia METHODS: Review of relevant advance care planning literature locally and internationally was undertaken.
RESULTS: Positive development in Malaysia includes implementation of advance care planning at institutional level, initiatives to develop educational programmes as well as research activities to understand the attitude and perception of patients on advance care planning. However, there remain challenges, including lack of knowledge and awareness, lack of legislative framework to guide advance care planning implementation and lack of strong initiatives at a national level.
CONCLUSIONS: It is evident that there is much to learn nationally and internationally about ACP before any decision on implementation of ACP is made in Malaysia. ACP is a public health issue and requires concerted effort of all stakeholders, including Government agencies, academic institutions, and non-government organizations to raise public awareness. More research is needed to shape the future direction of ACP development in Malaysia.
METHODS: A total of 332 patients who were mandated to undergo drug rehabilitation participated in this cross-sectional study. The study data were collected through face-to-face interviews using a semi-structured questionnaire.
RESULTS: The majority were males (95%, n = 314/332) and Malays (98%, n = 325/332) with a mean age of 32.3 years (SD = 9.16). Over two thirds of the respondents used kratom to alleviate heroin withdrawal symptoms and to reduce methamphetamine intake; 59% used it as a substitute for heroin and methamphetamine. A similar proportion used kratom to reduce heroin intake (58%), while only 15% used it for its euphoric effects. Multivariate analysis showed that previous attendees of government rehabilitation programs had lower odds of using kratom as a heroin substitute.
CONCLUSIONS: The potential of kratom to alleviate heroin withdrawal symptoms, and to reduce methamphetamine and heroin intake, among people who co-use heroin and methamphetamine warrants further research.
DESIGN: Budget impact analysis. Assumptions and costs in the opportunistic and novel CRC screening scenarios were derived from a previous evaluation of opportunistic CRC screening in community health clinics across Malaysia and the CRC-SIM research project, respectively.
SETTING: National level (with supplement analysis for district level). The BIA was conducted from the viewpoint of the federal government and estimated the annual financial impact over a period of 5 years.
RESULTS: The total annual cost of the current practice of opportunistic screening was RM1 584 321 (~I$1 099 460) of which 80% (RM1 274 690 or ~I$884 587) was expended on the provision of opportunistic CRC to adults who availed of the service. Regarding the implementation of national CRC screening programme, the net budget impact in the first year was estimated to be RM107 631 959 (~I$74 692 546) and to reach RM148 485 812 (~I$103 043 589) in the fifth year based on an assumed increased uptake of 5% annually. The costs were calculated to be sensitive to the probability of adults who were contactable, eligible and agreeable to participating in the programme.
CONCLUSIONS: Results from the BIA provided direct and explicit estimates of the budget changes to when implementing a population-based national CRC screening programme to aid decision making by health services planners and commissioners in Malaysia about whether such programme is affordable within given their budget constraint. The study also illustrates the use and value of the BIA approach in low-income and middle-income countries and resource-constrained settings.
METHODS: A cross-sectional study was carried out in the main city of Malaysia at a tertiary teaching hospital between January to April 2021. A total of 218 women diagnosed with endometriosis symptoms were recruited using the universal sampling method to answer the questionnaire.
RESULTS: The revised Malay version of the EHP-30 with 28 items demonstrated that the factor loading of the 28 items had an acceptable value range between 0.60-0.90. The model fit was acceptable after the inclusion of 28 items correlated errors of the root mean square of error approximation: 0.072, 90% confidence interval: [0.065-0.080], comparative fit index (0.939), Tucker-Lewis index (0.932), and Chi-square/degrees of Freedom (2.135). The Cronbach's alpha ranged from 0.89-0.97. Concurrent validity for the composite reliability was between 0.88-0.96, while the average variance extracted was between 0.65-0.74.
CONCLUSION: This revised Malay version of the EHP-30 is a reliable and valid tool that can be used for the next study.
PURPOSE: The objective of this study is to examine the social risk factors that drive older people to have suicidal feelings or tendencies and the extent to which these factors arise from the changes that occur in their social environment as a result of the process of modernization and industrialization.
METHODS: This study employed the phenomenological approach through qualitative data collection technique. A total of 20 informants comprising 10 males and 10 females of Malay, Chinese and Indian ethnicity were selected for the study using purposive sampling technique. In-depth interviews were conducted with the informants. Data were transcribed and subsequently analyzed thematically using the NVivo 11 software.
RESULTS: The findings revealed five conditions that led older people toward suicidal intentions. These include social and cultural changes, lack of social support, conflict in religious belief, influence of economic uncertainty and socio-economic status, and depression as a result of the changes in their social environment.
CONCLUSION: The implication of this research is that these factors affect older people directly as they struggle to adapt and respond to the major changes that occur in the social structure of the society they live in, stemming from the process of modernization and industrialization. Efforts to enact better policies and services for older people need to be addressed especially in developing countries based on assessment of their needs, weaknesses, strengths, and capabilities by incorporating elements of the worldview of the older people based on their experiences of daily lives.
METHODS: The development process was managed by a technical working group led by the Institute for Health Systems Research in the Ministry of Health. Situational analysis was conducted through a multi-pronged approach, underpinned by a review of the past and present healthcare sectoral and quality plans and guided by the WHO NQPS framework. This approach involved: (i) review of quality-related policy documents, (ii) online surveys of healthcare providers and the public, (iii) key-informant facilitated discussions and (iv) mapping of existing quality improvement initiatives (QIIs). Data gathered from these approaches informed the content of the new policy. Following thematic analysis, the findings were grouped into specific domains, which were then organized into a strengths, weaknesses, opportunities, and threats (SWOT) framework.
RESULTS: Ten key areas of concern identified were (i) a people-centred holistic approach, (ii) governance for quality, (iii) resources, (iv) quality culture, (v) stakeholder engagement, (vi) health management information system, (vii) workforce competency, (viii) knowledge exchange, (ix) quality indicators and (x) monitoring and evaluation of quality activities. These led to the formulation of seven strategic priorities for the planning of improvements aimed at addressing the key areas of concern. The national definition of quality was affirmed. A total of 40 QIIs were mapped and grouped into three broad categories, namely (i) regulatory, (ii) domain-specific QIIs and (iii) Quality Improvement (QI) method.
CONCLUSIONS: The National Policy for Quality in Healthcare for Malaysia was developed through a comprehensive situational analysis using a multi-method approach that identified priorities across national, state, institutional and community levels. This evidence-informed approach led to meaningful contextual adaptation of the NQPS framework to shape the strategic direction to advance quality and achieve effective and safe outcomes for all Malaysians.