This study examines the general public's knowledge of mental health and explores effective tools to promote good mental health through a household survey of a representative sample of the Malaysian population residing in Klang Valley, Malaysia.
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.
INTRODUCTION: The importance of Paediatric Palliative Care (PPC) is increasingly recognised worldwide, with the World Health Organzsation (WHO) and the American Academy of Pediatrics (AAP) endorsing the development and wide availability of PPC. When these children are in the terminal phase of their illness, PPC should be tailored to the different needs and desires of the child and the family, with the goal of providing the best possible quality of life (QOL) for the days that remain.
METHOD: Malaysia has yet to develop a national PPC policy. In anticipation of this, as part of a needs based qualitative study, parents' views were solicited, as to the unmet needs of their children during the terminal phases of their illness. A purposive sampling was conducted amongst fifteen parents of nine deceased children (ages 2-14 years, eight cancer, one Prader Willi Syndrome) who had received care in the Paediatric Department, Malacca General Hospital, a Malaysian government hospital. Two focus group discussions and three in-depth interviews were conducted, based on a semi-structured interview guideline. The interviews were audiotaped with permission and the tape recordings were transcribed verbatim. The data were managed and analysed by NVivo 9 software using a thematic analysis approach.
RESULTS: The frequently emerging themes were the strengths and weaknesses pertaining to the healthcare system, processes within palliative care. These were symptom control, closed communication and lack of support and anticipatory guidance as death approached.
CONCLUSION: Dying Malaysian children and their families deserve to receive care that is more consistent with optimal palliative care.
This paper describes findings on selected determinants of sexual intercourse among 468 unmarried adolescents from a survey in Malaysia. Data on respondents' background, sexual experience, contraceptive use, and sexual attitudes are provided. Based on multiple logistic regressions, factors significantly predictive of sexual experience are gender, employment, and sexual attitudes.
A survey was conducted to assess student's sexual knowledge and attitudes using a questionnaire based on the Sex Knowledge and Attitude Test (SKAT-II) to compare medical and nursing students with students (non-medical/nursing) who registered for a sexual health course. 85 Sexual Health, 115 medical and 81 nursing students voluntarily participated in the survey. This study showed that all the student groups showed relatively low scores in knowledge. Furthermore, average knowledge scores differed significantly between the three student groups with medical students scoring highest and nursing students lowest. Besides student groups, several other factors were found to be significantly associated with Knowledge score namely, race, religion, age, perception of the importance of religion and the extent to which religious beliefs influence sexual attitudes. Furthermore, multivariate statistical analyses showed that among these factors, student group, race/religion and religious importance were significant predictors of sexual knowledge. Specifically, being a medical student was associated with higher scores relative to a non-medical student, being a Malay student was independently associated with a lower average score compared to other races, and perceiving religion as extremely important was associated with a lower score.
Sexuality of persons with spinal cord injury has received increased attention especially in the Western countries. However, in the local context, studies pertaining to the sexuality of the disabled are almost nil. This paper utilized a qualitative approach in assessing sexual knowledge, attitudes and practices of persons with spinal cord injury. Eight focus group discussions consisting of 28 adult spinal cord injured persons were carried out. The results showed that the frequency of sexual activity decreased following injury. The disabled themselves have a negative self-concept and a low self-esteem and this affects their attitudes towards sexuality and their sexual behaviour. Health care professionals tend to neglect this issue perhaps due to their insensitivity to the sexual needs for the disabled or a lack of understanding and expertise in this area. A need for sexual information related to their disability is warranted in the areas of reproduction, contraception and their ability/disability in achieving an erection or ejaculation. This study indicated a need for more comprehensive research in this neglected area of sexual issues of persons with disabilities. Public health education and counseling is deemed necessary for the disabled themselves so as to accommodate their sexual lives to their physical capabilities and desires. Attitudes and misconceptions of the public need to be corrected. Above all, there is a need for education and training for health care professionals in the area of sexual rehabilitation, which is currently non-existent in the country. Perhaps, it is timely to incorporate sexual rehabilitation as part of a holistic medical rehabilitation of the disabled.
Glutathione S-Transferases (GSTs) are phase II detoxification enzymes that may have evolved in response to changes of environmental substrates. GST genes formed a multigene family and in mammals, there are six classes known as Alpha, Mu, Omega, Pi, Theta, and Zeta. Recent studies in phase I detoxification system specifically the cytochrome P450s provided a general explanation on why genes from a common origin such as those in a multigene family have both phylogenetically stable and unstable genes. Genes that participate in core functions of organisms such as development and physiology are stable whereas genes that play a role in detoxification are unstable and evolve in a process known as birth-death evolution, which is characterised by frequent gene gains and losses. The generality of the birth-death model at explaining the evolution of detoxification enzymes beyond the phase I enzyme has not been comprehensively explored. This work utilized 383 Gst genes and 300 pseudogenes across 22 mammalian species to study gene gains and losses. GSTs vary greatly in their phylogenetic stability despite their overall sequence similarity. Stable Gst genes from Omega and Zeta classes do not show fluctuation in gene numbers from human to opossum. These genes play a role in biosynthesis related functions. Unstable genes that include Alpha, Mu, Pi and Theta undergo frequent gene gain and loss in a process known as birth-death evolution. Gene members of these four classes are well known for their roles in detoxification. Our positive selection screen identified five positively selected sites in mouse GSTA3. Previous studies showed two of these sites (108H and 208E) were biochemically tested as important residues that conferred catalytic activity against the toxic aflatoxin B1-8,9-epoxide. The functional significance against aflatoxin of the remaining three positively selected sites warrant further investigation.
Food marketing is one of the main factors in the increase in childhood obesity. The objective is to compare the strategies used for promotion of food and beverages advertisements on Sri Lankan television for children and adults.
STUDY DESIGN: Qualitative study using individual in-depth interviews.
OBJECTIVE: To explore the roles of patients, their caregivers and doctors when making decisions on the method of bladder drainage after spinal cord injury (SCI).
SETTING: Five public hospitals in Malaysia.
METHODS: Semistructured (one-to-one) interviews with 17 male patients with SCI, 4 caregivers and 10 rehabilitation professionals.
RESULTS: Eight themes describing the respective decisional roles of patients, their caregivers and doctors emerged from the analysis: patient's right and responsibilities, patient as an informed decision maker, forced to accept decision; surrogate decision maker, silent partner; doctor knows best, over-ride patient's decision, or reluctant decision maker. Both patients and doctors acknowledged the importance of patient autonomy but not all patients had the chance to practice it. Some felt that they were forced to accept the doctor's decision and even alleged that the doctor refused to accept their decision. Doctors considered the caregiver as the decision maker in cases that involved minors, elderly and those with tetraplegia. Some patients considered bladder problems an embarrassing subject to discuss with their caregivers and did not want their involvement. Doctors were described as knowledgeable and were trusted by patients and their caregivers to make the most appropriate option. Some doctors were happy to assume this role whereas some others saw themselves only as information providers.
CONCLUSIONS: A paternalistic model is prevalent in this decision-making process and there is a discrepancy between patients' preferred and actual decisional roles.
This study evaluated the impact of maternal marital status on birth outcomes among young Malaysian women and investigated other risk factors influencing the birth outcomes. Pregnant women with and without marital ties at the point of pregnancy diagnosis were invited to participate in this study. Participants were interviewed using a structured questionnaire at pregnancy diagnosis and shortly after childbirth. From a total of 229 unmarried and 213 married women who participated, marital status was significantly associated with preterm birth (odds ratio [OR], 1.66; 95% confidence interval [CI], 1.05-2.61) and low birth weight (OR, 3.61; 95% CI, 1.98-6.57). Other factors significantly associated with birth outcomes was prenatal care (OR, 4.92; 95% CI, 1.43-16.95), "use of drugs" (OR, 10.39; 95% CI, 1.14-94.76), age (OR, 1.12; 95% CI, 1.07-1.16), and number of prenatal visits (OR, 1.03; 95% CI, 1.00-1.07). Promoting access to prenatal care and social support programs for unmarried mothers may be important to reduce adverse pregnancy outcomes.