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Fulltext The association between polyunsaturated fatty acids and depression among Iranian postgraduate students in Malaysia

Yary T, Aazami S

Lipids Health Dis, 2011;10:151.
PMID: 21864357 DOI: 10.1186/1476-511X-10-151

The incidence of depression is expected to increase over the next 20 years, and many people will have to deal with it. It has been reported that up to 40% of university students experience levels of depression. Several negative consequences are associated with depression symptoms, such as memory impairment, suicide, and substance abuse. Recently, researchers have been studying possible associations between depression and polyunsaturated fatty acids (PUFAs), which may modify depression symptoms. The aim of the present study was to find an association between PUFA levels and depression among Iranian postgraduate students in Malaysia.

Matched MeSH terms: Logistic Models
Fulltext Risk Factors Associated with Sarcopenia Among Independently Mobile, Institutionalised Older People in the Klang Valley of Malaysia: A Cross-Sectional Study

Yap SF, Boo NY, Pramod DS, Thaw Z, Liew SF, Woo LF, et al.

Malays J Med Sci, 2020 Mar;27(2):120-128.
PMID: 32788848 MyJurnal DOI: 10.21315/mjms2020.27.2.13

Background: Studies on sarcopenia among Malaysian older people (OP ≥ 60 years of age) living in the community but not in long-term care (LTC) homes have been reported previously. This study aimed to determine the prevalence of sarcopenia and its risk factors in OP in Malaysian LTC homes.
Methods: This cross-sectional study was conducted with 202 independently mobile OP (males 32%) in seven LTC homes in the Klang Valley of Malaysia. Trained personnel measured their anthropometrics, body composition, gait speed, hand grip strength and timed up-and-go (TUG) duration. Criteria of the European Working Group on Sarcopenia in Older People (EWGSOP) and of the Asian Working Group for Sarcopenia were used to identify the presence of sarcopenia. The mini-nutritional assessment (MNA) was used to determine their nutritional status. Additionally, logistic regression analysis was performed to identify significant risk factors associated with pre-sarcopenia/sarcopenia.
Results: Pre-sarcopenia/sarcopenia was detected in 103 (51%) OP. The significant risk factors were body mass index (BMI, weight/height2; adjusted odds ratio [AOR] = 0.44, P < 0.001), percentage of body fat (PBF; AOR = 1.26, P < 0.001), age group (≥ 80 years; AOR = 3.63, P = 0.025) and 'at risk of malnutrition' status (AOR = 2.63, P = 0.049).
Conclusion: Sarcopenia is common among OP in LCT homes. The risk increases with decreasing BMI, increasing PBF, age ≥ 80 years and suboptimal nutrition status.

Matched MeSH terms: Logistic Models
Statistical-learning strategies generate only modestly performing predictive models for urinary symptoms following external beam radiotherapy of the prostate: A comparison of conventional and machine-learning methods

Yahya N, Ebert MA, Bulsara M, House MJ, Kennedy A, Joseph DJ, et al.

Med Phys, 2016 May;43(5):2040.
PMID: 27147316 DOI: 10.1118/1.4944738

Given the paucity of available data concerning radiotherapy-induced urinary toxicity, it is important to ensure derivation of the most robust models with superior predictive performance. This work explores multiple statistical-learning strategies for prediction of urinary symptoms following external beam radiotherapy of the prostate.

Matched MeSH terms: Logistic Models
Breeding habitat preference of preimaginal black flies (Diptera: Simuliidae) in Peninsular Malaysia

Ya'cob Z, Takaoka H, Pramual P, Low VL, Sofian-Azirun M

Acta Trop, 2016 Jan;153:57-63.
PMID: 26476394 DOI: 10.1016/j.actatropica.2015.10.007

To investigate the breeding habitat preference of black flies, a comprehensive black fly survey was conducted for the first time in Peninsular Malaysia. Preimaginal black flies (pupae and larvae) were collected manually from 180 stream points encompassing northern, southern, central and east coast of the Peninsular Malaysia. A total of 47 black fly species were recorded in this study. The predominant species were Simulium trangense (36.7%) and Simulium angulistylum (33.3%). Relatively common species were Simulium cheongi (29.4%), Simulium tani (25.6%), Simulium nobile (16.2%), Simulium sheilae (14.5%) and Simulium bishopi (10.6%). Principal Component Analysis (PCA) of all stream variables revealed four PCs that accounted for 69.3% of the total intersite variance. Regression analysis revealed that high species richness is associated with larger, deeper, faster and higher discharge streams with larger streambed particles, more riparian vegetation and low pH (F=22.7, d.f.=1, 173; P<0.001). Relationship between species occurrence of seven common species (present in >10% of the sampling sites) was assessed. Forward logistic regression analysis indicated that four species were significantly related to the stream variables. S. nobile and S. tani prefer large, fast flowing streams with higher pH, large streambed particles and riparian trees. S. bishopi was commonly found at high elevation with cooler stream, low conductivity, higher conductivity and more riparian trees. In contrast, S. sheilae was negatively correlated with PC-2, thus, this species commonly found at low elevation, warmer stream with low conductivity and less riparian trees. The results of this study are consistent with previous studies from other geographic regions, which indicated that both physical and chemical stream conditions are the key factors for black fly ecology.

Matched MeSH terms: Logistic Models
Prescribing patterns of low doses of antipsychotic medications in older Asian patients with schizophrenia, 2001-2009

Xiang YT, Dickerson F, Kreyenbuhl J, Ungvari GS, Wang CY, Si TM, et al.

Int Psychogeriatr, 2012 Jun;24(6):1002-8.
PMID: 22300452 DOI: 10.1017/S1041610211002791

This study examined the use of low doses of antipsychotic medications (300 mg/day CPZeq or less) in older Asian patients with schizophrenia and its demographic and clinical correlates.

Matched MeSH terms: Logistic Models
Social contact, socioeconomic status, and the health status of older Malaysians

Wu ZH, Rudkin L

Gerontologist, 2000 Apr;40(2):228-34.
PMID: 10820926

We tested the applicability of the stress buffering hypothesis in a developing country setting with data from the Senior Sample of the Malaysian Family Life Survey-2. Using ordered logistic regression methods, we examined whether having daily contact with adult children moderates the effect of low socioeconomic status (SES; conceptualized as a chronic stressor) on self-assessed health status. We found that low SES is associated with poorer health for all three ethnic groups--Malay, Chinese, and Indian. Further, for Malays and Chinese, we found that the negative effects of low SES on health tend to be stronger for older people with less frequent contact with adult children than for those who have daily contact. These results provide general support for the buffering model and suggest that, as found in developed countries, active intergenerational relationships in developing country settings may have protective effects on the health of older people experiencing chronic stressors.

Matched MeSH terms: Logistic Models
Fulltext Effects of Air Pollution and the Introduction of the London Low Emission Zone on the Prevalence of Respiratory and Allergic Symptoms in Schoolchildren in East London: A Sequential Cross-Sectional Study

Wood HE, Marlin N, Mudway IS, Bremner SA, Cross L, Dundas I, et al.

PLoS One, 2015;10(8):e0109121.
PMID: 26295579 DOI: 10.1371/journal.pone.0109121

The adverse effects of traffic-related air pollution on children's respiratory health have been widely reported, but few studies have evaluated the impact of traffic-control policies designed to reduce urban air pollution. We assessed associations between traffic-related air pollutants and respiratory/allergic symptoms amongst 8-9 year-old schoolchildren living within the London Low Emission Zone (LEZ). Information on respiratory/allergic symptoms was obtained using a parent-completed questionnaire and linked to modelled annual air pollutant concentrations based on the residential address of each child, using a multivariable mixed effects logistic regression analysis. Exposure to traffic-related air pollutants was associated with current rhinitis: NOx (OR 1.01, 95% CI 1.00-1.02), NO2 (1.03, 1.00-1.06), PM10 (1.16, 1.04-1.28) and PM2.5 (1.38, 1.08-1.78), all per μg/m3 of pollutant, but not with other respiratory/allergic symptoms. The LEZ did not reduce ambient air pollution levels, or affect the prevalence of respiratory/allergic symptoms over the period studied. These data confirm the previous association between traffic-related air pollutant exposures and symptoms of current rhinitis. Importantly, the London LEZ has not significantly improved air quality within the city, or the respiratory health of the resident population in its first three years of operation. This highlights the need for more robust measures to reduce traffic emissions.

Matched MeSH terms: Logistic Models
Fulltext Prevalence and modifiable risk factors of noncommunicable diseases among Jakun orang asli at Tasik Chini, Pekan, Pahang

Wong, C.M., Faiz D., Diana Safraa S., Raja Mohd Azim R.H., Siti Zubaidah A.R.

International Medical Journal Malaysia, 2018;17(3):3-16.
MyJurnal

Introduction: Non-communicable disease accounted for 73% of premature death in year 2015 Malaysian national survey. The orang asli population may be affected similarly. The prevention of non-communicable diseases should start as early as modifiable risk factors prevention, as proposed by STEPWISE approach of WHO. This study aims to identify the prevalence of hypertension, diabetes mellitus and dyslipidaemia among Jakun orang asli population and examine the association with risk factors. Methods: This is a cross-sectional study analysing 72 case reports of General health screening done in year 2015. The study population was adult Jakun orang asli Tasik Chini using cluster sampling followed by simple random sampling methods. Chi Square test was used for bivariate analysis of relationship each variable has with the diseases, and binary logistic regression was used to analyse association of covariates with each disease. Results: The prevalence was 41.7% for hypertension, 25% for Diabetes mellitus, 6.9% for dyslipidaemia. Education level was significantly related to hypertension, X2 = 11.565 (1), p =0.001; obesity was significantly related to diabetes, X 2 = 8.333 (1), p=0.004. After adjusted for covariates, low education level has 13.379 odds of getting hypertension. Obesity has 7.384 odds of getting diabetes mellitus; female gender has higher odds of getting dyslipidaemia while younger age, physically active and not smoking are protective factors. Conclusion: Higher prevalence of hypertension and diabetes mellitus was found among Tasik Chini orang asli population. Lower sociodemographic characteristics and unhealthy lifestyle factors are associated with the diseases.

Matched MeSH terms: Logistic Models
Fulltext Prevalence of microvascular complications in newly diagnosed type 2 diabetes mellitus in primary healthcare clinics

Wong WL, Valliappan VN, Leong MC, Aminudin SNA, Chew SCJ, Cheong AT

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):237-243.
MyJurnal

Introduction: Delayed diagnosis of type 2 diabetes mellitus (T2D) increases the risk of presenting late with microvas- cular complications due to untreated long-standing hyperglycaemia. This study aimed to determine the prevalence of microvascular complications in newly diagnosed T2D patients in primary healthcare clinics.
Methods: This was a cross-sectional study carried out in three government primary healthcare clinics in the state of Selangor, Malaysia. Malaysian aged 18 years and above with newly diagnosed T2D (<6 months of diagnosis) were invited to participate in the study. Data collected included the sociodemographic characteristic and the clinical profile (weight, height, waist circumference, blood pressure, lipid, glycaemic, urine albumin, microalbuminuria and renal profile). The assessment of nephropathy, peripheral neuropathy and retinopathy were performed using standard protocol. Multivariate logistic regression analysis was used to identify the significant factors that contribute to the presence of microvascular complications.
Results: A total of 162 newly diagnosed patients were recruited. The majority was women (64%). The mean age was 51 (SD 11) years. About one-third of the patients (27.7%) had developed at least one microvascular complication. Nephropathy was the commonest microvascular complication (19.2%), followed by peripheral neuropathy (8.6%) and retinopathy (6.5%). Poor glycaemic control was found to be a significant factor contributing to the presence of microvascular complications (OR 5.8, 95%CI:1.466, 23.288).
Conclusion: There is a high prevalence of microvascular complications among the newly diagnosed T2D. There is a need to develop appropriate strategies to increase the awareness and early detection of T2D.
Study site: three Klinik Kesihatan, Selangor, Malaysia

Matched MeSH terms: Logistic Models
Risk factors for developing neonatal septicaemia at a Malaysian hospital

Wong NA, Hunt LP, Marlow N

J Trop Pediatr, 1997 02;43(1):54-8.
PMID: 9078832 DOI: 10.1093/tropej/43.1.54

A case-control study of antecedents of neonatal septicaemia was performed using 50 cases of neonatal septicaemia and 73 comparison infants from a Malaysian hospital nursery. Multivariate analysis indicated the following independent risk factors: maternal primiparity, pre-eclampsia, prolonged rupture of membranes, twin pregnancy, prematurity, assisted ventilation, umbilical catheterization, and formula feeding. Although the spectrum of causative organisms varied between our study and past studies from Western countries, the risk factors for developing neonatal septicaemia were strikingly similar. Therefore, preventative guidelines based on risk factors described in Western countries, should help reduce the incidence of neonatal septicaemia at this Malaysian hospital.

Matched MeSH terms: Logistic Models
Risk of Colorectal Neoplasia in Individuals With Self-Reported Family History: A Prospective Colonoscopy Study from 16 Asia-Pacific Regions

Wong MC, Ching JY, Chiu HM, Wu KC, Rerknimitr R, Li J, et al.

Am J Gastroenterol, 2016 11;111(11):1621-1629.
PMID: 26977757 DOI: 10.1038/ajg.2016.52

OBJECTIVES: We tested the hypothesis that the risk of colorectal cancer (CRC), advanced colorectal neoplasia (ACN), and colorectal adenoma among screening participants with different first-degree relatives (FDRs) affected by CRC was similar.
METHODS: A multi-center, prospective colonoscopy study involving 16 Asia-Pacific regions was performed from 2008 to 2015. Consecutive self-referred CRC screening participants aged 40-70 years were recruited, and each subject received one direct optical colonoscopy. The prevalence of CRC, ACN, and colorectal adenoma was compared among subjects with different FDRs affected using Pearson's χ2 tests. Binary logistic regression analyses were performed to evaluate the risk of these lesions, controlling for recognized risk factors including age, gender, smoking habits, alcohol drinking, body mass index, and the presence of diabetes mellitus.
RESULTS: Among 11,797 asymptomatic subjects, the prevalence of CRC was 0.6% (none: 0.6%; siblings: 1.1%; mother: 0.5%; father: 1.2%; ≥2 members: 3.1%, P<0.001), that of ACN was 6.5% (none: 6.1%; siblings: 8.3%; mother: 7.7%; father: 8.7%; ≥2 members: 9.3%, P<0.001), and that of colorectal adenoma was 29.3% (none: 28.6%; siblings: 33.5%; mother: 31.8%; father: 31.1%; ≥2 members: 38.1%, P<0.001). In multivariate regression analyses, subjects with at least one FDR affected were significantly more likely to have CRC (adjusted odds ratio (AOR)=2.02-7.89), ACN (AOR=1.55-2.06), and colorectal adenoma (AOR=1.31-1.92) than those without a family history. The risk of CRC (AOR=0.90, 95% confidence interval (CI) 0.34-2.35, P=0.830), ACN (AOR=1.07, 95% CI 0.75-1.52, P=0.714), and colorectal adenoma (AOR=0.96, 95% CI 0.78-1.19, P=0.718) in subjects with either parent affected was similar to that of subjects with their siblings affected.
CONCLUSIONS: The risk of colorectal neoplasia was similar among subjects with different FDRs affected. These findings do not support the need to discriminate proband identity in screening participants with affected FDRs when their risks of colorectal neoplasia were estimated.

Matched MeSH terms: Logistic Models
Physical, psychological and sexual effects in multi-ethnic Malaysian women who have undergone hysterectomy

Wong LP, Arumugam K

J Obstet Gynaecol Res, 2012 Aug;38(8):1095-105.
PMID: 22540215 DOI: 10.1111/j.1447-0756.2011.01836.x

The postoperative effects on Asian women after hysterectomy have not been fully explored. This study was undertaken to investigate the physical, psychological and sexual functioning effects in multi-ethnic Malaysian women who have undergone hysterectomy.

Matched MeSH terms: Logistic Models
Fulltext Socio-demographic and behavioural characteristics of illegal motorcycle street racers in Malaysia

Wong LP

BMC Public Health, 2011;11:446.
PMID: 21649937 DOI: 10.1186/1471-2458-11-446

This study sought to understand the factors associated with street racing among the illegal motorcycle racers in Malaysia or known as the "Mat Rempit".

Matched MeSH terms: Logistic Models
Factors influencing the uptake of 2009 H1N1 influenza vaccine in a multiethnic Asian population

Wong LP, Sam IC

Vaccine, 2010 Jun 17;28(28):4499-505.
PMID: 20451639 DOI: 10.1016/j.vaccine.2010.04.043

The study aimed to determine factors influencing the uptake of 2009 H1N1 influenza vaccine in a multiethnic Asian population. Population-based, cross-sectional survey was conducted between October and December 2009. Approximately 70% of overall participants indicated willingness to be vaccinated against the 2009 H1N1 influenza. Participants who indicated positive intention to vaccinate against 2009 H1N1 influenza were more likely to have favorable attitudes toward the 2009 H1N1 vaccine. A halal (acceptable to Muslims) vaccine was the main factor that determined Malay participants' decision to accept vaccination, whereas safety of the vaccine was the main factor that influenced vaccination decision for Chinese and Indian participants. The study highlights the challenges in promoting the 2009 H1N1 vaccine. Ethnic-sensitive efforts are needed to maximize acceptance of H1N1 vaccines in countries with diverse ethnic communities and religious practices.

Matched MeSH terms: Logistic Models
Fulltext Anxiety symptoms and preventive measures during the COVID-19 outbreak in Taiwan

Wong LP, Hung CC, Alias H, Lee TS

BMC Psychiatry, 2020 07 16;20(1):376.
PMID: 32677926 DOI: 10.1186/s12888-020-02786-8

BACKGROUND: It is hypothesized that anxiety and behavioral responses are intense at the beginning of an epidemic. The objective of this study was to investigate anxiety symptoms and use of preventive measures against COVID-19. The study also compared the association between preventive measures and anxiety symptoms during the week immediately preceding the study and those symptoms and measures at the beginning of the outbreak.
METHODS: A cross-sectional population survey using an online questionnaire commenced on 14 February 2020. The study participants were residents of Taiwan ages 20 to 70 years. The 6-item state version of the State-Trait Anxiety Inventory (STAI-6) was used to assess anxiety symptoms. The questions about preventive measures asked participants about their personal protection, cough etiquette, contact precautions, voluntary quarantine, and prompt reporting. Multivariable logistic regression was used to determine the factors influencing an increase in the preventive measures scores.
RESULTS: Of a total of 3555 completed responses, a total of 52.1% (95% confidence interval [CI] 50.4-53.7) of the respondents reported moderate to severe levels of anxiety symptoms in the past week, whereas 48.8% (95%CI 47.2-50.5) reported moderate to severe anxiety symptoms at the beginning of the outbreak. With a higher score indicating greater anxiety, the median scores for anxiety symptoms in the past week and at the beginning of the outbreak were 46.7 (IQR [interquartile range] 36.7-53.3) and 43.3 (IQR 36.7-53.3), respectively. The median scores for the preventive measures taken in the past week and at the beginning of the outbreak were 26.0 (IQR 21.0-30.0) and 24.0 (IQR 19.0-28.0), respectively, out of a maximum score of 36. In the multivariable analysis, an increased anxiety symptom score from the beginning of the outbreak to the past week (adjusted OR = 7.38, 95%CI 6.28-8.66) was a strongly significant determinant of an increased preventive measures score in the past week compared with the score at the beginning of the outbreak.
CONCLUSIONS: Anxiety and preventive measures scores were high and increased with the epidemic rate. Higher anxiety was associated with an increased use of preventive measures against COVID-19.

Matched MeSH terms: Logistic Models
Fulltext Nationwide study of factors associated with public's willingness to use home self-test kit for dengue fever in Malaysia

Wong LP, Atefi N, AbuBakar S

BMC Public Health, 2016 08 12;16:780.
PMID: 27520825 DOI: 10.1186/s12889-016-3409-y

BACKGROUND: As there is no specific treatment for dengue, early detection and access to proper treatment may lower dengue fatality. Therefore, having new techniques for the early detection of dengue fever, such as the use of dengue test kit, is vitally important. The aims of the study were: 1) identify factors associated with acceptance of a home self-test kit for dengue fever if the dengue test is available to the public and 2) find out the characteristics of the test kits that influence the use of the dengue test kit.
METHODS: A national telephone survey was carried out with 2,512 individuals of the Malaysian public aged 18-60 years old. Individuals were contacted by random digit dialling covering the whole of Malaysia from February 2012 to June 2013.
RESULTS: From 2,512 participants, 6.1 % reported to have heard of the availability of the dengue home test kit and of these, 44.8 % expressed their intention to use the test kit if it was available. Multivariate logistic regressions indicated that participants with primary (OR: 0.65; 95 % CI: 0.43-0.89; p = 0.02, vs. tertiary educational level) and secondary educational levels (OR: 0.73; 95 % CI: 0.57-0.90; p = 0.01, vs. tertiary educational level) were less likely than participants with a tertiary educational level to use a home self-testing dengue kit for dengue if the kit was available. Participants with lower perceived barriers to dengue prevention (level of barriers 0-5) were less likely (OR: 0.67, 95 % CI: 0.53-0.85, p

Matched MeSH terms: Logistic Models
Fulltext A 3-year cross-sectional study on breast cancer among sandakan indigenous women: do they present earlier?

Wong K. H.

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):35-35.
MyJurnal

Introduction: Breast cancer is the commonest cancer in Malaysia, predominantly among women under age of 60 and they often presented late. Borneo is home to multi-racial indigenous with heterogeneous background and breast cancer profile can be absolutely unique. This study aims to examine the demographic characteristics and stage at presentation in Sandakan women with newly diagnosed breast cancer. Methods: This is a cross-sectional, retrospec-tive study involving those women who were newly diagnosed with breast cancer from January 2016 to December 2018 in Duchess of Kent Hospital, Sandakan identified via hospital cancer registry and patient records. Only breast cancer with epithelial origin was included. Age, ethnicity and stages at presentation of breast cancer were analysed. Logistic regression was used to study their relationships. Results: 110 women were newly diagnosed as breast cancer. Mean age was 53.5 (SD 12.7), the youngest at 30 and the eldest at 97. Majority (64.6%) were local indigenous wom-en, constituted by 25.4% Sungai, 14.1% Kadazan-Dusun, 12.7% Bugis and the minorities. Chinese women are the main local non-indigenous (32.7%) followed by 2.7% Malay. 52.1% presented at late stages (stage III/IV). Subgroup analysis of T-staging revealed 41.7% had advanced symptoms (T3/T4). Indigenous group was more likely to present at younger ages (OR 12.0; 95%CI 1.5-93.8) and with advanced symptoms (OR 3.1; 95%CI 1.2-8.0). Conclusion: Awareness on breast cancer remains inadequate particularly among indigenous women. Difficult healthcare accessi-bility and incline towards traditional medicine could attribute to late presentation. Outreach awareness programmes are warranted in addition to mobile screening services.

Matched MeSH terms: Logistic Models
Fulltext Prevalence and Predictors of Malnutrition Risk among Post-Stroke Patients in Outpatient Setting: A Cross-Sectional Study

Wong HJ, Harith S, Lua PL, Ibrahim KA

Malays J Med Sci, 2020 Jul;27(4):72-84.
PMID: 32863747 MyJurnal DOI: 10.21315/mjms2020.27.4.7

Background: The present study examined the prevalence and predictors of malnutrition risk among post-stroke patients.
Methods: Post-stroke patients who attended the outpatient clinics in three hospitals of Peninsular Malaysia were enrolled in the study. The risk of malnutrition was assessed using the Malnutrition Risk Screening Tool-Hospital. Data including demographic characteristics, clinical profiles, dietary nutrients intake, body mass index (BMI) and hand grip strength were collected during the survey. The crude odds ratio (OR) and adjusted odds ratio (AOR) were reported for univariate and multivariate logistic regression analyses, respectively.
Results: Among 398 patients included in the study, 40% were classified as high-risk for malnutrition. In the multivariable logistic regression, tube feeding (AOR: 13.16, 95% confidence interval [CI]: 3.22-53.77), loss of appetite (AOR: 8.15, 95% CI: 4.71-14.12), unemployment (AOR: 4.26, 95% CI: 1.64-11.12), wheelchair-bound (AOR: 2.23, 95% CI: 1.22-4.09) and BMI (AOR: 0.87, 95% CI: 0.82-0.93) were found to be significant predictors of malnutrition risk among stroke patients.
Conclusion: The risk of malnutrition is highly prevalent among post-stroke patients. Routine nutritional screening, identification of risk factors, and continuous monitoring of dietary intake and nutritional status are highly recommended even after the stroke patient is discharged.

Matched MeSH terms: Logistic Models
Factors affecting the employability in people with epilepsy

Wo MC, Lim KS, Choo WY, Tan CT

Epilepsy Res, 2016 Dec;128:6-11.
PMID: 27792885 DOI: 10.1016/j.eplepsyres.2016.10.003

PURPOSE: People with epilepsy (PWE) are negatively prejudiced in their ability to work. This study aimed to examine demographic, clinical and psychological factors associated with employability in PWE.

METHODS: This study recruited epilepsy patients from a neurology clinic in Malaysia. Employability was measured using employment ratio, with a ratio ≥90% (ER90) classified as high employability. Basic demographic data such as age, gender, marital status, religion, education level and household income was collected. Clinical measures consisted of age of seizure onset, seizure frequency, type of epilepsy, aura, polytherapy, nocturnal seizures and seizure control. Psychological measures included Work Self-Determination Index (WSDI), Rosenberg Self-Esteem Scale (SES), and Multidimensional Scale of Perceived Social Support (MSPSS).

RESULTS: Of 146 PWE, 64.4% had high employability. The participants were predominantly female (52%), Chinese (50.7%), single (50%), having tertiary education (55.5%) and focal epilepsy (72.6%). Clinically, only type of epilepsy was significantly correlated to employability of PWE. Employability of PWE was associated with ability to work (indicated by education level, work performance affected by seizures, ability to travel independently and ability to cope with stress at work) and family overprotection. The high employability group was found to have lower self-perceived stigma (ESS), higher self-determined motivation (WSDI), self-esteem (SES) and perceived social support (MSPSS), than the low employability group. Logistic regression analysis showed that tertiary education level (AOR 3.42, CI: 1.46-8.00), higher self-determination (WSDI, AOR 1.09, CI: 1.012-1.17), lower family overprotection (AOR 0.76, CI: 0.61-0.95), and generalised epilepsy (AOR 4.17, CI: 1.37-12.70) were significant predictors for higher employability in PWE.

CONCLUSION: Ability to work (education level), clinical factor (type of epilepsy) and psychological factor (self-determined motivation and family overprotection) were important factors affecting employability in PWE.

Study site: neurology clinic Universiti Malaya Medical Centre (UMMC)

Matched MeSH terms: Logistic Models
Admission Clinicopathological Factors Associated with Prolonged Hospital Stay Among Hospitalized Patients with Dengue Viral Infections

Willeam Peter SS, Hassan SS, Khei Tan VP, Ngim CF, Azreen Adnan NA, Pong LY, et al.

Vector Borne Zoonotic Dis, 2019 07;19(7):549-552.
PMID: 30668248 DOI: 10.1089/vbz.2018.2379

Background:
There is an escalation of frequency and magnitude of dengue epidemics in Malaysia, with a concomitant increase in patient hospitalization. Prolonged hospitalization (PH) due to dengue virus (DENV) infections causes considerable socioeconomic burden. Early identification of patients needing PH could optimize resource consumption and reduce health care costs. This study aims to identify clinicopathological factors present on admission that are associated with PH among patients with DENV infections.
Methods:
This study was conducted in a tertiary referral hospital in Southern Malaysia. Relevant clinical and laboratory data upon admission were retrieved from medical records of 253 consecutive DENV nonstructural protein 1 (NS1) antigen and PCR-positive hospitalized patients. The DENV serotype present in each patient was determined. Patients were stratified based on duration of hospital stay (<4 vs. ≥4 days). Data were analyzed using IBM® SPSS® 25.0. Multivariate logistic regression was performed to examine the association between PH and admission parameters.
Results:
Of 253 DENV hospitalized patients, 95 (37.5%) had PH (≥4 days). The mean duration of hospital stay was 3.43 ± 2.085 days (median = 3 days, interquartile range = 7 days). Diabetes mellitus (adjusted odds ratio [AOR] = 6.261, 95% confidence interval [CI] = 2.130-18.406, p = 0.001), DENV-2 serotype (AOR = 2.581, 95% CI = 1.179-5.650, p = 0.018), duration of fever ≤4 days (AOR = 2.423, 95% CI = 0.872-6.734, p = 0.09), and a shorter preadmission fever duration (AOR = 0.679, 95% CI = 0.481-0.957, p = 0.027) were independently associated with PH. However, PH was not found to be associated with symptoms on admission, secondary DENV infections or platelet count, hematocrit, or liver enzyme levels on admission.
Conclusions:
Early identification of these factors at presentation may alert clinicians to anticipate and recognize challenges in treating such patients, leading to more focused management plans that may shorten the duration of hospitalization.

Matched MeSH terms: Logistic Models

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