Displaying publications 41 - 60 of 924 in total

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  1. Fulltext Antimicrobial stewardship in rural and remote primary health care: a narrative review
    Yau JW, Thor SM, Tsai D, Speare T, Rissel C
    Antimicrob Resist Infect Control, 2021 07 13;10(1):105.
    PMID: 34256853 DOI: 10.1186/s13756-021-00964-1
    BACKGROUND: Antimicrobial resistance is an emerging problem worldwide and poses a significant threat to human health. Antimicrobial stewardship programmes are being implemented in health systems globally, primarily in hospitals, to address the growing threat of antimicrobial resistance. Despite the significance of primary health care services in providing health care to communities, antimicrobial stewardship programmes are not well established in this sector, especially in rural and remote settings. This narrative review aims to identify in rural and remote primary health care settings the (1) correlation of antimicrobial resistance with antibiotic prescribing and volume of antibiotic use, (2) appropriateness of antimicrobial prescribing, (3) risk factors associated with inappropriate use/prescribing of antibiotics, and (4) effective antimicrobial stewardship strategies.

    METHODS: The international literature was searched for English only articles between 2000 and 2020 using specified keywords. Seven electronic databases were searched: Scopus, Cochrane, Embase, CINAHL, PubMed, Ovid Medline and Ovid Emcare. Publication screening and analysis were conducted using Joanna Briggs Institute systematic review tools.

    RESULTS: Fifty-one eligible articles were identified. Inappropriate and excessive antimicrobial prescribing and use directly led to increases in antimicrobial resistance. Increasing rurality of practice is associated with disproportionally higher rates of inappropriate prescribing compared to those in metropolitan areas. Physician knowledge, attitude and behaviour play important roles in mediating antimicrobial prescribing, with strong intrinsic and extrinsic influences including patient factors. Antimicrobial stewardship strategies in rural and remote primary health care settings focus on health care provider and patient education, clinician support systems, utility of antimicrobial resistance surveillance, and policy changes. Results of these interventions were generally positive with decreased antimicrobial resistance rates and improved appropriateness of antimicrobial prescribing.

    CONCLUSIONS: Inappropriate prescribing and excessive use of antimicrobials are an important contributor to the increasing resistance towards antimicrobial agents particularly in rural and remote primary health care. Antimicrobial stewardship programmes in the form of education, clinical support, surveillance, and policies have been mostly successful in reducing prescribing rates and inappropriate prescriptions. The narrative review highlighted the need for longer interventions to assess changes in antimicrobial resistance rates. The review also identified a lack of differentiation between rural and remote contexts and Indigenous health was inadequately addressed. Future research should have a greater focus on effective interventional components and patient perspectives.

    Matched MeSH terms: Rural Health Services*
  2. Fulltext Occlusion, malocclusion and method of measurements - an overview
    Hassan, R., Rahimah, A.K.
    Archives of Orofacial Sciences, 2007;2(1):3-9.
    MyJurnal
    Epidemiological studies of occlusion and malocclusion not only help in orthodontic treatment planning and evaluation of dental health services but also offer a valid research tool for ascertaining the operation of distinct environmental and genetic factors in the aetiology of malocclusion. The objective of this article was to give an overview on occlusion, malocclusion and the various methods on measuring the occlusion. Each index and method of the assessment described was based on the opinion of an individual or a group of individuals. It had been widely agreed that no particular index or method available that are truly inclusive of all occlusal criteria. Therefore, different indices or method had been developed according to different requirements and it may be necessary to use more than one index in order to gather information to suit the objective of the particular study.
    Matched MeSH terms: Dental Health Services
  3. Child health in Malaysia
    Ariffin W
    Arch Dis Child, 1994 Nov;71(5):452-6.
    PMID: 7826121
    Matched MeSH terms: Child Health Services/organization & administration*
  4. Sex inequality in kidney transplantation rates
    Schaubel DE, Stewart DE, Morrison HI, Zimmerman DL, Cameron JI, Jeffery JJ, et al.
    Arch. Intern. Med., 2000 8 6;160(15):2349-54.
    PMID: 10927733 DOI: 10.1001/archinte.160.15.2349
    BACKGROUND: Men in the United States undergoing renal replacement therapy are more likely than women to receive a kidney transplant. However, the ability to pay may, in part, be responsible for this finding.

    OBJECTIVE: To compare adult male and female transplantation rates in a setting in which equal access to medical treatment is assumed.

    METHODS: Using data from the Canadian Organ Replacement Register, the rate of first transplantations was computed for the 20, 131 men and the 13,458 women aged 20 years or older who initiated renal replacement therapy between January 1, 1981, and December 31, 1996. Poisson regression analysis was used to estimate the male-female transplantation rate ratio, adjusting for age, race, province, calendar period, underlying disease leading to renal failure, and dialytic modality. Actuarial survival methods were used to compare transplantation probability for covariable-matched cohorts of men and women.

    RESULTS: Men experienced 20% greater covariable-adjusted kidney transplantation rates relative to women (rate ratio, 1.20; 95% confidence interval, 1.13-1.27). The sex disparity was stronger for cadaveric transplants (rate ratio, 1.23) compared with those from living donors (rate ratio, 1.10). The 5-year probability of receiving a transplant was 47% for men and 39% for women within covariable-matched cohorts (P
    Matched MeSH terms: Health Services Accessibility/statistics & numerical data
  5. Accessibility of breast and cervical cancer services in Malaysia
    Arrows Change, 1997 Dec;3(3):3.
    PMID: 12294552
    Matched MeSH terms: Health Services*; Health Services Accessibility*
  6. Symposium and workshop on healthy lifestyle programs for weight management
    Florentino RF
    Asia Pac J Clin Nutr, 2004;13(4):409-13.
    PMID: 16637126
    Matched MeSH terms: School Health Services
  7. Estimating radiotherapy demands in South East Asia countries in 2025 and 2035 using evidence-based optimal radiotherapy fractions
    Yahya N, Roslan N
    Asia Pac J Clin Oncol, 2018 Oct;14(5):e543-e547.
    PMID: 29316293 DOI: 10.1111/ajco.12831
    BACKGROUND AND PURPOSE: As about 50% of cancer patients may require radiotherapy, the demand of radiotherapy as the main treatment to treat cancer is likely to rise due to rising cancer incidence. This study aims to quantify the radiotherapy demand in countries in Southeast Asia (SEA) in 2025 and 2035 using evidence-based optimal radiotherapy fractions.

    MATERIALS AND METHODS: SEA country-specific cancer incidence by tumor site for 2015, 2025 and 2035 was extracted from the GLOBOCAN database. We utilized the optimal radiotherapy utilization rate model by Wong et al. (2016) to calculate the optimal number of fractions for all tumor sites in each SEA country. The available machines (LINAC & Co-60) were extracted from the IAEA's Directory of Radiotherapy Centres (DIRAC) from which the number of available fractions was calculated.

    RESULTS: The incidence of cancers in SEA countries are expected to be 1.1 mil cases (2025) and 1.4 mil (2035) compared to 0.9 mil (2015). The number of radiotherapy fractions needed in 2025 and 2035 are 11.1 and 14.1 mil, respectively, compared to 7.6 mil in 2015. In 2015, the radiotherapy fulfillment rate (RFR; required fractions/available fractions) varied between countries with Brunei, Singapore and Malaysia are highest (RFR > 1.0 - available fractions > required fractions), whereas Cambodia, Indonesia, Laos, Myanmar, Philippines, Timor-Leste and Vietnam have RFR 

    Matched MeSH terms: Health Services Needs and Demand*
  8. A glimpse of public health in China
    Low WY, Binns C
    Asia Pac J Public Health, 2015 Mar;27(2 Suppl):7S-8S.
    PMID: 25712494 DOI: 10.1177/1010539515574405
    Matched MeSH terms: Health Services Accessibility/organization & administration
  9. Access to safe legal abortion in Malaysia: women's insights and health sector response
    Low WY, Tong WT, Wong YL, Jegasothy R, Choong SP
    Asia Pac J Public Health, 2015 Jan;27(1):33-7.
    PMID: 25452590 DOI: 10.1177/1010539514562275
    Malaysia has an abortion law, which permits termination of pregnancy to save a woman's life and to preserve her physical and mental health (Penal Code Section 312, amended in 1989). However, lack of clear interpretation and understanding of the law results in women facing difficulties in accessing abortion information and services. Some health care providers were unaware of the legalities of abortion in Malaysia and influenced by their personal beliefs with regard to provision of abortion services. Accessibility to safer abortion techniques is also an issue. The development of the 2012 Guidelines on Termination of Pregnancy and Guidelines for Management of Sexual and Reproductive Health among Adolescents in Health Clinics by the Ministry of Health, Malaysia, is a step forward toward increasing women's accessibility to safe abortion services in Malaysia. This article provides an account of women's accessibility to abortion in Malaysia and the health sector response in addressing the barriers.
    Matched MeSH terms: Health Services Accessibility*
  10. Global School-based Student Health Survey, Malaysia
    Low WY, Binns C
    Asia Pac J Public Health, 2014 Sep;26(5 Suppl):7S-8S.
    PMID: 25143527 DOI: 10.1177/1010539514545287
    Matched MeSH terms: School Health Services
  11. School health in Malaysia: where are we now?
    Pavlin BI, Ali O, Poh BK
    Asia Pac J Public Health, 2014 Sep;26(5 Suppl):4S-6S.
    PMID: 25143526 DOI: 10.1177/1010539514545286
    Matched MeSH terms: School Health Services*
  12. Methodology of the National School-based Health Survey in Malaysia, 2012
    Yusoff F, Saari R, Naidu BM, Ahmad NA, Omar A, Aris T
    Asia Pac J Public Health, 2014 Sep;26(5 Suppl):9S-17S.
    PMID: 25038193 DOI: 10.1177/1010539514542424
    The National School-Based Health Survey 2012 was a nationwide school health survey of students in Standard 4 to Form 5 (10-17 years of age), who were schooling in government schools in Malaysia during the period of data collection. The survey comprised 3 subsurveys: the Global School Health Survey (GSHS), the Mental Health Survey, and the National School-Based Nutrition Survey. The aim of the survey was to provide data on the health status of adolescents in Malaysia toward strengthening the adolescent health program in the country. The design of the survey was created to fulfill the requirements of the 3 subsurveys. A 2-stage stratified sampling method was adopted in the sampling. The methods for data collection were via questionnaire and physical examination. The National School-Based Health Survey 2012 adopted an appropriate methodology for a school-based survey to ensure valid and reliable findings.
    Study name: Global School-Based Student Health Survey (GSHS)
    Matched MeSH terms: School Health Services*
  13. Sexuality education in Malaysia: perceived issues and barriers by professionals
    Khalaf ZF, Low WY, Merghati-Khoei E, Ghorbani B
    Asia Pac J Public Health, 2014 Jul;26(4):358-66.
    PMID: 24489084 DOI: 10.1177/1010539513517258
    This research explored the perspectives of Malaysian professionals on the issues and barriers affecting the implementation of sexuality education in Malaysia. This qualitative study involved in-depth interviews with 15 key professionals working in the field of sexuality and reproductive health in Malaysia. Thematic analysis was selected to analyze data. Barriers to sexuality education were perceived from 5 aspects: feasibility, acceptability, accountability, strategies, and community unawareness. Respondents believed that implementing national sexuality education is a time-consuming project. They regarded Malaysian multicultural society as a barrier to national sexuality education, and they believed that school-based sexuality education is not easily accomplished in Malaysia; also abstinence-only policy restricts the access of young people to accurate information. Lack of community involvement was perceived as a key concern to sexuality education. Campaigning to promote awareness of families, teachers, community leaders, and policy makers are recommended to help establishing national sexuality education in Malaysia.
    Matched MeSH terms: Health Services Accessibility*
  14. Inequality of the use of skilled birth assistance among rural women in Bangladesh: facts and factors
    Kamal SM, Hassan CH, Kabir MA
    Asia Pac J Public Health, 2015 Mar;27(2):NP1321-32.
    PMID: 23572376 DOI: 10.1177/1010539513483823
    This study examines the inequality of the use of skilled delivery assistance by the rural women of Bangladesh using the 2007 Bangladesh Demographic and Health Survey data. Simple cross-tabulation and univariate and multivariate statistical analyses were employed in the study. Overall, 56.1% of the women received at least one antenatal care visit, whereas only 13.2% births were assisted by skilled personnel. Findings revealed apparent inequality in using skilled delivery assistance by socioeconomic strata. Birth order, women's education, religion, wealth index, region and antenatal care are important determinants of seeking skilled assistance. To ensure safe motherhood initiative, government should pay special attention to reduce inequality in seeking skilled delivery assistance. A strong focus on community-based and regional interventions is important in order to increase the utilization of safe maternal health care services in rural Bangladesh.
    Matched MeSH terms: Maternal Health Services/utilization*
  15. Public health strategies to address Asian men's health needs
    Tong SF, Low WY
    Asia Pac J Public Health, 2012 Jul;24(4):543-55.
    PMID: 22815311 DOI: 10.1177/1010539512452756
    Men's health discourse has been around for more than 2 decades. The higher mortality rates and the shorter life expectancy in Asian men compared with their women counterparts show the disadvantaged status of men's health. Thus, discussions on men's health should address their health needs and not be confined to sex-specific male urology and reproductive health. In Asia, assessing men's health needs is challenging because of the vast differences in the socioeconomic status and the diverse culture among its member countries. Although, the epidemiology of men's health provides the focus for what to address in improving men's health, having an optimal strategy requires the understanding of men's health-seeking behaviors and the social determinants surrounding them. Thus, public health approaches addressing health behaviors and health promotion in the society should be one of the keys in improving men's health status. Locally relevant information is needed to inform effective public health approaches.
    Matched MeSH terms: Health Services Needs and Demand*
  16. The 2004 tsunami in Penang, Malaysia: early mental health intervention
    Krishnaswamy S, Subramaniam K, Indran T, Low WY
    Asia Pac J Public Health, 2012 Jul;24(4):710-8.
    PMID: 22790355 DOI: 10.1177/1010539512453261
    Disasters, natural or man-made, bring numerous health care challenges. In any crisis, mental health programs are a requirement during both the acute and postemergency phases. In the Asian tsunami on December 26, 2004, some of the northwestern coastal areas of Malaysia, particularly the island of Penang, were affected with devastating effects on the residents. Such disasters can predispose to mental health problems among the affected people. An early mental health intervention program was carried out in Balik Pulau, Penang, an area badly affected by the tsunami. The objective of the intervention program was to identify the victims, counsel them, make referrals if necessary, and provide help and resources to prevent the development of mental health problems. Penang residents identified as tsunami victims by the local health authorities were recruited. A group of health care workers, school teachers, village authorities, and volunteers were trained to carry out the crisis intervention program by health care workers experienced in crisis interventions. A total of 299 adults participated in the crisis intervention program, with follow-up assessments being made 4 to 6 weeks later. At the follow-up assessment, 1% of the victims had a problem and they were then referred for further medical assessment. This indicates that the intervention program in the first 2 weeks after the tsunami disaster with referrals to medical services may have helped stabilize the victims.
    Matched MeSH terms: Mental Health Services/organization & administration*
  17. Extent and determinants of patients' unvoiced needs
    Low LL, Sondi S, Azman AB, Goh PP, Maimunah AH, Ibrahim MY, et al.
    Asia Pac J Public Health, 2011 Sep;23(5):690-702.
    PMID: 21878464 DOI: 10.1177/1010539511418354
    Patients with issues or health problems usually plan to discuss their concerns with their health care providers. If these concerns were not presented or voiced during the health care provider-patient encounter, the patients are considered to have unvoiced needs. This article examines the extent and possible determinants of patients' unvoiced needs in an outpatient setting. A cross-sectional study was conducted in 5 Ministry of Health Malaysia primary health facilities throughout the country. Of 1829 who participated, 5 did not respond to the question on planned issues. Of the 1824 respondents, 57.9% (95% confidence interval = 47.1-68.7) claimed to have issues/problems they planned to share, of whom 15.1% to 26.7% had unvoiced needs. Extent of unvoiced needs differed by employment status, perceived category of health care provider, and study center. Perceived category of health care provider, method of questionnaire administration, and study center were the only significant determinants of unvoiced needs. Unvoiced needs do exist in Malaysia and there is a need for health care providers to be aware and take steps to counter this.

    Study site: 5 Ministry of Health Malaysia primary health facilities throughout the country
    Matched MeSH terms: Health Services Needs and Demand/statistics & numerical data*; Rural Health Services/statistics & numerical data; Urban Health Services/statistics & numerical data
  18. Dental health status and treatment needs in the infantry regiment of the Malaysian Territorial Army
    Jasmin B, Jaafar N
    Asia Pac J Public Health, 2011 Apr;23(2):203-8.
    PMID: 21159693 DOI: 10.1177/1010539510391234
    The aim of this study was to determine the dental health status and treatment needs of personnel in the Infantry Regiment of the Malaysian Territorial Army (TA).This cross-sectional study involved stratified and systematic random sampling with a total sample size of 300. Dental health status and treatment needs were assessed using the standard WHO oral assessment criteria (1997). The prevalence of caries experience was 96% (mean ± SD DMFT [decayed, missing, filled teeth] = 8.0 ± 5.5). Active decay prevalence was high (85%; mean ± SD = 3.6 ± 3.1) indicating high unmet treatment need. Missing teeth prevalence was high (69%; mean ± SD = 2.8 ± 3.7). Filled teeth prevalence was low (56%, mean ± SD = 1.5 ± 2.0). In all, 90% of participants required some form of dental treatment, of whom 85% required restorative treatment, 5% advanced restorative treatment, 36.7% extractions, and 45.3% prosthetic treatment. These findings suggest that there was a high need for dental treatment in the Infantry Battalions of Malaysian TA Regiments and the service must be made available to cater to the needs.
    Matched MeSH terms: Dental Health Services*
  19. Measuring service quality of public dental health care facilities in Kelantan, Malaysia
    John J, Yatim FM, Mani SA
    Asia Pac J Public Health, 2011 Sep;23(5):742-53.
    PMID: 20460281 DOI: 10.1177/1010539509357341
    This study investigates patients' expectations and perceptions of service quality in public dental health care and measures their "satisfaction gap." This descriptive study involved 481 dental outpatients in Kelantan, Malaysia. A modified SERVQUAL 20-item instrument was used to assess patients' expectations before and perceptions after receiving dental treatment. The "satisfaction gap" was then measured.
    RESULTS: showed that patients visiting for management of dental pain were more satisfied (P = .007) than those visiting with appointment. The most significant service quality dimensions were related to responsiveness, assurance, and empathy of the dental health care providers. There was a significant difference between the patients' expectations and their perceptions of service provided (P < .01) with regard to all dimensions. In conclusion, dental service providers should give emphasis to the compassionate and emotional aspects of care and to remember that they are integral components of quality service.
    Matched MeSH terms: Health Services Research
  20. Fulltext Dietary modification in a workplace health promotion program in Kuala Lumpur, Malaysia
    Moy FM, Ab Sallam A, Wong ML
    Asia Pac J Public Health, 2008 Oct;20 Suppl:166-72.
    PMID: 19533877
    Lifestyle modification is effective in the prevention of cardiovascular diseases. This study aimed to promote healthy lifestyle behaviours to prevent cardiovascular disease. This study was a quasi-experimental trial with a follow up of two years. The intervention group (n = 102) received intensive individual and group counselling on diet and physical activity. The comparison group (n = 84) was given minimal education through mail and group counselling. Following the intervention, both groups reduced their total fat intake through a replacement in carbohydrate intake. The saturated fat and cholesterol intake was also reduced with a larger magnitude in the intervention group. Fruits and vegetables consumption was increased within the intervention group. The intervention group showed a statistically significant reduction in their mean total cholesterol levels with an intervention effect of -0.38 (95% C.I. = -0.63, -0.14) mmol/l. This study has achieved moderate improvement in dietary intakes as well as the total cholesterol of the participants.
    Matched MeSH terms: Occupational Health Services/methods*
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