Results: Candidal growth was found in 21.42% (n = 24) of COPD cases and 1.1% (n = 11) of control cases (p < 0.05) (95% CI 0.45, 0.59). The DMFT score was 8.26 in COPD subjects and 4.6 in controls, the SiC score was 16.42 in COPD subjects and 10.25 in controls, and the CPITN score for both COPD and control cases was score 2.
Conclusion: In conclusion, there was a higher candidal load among subjects suffering from COPD. Theophylline medication can be a risk factor for increased candidal load in COPD patients.
Methods: We adopted a comparative cross-sectional study on pre-clinical medical students who appeared in two different admission tests. The stress, anxiety, and depression levels of students were measured by the depression, anxiety, stress scale (DASS-21), and their burnout level was measured by the Copenhagen Burnout Inventory.
Results: The stress, anxiety, and depression scores between MMI and PI were not significantly different (p-value > 0.05). The personal, work and client burnout scores between MMI and PI were not significantly different (p-value > 0.05). The prevalence of stress (MMI = 39%, PI = 36.9%), anxiety (MMI = 78%, PI = 67.4%), depression (MMI = 41%, PI = 36.2%) and burnout (MMI = 29%, PI = 31.9%) between MMI and PI cohorts was not significantly different (p-value > 0.05). These results showed similar levels of stress, anxiety, depression, and burnout in students at the end of the pre-clinical phase.
Conclusions: This study showed similar psychological health status of the pre-clinical students who were enrolled by two different admission tests. The prevalence of stress, anxiety, burnout, and depression among the pre-clinical medical students was comparable to the global prevalence. The results indicate that medical schools can consider implementing either MMI or PI to recruit suitable candidates for medical training.
METHODS: A multi-stage sampling design was adopted for the study and data collection took place in three phases in 2010, 2011, and 2012 in the Northern region of Malaysia. Face-to-face interviews involved respondents answering both 13 TTO and 15 VAS valuation tasks were carried out. Both additive and multiplicative model specifications were explored using the valuation data. Model performance was evaluated using out-of-sample predictive accuracy by applying the cross-validation technique. The distribution of the model values was also graphically compared on Bland-Altman plots and kernel density distribution curves.
RESULTS: Data from 630 and 611 respondents were included for analyses using TTO and VAS models, respectively. In terms of main-effects specifications, cross-validation results revealed a slight superiority of multiplicative models over its additive counterpart in modelling TTO values. However, both main-effects models had roughly equal predictive accuracy for VAS models. The non-linear multiplicative model with I32 term, MULT7_TTO, performed best for TTO models; while, the linear additive model with N3 term, ADD11_VAS, outperformed the other VAS models. Multiplicative modelling neither altered the dimensional rankings of importance nor did it change the distribution of values of the health states.
CONCLUSION: Using EQ-5D-3L valuation data, multiplicative modelling was shown to improve out-of-sample predictive accuracy of TTO models but not of VAS models.
METHODS: For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5-19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence.
FINDINGS: We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9-10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes-gaining too little height, too much weight for their height compared with children in other countries, or both-occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls.
INTERPRETATION: The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks.
FUNDING: Wellcome Trust, AstraZeneca Young Health Programme, EU.
DESIGN: Systematic review.
DATA SOURCES: EMBASE, MEDLINE, Scopus and Global Health databases.
ELIGIBILITY CRITERIA: Studies were eligible if they: (1) included Nepalese migrant workers aged 18 or older working in the GCC countries or Malaysia or returnee migrant workers from these countries; (2) were primary studies that investigated health and well-being status/issues; and (3) were published in English language before 8 May 2020.
STUDY APPRAISAL: All included studies were critically appraised using Joanna Briggs Institute study specific tools.
RESULTS: A total of 33 studies were eligible for inclusion; 12 studies were conducted in Qatar, 8 in Malaysia, 9 in Nepal, 2 in Saudi Arabia and 1 each in UAE and Kuwait. In majority of the studies, there was a lack of disaggregated data on demographic characteristics of Nepalese migrant workers. Nearly half of the studies (n=16) scored as 'high' quality and the rest (n=17) as 'moderate' quality. Five key health and well-being related issues were identified in this population: (1) occupational hazards; (2) sexual health; (3) mental health; (4) healthcare access and (5) infectious diseases.
CONCLUSION: To our knowledge, this is the most comprehensive review of the health and well-being of Nepalese migrant workers in the GCC countries and Malaysia. This review highlights an urgent need to identify and implement policies and practices across Nepal and destination countries to protect the health and well-being of migrant workers.
METHODOLOGY AND ANALYSIS: The population of interest is the coastal communities residing within the Tun Mustapha Park in Sabah, Malaysia. The data collection is planned for a duration of 6 months and the findings are expected by December 2020. A random cluster sampling will be conducted at three districts of Sabah. This study will collect 600 adult respondents (300 households are estimated to be collected) at age of 18 and above. The project is a cross sectional study via face-to-face interview with administered questionnaires, anthropometrics measurements and observation of the living condition performed by trained interviewers.
OBJECTIVE: To examine ethnic differences in participation in medical check-ups among the elderly.
DESIGN: A nationally representative data set was employed. Multiple logistic regressions were utilised to examine the relationship between ethnicity and the likelihood of undergoing medical check-ups. The regressions were stratified by age, income, marital status, gender, household location, insurance access and health status. These variables were also controlled for in the regressions (including stratified regressions).
PARTICIPANTS: The respondents were required to be residents of Malaysia and not be institutionalised. Overall, 30,806 individuals were selected to be interviewed, but only 28,650 were actually interviewed, equivalent to a 93% response rate. Of those, only 2248 were used in the analyses, because 26,402 were others or below aged 60.
MAIN MEASURES: The dependent variable was participation in a medical check-up. The main independent variables were the three major ethnic groups in Malaysia (Malay, Chinese, Indian).
KEY RESULTS: Among the elderly aged 70-79 years, Chinese (aOR 1.89; 95% CI 1.28, 2.81) and Indians (aOR 2.39; 95% CI 1.20, 4.74) were more likely to undergo medical check-ups than Malays. Among the elderly with monthly incomes of ≤ RM999, Chinese (aOR 1.44; 95% CI 1.12, 1.85) and Indians (aOR 1.50; 95% CI 0.99, 2.28) were more likely to undergo medical check-ups than Malays. Indian males were more likely to undergo medical check-ups than Malay males (aOR 2.32; 95% CI 1.15, 4.67). Chinese with hypercholesterolaemia (aOR 1.45; 95% CI 1.07, 1.98) and hypertension (aOR 1.32; 95% CI 1.02, 1.72) were more likely to undergo medical check-ups than Malays.
CONCLUSIONS: There were ethnic differences in participation in medical check-ups among the elderly. These ethnic differences varied across age, income, marital status, gender, household location, insurance access and health status.
DESIGN: Analysis of cross-sectional data collected from participants in a prospective cohort study.
SETTING: The Victorian rural towns of Morwell and Sale in 2018-2019.
PARTICIPANTS: A weighted random sample of 1119 eligible participants from Morwell or Sale, aged ≥55-90 years for men and ≥60-90 years for women, was drawn from the Hazelwood Health Study's Adult Survey cohort.
MAIN OUTCOME MEASURES: Blood pressure, body mass index, left ventricular hypertrophy by electrocardiogram, estimated glomerular filtration rate and glycosylated haemoglobin (HbA1c ) were measured. Participants with hypertension were categorised as managed, undermanaged or unmanaged.
RESULTS: Testing undertaken of 498 participants estimated the weighted prevalence of hypertension (defined as blood pressure ≥ 140/90 mm Hg, a self-reported doctor diagnosis of hypertension or taking antihypertensive medication) to be 79.9% (95% confidence interval: 75.7-83.4). Of those, 54.5% (49.4-60.0) had managed hypertension (<140/90 mm Hg), 37.1% (32.3-42.1) undermanaged hypertension and 8.4% (5.9-11.9) a new finding of hypertension (unmanaged hypertension). Current employment (relative risk 1.47, 95% confidence interval: 1.06-2.02) and single marital status (relative risk 1.45, 1.4-1.84) were associated with under- or unmanaged hypertension. Compared with no hypertension, the hypertensive groups were more likely to demonstrate markers of end-organ damage such as left ventricular hypertrophy and impaired renal function.
CONCLUSION: Hypertension is a highly prevalent condition among older rural Australians which is suboptimally identified and managed.
METHODS AND ANALYSIS: This is a cross-sectional study among 375 Malaysian medical doctors who met the inclusion criteria. A predetermined self-administered questionnaires will be used to collect information regarding the sociodemographic, health status, workplace information, work commuting information, driving behaviour, history of RCI, fatigue, sleep quality, mental health status and work engagement. The questionnaires consist of the following instruments: (1) sociodemographic, health status, workplace information, work commuting information, driving behaviour and history of RCI; (2) Checklist of Individual Strength Questionnaire; (3) Pittsburgh Sleep Quality Index; (4) 21-item Depression Anxiety and Stress Scale; and (5) Utrecht's Work Engagement Scale. The data will be analysed using SPSS program V.24. Descriptive and inferential statistics will be used to determine the prevalence and predictors of RCI.
ETHICS AND DISSEMINATION: This study protocol has received ethics approval from the Medical Research and Ethics Committee (MREC), Ministry of Health Malaysia (NMRR-18-3983-40609) and the Ethics Committee for Research Involving Human Subject, University Putra Malaysia (JKEUPM). Online written informed consent will be obtained from each study participant by the researchers. Results of the study will be disseminated through relevant journals and conferences.
TRIAL REGISTRATION NUMBER: NCT04243291.
METHODS: A simulation-based approach contingent on all single-level transitions defined by the EQ-5D-5L descriptive system was used to estimate the MID for each algorithm.
RESULTS: The resulting mean (and standard deviation) instrument-defined MID estimates were Germany, 0.083 (0.022); Indonesia, 0.093 (0.012); Ireland, 0.098 (0.023); Malaysia, 0.072 (0.010); Poland, 0.080 (0.030); Portugal, 0.080 (0.018); Taiwan, 0.101 (0.010); and the United States, 0.078 (0.014).
CONCLUSIONS: These population preference-based MID estimates and accompanying evidence of how such values vary as a function of baseline index score can be used to aid interpretation of index score change. The marked consistency in the relationship between the calculated MID estimate and the range of the EQ-5D-5L index score, represented by a ratio of 1:20, might substantiate a rule of thumb allowing for MID approximation in EQ-5D-5L index score warranting further investigation.
Aims: This study investigated the impact of an extramural program involving PWD on dental students' professionalism and students' perception of training in managing patients with special needs.
Materials and Methods: A group of 165 undergraduate dental students (year 1 to year 5) participated in a voluntary program, involving 124 visually impaired children, at a special education school in Kuala Lumpur, Malaysia. A dedicated module in oral health was developed by specialists in special care dentistry, pedodontics, and medical sciences. Dental students then participated in a semi-structured focus group interview survey to discuss perceptions of their learning experiences. Qualitative data were analyzed via thematic analysis.
Results: The program had positive impact on various aspects categorized into four major domains: professional knowledge (e.g., understanding of oral-systemic-social-environmental health interaction and understanding of disability), professional skills (e.g., communication and organizational skills), professional behavior (e.g., empathy and teamwork), and value-added learning (e.g., photography and information technology skills). Students showed improved willingness to manage, and comfort in managing PWD, and expressed support for future educational programs involving this patient cohort.
Conclusion: Improved knowledge, skills, attitudes, and personal values, as well as support for future programs, indicate the positive impact of extramural educational activities involving PWD in developing professionalism in patient care, while providing an opportunity for students to be exposed to managing patients with special needs.