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Fulltext Aging male symptoms scale (AMS) for health-related quality of life in aging men: translation and adaptation in Malay

Tan HM, Low WY, Tong SF, Hanif J, Appannah G, Lee VKM, et al.

Malaysian Journal of Public Health Medicine, 2015;15(2):17-23.
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The Aging Male Symptoms Scale (AMS) measures health-related quality of life in aging men. The objective of this paper is to describe the translation and validation of the AMS into Bahasa Melayu (BM). The original English version of the AMS was translated into BM by 2 translators to produce BM1 and BM2, and subsequently harmonized to produce BM3. Two other independent translators, blinded to the English version, back-translated BM3 to yield E2 and E3. All versions (BM1, BM2, BM3, E2, E3) were compared with the English version. The BM pre-final version was produced, and pre-tested in 8 participants. Proportion Agreement, Weighted Kappa, Spearman Rank Correlation Coefficient, and verbatim responses were used. The English and the BM versions showed excellent equivalence (weighted Kappa and Spearman Rank Coefficients, ranged from 0.72 to 1.00, and Proportion Agreement values ranged from 75.0% to 100%). In conclusion, the BM version of the AMS was successfully translated and adapted.
Fulltext HIV/AIDS-Related Knowledge Among Malaysian Young Adults: Findings From a Nationwide Survey

Wong LP, Chin CK, Low WY, Jaafar N

J Int AIDS Soc, 2008 Jun 24;10(6):148.
PMID: 19825143 DOI: 10.1186/1758-2652-10-6-148

PURPOSE: HIV/AIDS poses a serious threat to young people, both in Malaysia and throughout the world. A nationwide cross-sectional survey was conducted to assess the knowledge, attitudes, and beliefs about HIV/AIDS among the Malaysian public. This article reports the findings of knowledge about HIV/AIDS among young adults.
METHODS: A total of 1075 young adult respondents aged 15-24 years participated in this survey. The response rate was 82.2%.
RESULTS: The data indicated that HIV/AIDS knowledge among the respondents was moderate, with a mean knowledge score of 20.1 out of 32 points. The great majority had adequate knowledge of the major routes of HIV transmission, but fewer were aware of other modes of transmission, such as tattooing and piercing, sharing personal items, and breast-feeding from an infected mother. The great majority knew that HIV is not transmitted by mosquito bites, sharing meals, casual contact, and using public swimming pools and toilets.
CONCLUSION: Misconceptions about HIV/AIDS exist although generally knowledge on HIV/AIDS transmission and prevention was accurate. Education and intervention programs are needed to increase the level of knowledge and awareness of HIV/AIDS. The findings have important implications for the development of primary HIV/AIDS prevention programs for young adults in Malaysia.
The feasibility of the Golombok-Rust Inventory of Marital State (GRIMS) in assessing marital satisfaction in a Malaysian population

Quek KF, Low WY, Razack AH, Chua CB, Loh CS

J Sex Marital Ther, 2002 Oct-Dec;28(5):423-6.
PMID: 12378843

The purpose of this study is to validate the English version of the Golombok-Rust Inventory of Marital State (GRIMS) in a Malaysian population. Using the test-retest method and Cronbach's alpha, we assessed reliability and internal consistency. Sensitivity to change was expressed as the effect size. Internal consistency was excellent (Cronbach's alpha value = 0.59 to 0.91) Test-retest correlation coefficient and intraclass correlation coefficient were highly significant in majority items (ICC = 0.62 and above), and there was a high degree of sensitivity and specificity. The GRIMS is suitable, reliable, valid, and sensitive to clinical change in a Malaysian population.
The male marital satisfaction following treatment for lower urinary tract symptoms

Quek KF, Loh CS, Low WY, Razack AH, Dublin N

J Sex Marital Ther, 2003 Mar-Apr;29(2):173-6.
PMID: 12623769
Fulltext Self-determination and goal orientation in track and field

Chin NS, Khoo S, Low WY

J Hum Kinet, 2012 Jun;33:151-61.
PMID: 23486244 DOI: 10.2478/v10078-012-0054-0

This study investigated gender, age group and locality differences in adolescent athletes' self-determination motivation and goal orientations in track and field. It also examined the relationship between the self-determination theory and achievement goal theory. A total of 632 (349 boys, 283 girls) adolescent athletes (aged 13-18 years) completed the Sports Motivation Scale and Task and Ego Orientation in Sport Questionnaire. Results indicated significant differences between gender on intrinsic motivation, extrinsic motivation, amotivation (t(630) = 4.10, p < 0.05) and ego orientation (t(630) = 2.48, p < 0.05). Male students reported higher intrinsic motivation, extrinsic motivation, amotivation and ego orientation. A significant difference was found between age groups on task orientation (t(630) = 1.94, p < 0.05) and locality on ego orientation (t(630) = 1.94, p < 0.05). Older athletes showed significantly higher task orientation. Rural athletes had higher ego orientation whereas urban athletes have higher intrinsic motivation. Task orientation was related to intrinsic motivation (r = 0.55, p < 0.01), extrinsic motivation (r = 0.55, p < 0.01), but weakly related to amotivation (r = 0.10, p < 0.01). Ego orientation was related to intrinsic motivation (r = 0.30, p < 0.01), extrinsic motivation (r = 0.36, p < 0.01) and amotivaion (r = 0.36, p < 0.01). Task orientation was related to ego orientation (r = 0.29, p < 0.01). Multiple regression analysis showed intrinsic motivation, extrinsic motivation and amotivation accounted for 30.5% of the variances in task orientation.
Sexual Fluidity in a Malaysian Sample: A Case for the Presence of Facilitative Environments within a Restrictive Sociocultural and Political Landscape

Pinto J, Lai SY, Low WY

J Homosex, 2023 Dec 06;70(14):3399-3420.
PMID: 35771718 DOI: 10.1080/00918369.2022.2094745

This study investigated sexual fluidity in attractions and subsequent fluidity in sexual identities, its associations with sexual orientation identity labels, and self-reported likelihood of future change in sexual identity labels in a sample of same-sex attracted Malaysian women and men. Participants completed an online questionnaire measuring sexual fluidity in attractions and sexual identity, sexual orientation identity labels and likelihood of future change in identity labels. Sexual fluidity in attractions was reported by 72% of women and 64% of men, with 44% of women and 38% of men reporting subsequent fluidity in sexual orientation identities. There were no significant gender differences observed in the frequency of sexual fluidity in attractions and change in sexual identity labels. There were also no significant gender differences in the self-reported likelihood of future change in sexual identity labels. Sexual fluidity was found to be associated with sexual identity labels representing non-exclusive sexual attractions for both men and women. Findings provide preliminary support for the presence of facilitative environments within a largely conservative and restrictive sociocultural and political landscape.
Addressing unmet needs of patients with chronic diseases: Impact of the VISIT website during consultations

Lee YK, Ng CJ, Low WY

J Eval Clin Pract, 2017 Dec;23(6):1281-1288.
PMID: 28585242 DOI: 10.1111/jep.12777

RATIONALE, AIMS, AND OBJECTIVES: Patient concerns are often neglected in consultations, especially for chronic diseases where patients and providers fall into the routine of chronic disease management in consultations. One strategy to elicit patient concerns has been to ask patients to complete agenda lists before the consultation. This study aimed to explore the impact of a preconsultation agenda website in addressing patients' unmet needs during chronic disease consultations.
METHODS: Patients entered their concerns into a website (Values In Shared Interactions Tool (VISIT)). Doctors accessed this information via the electronic medical records before consultations. Individual in-depth interviews were then conducted with patients and doctors on the website's impact on consultations. Interviews were transcribed verbatim and analysed thematically.
RESULTS: The average age (years) was 65.7 for patients (n = 8) and 35.7 for doctors (n = 7). Patients in the study entered between 1 to 6 items in the website. From postconsultation interviews, we found that the website impacted the consultation in 5 ways: (1) It facilitated patients to communicate their full agenda to doctors; (2) it helped address unmet patient needs as it gave them opportunity to raise other issues besides their chronic condition; (3) it facilitated rapport between doctor and patient; (4) it facilitated doctors to organize their consultation around the concerns the patient had listed; and (5) it disrupted the doctor's usual consultation style if the list of concerns was lengthy.
CONCLUSIONS: Integrating patient concerns into electronic health records helped to facilitate patient-centred consultations. Doctors found this information useful but felt uneasy if the agenda list was too long or too complex. Areas for future studies include training doctors to manage complex agendas and formal evaluation of the VISIT tool.
Study site: Primary care clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Challenges in the Ethical Review of Clinical and Biomedical Research in Malaysia: A Mixed Methods Study

See HY, Mohamed MS, Nor SNM, Low WY

J Empir Res Hum Res Ethics, 2021 12;16(5):487-500.
PMID: 34292842 DOI: 10.1177/15562646211033191

Empirical evidence of the ethical review of clinical and biomedical research in Malaysia is limited. We have conducted a convergent mixed methods research, which comprises an online survey and semistructured interviews to examine the challenges in the ethical review of clinical and biomedical research. Data collected reveal that the ethics review process is inconsistent, duplicate, and inadequate. The results indicate a strong need for a centralized ethical review mechanism and a national system for mutual recognition of ethics reviews to improve the effectiveness and efficiency of the ethics review system in Malaysia. A joint research ethics committee review between Malaysia and sponsoring countries for multinational research should also be encouraged as it could address the concerns of the lack of expertise and training.
Psychometric properties of the self-report Malay version of the Pediatric Quality of Life (PedsQLTM) 4.0 Generic Core Scales among multiethnic Malaysian adolescents

Ainuddin HA, Loh SY, Chinna K, Low WY, Roslani AC

J Child Health Care, 2015 Jun;19(2):229-38.
PMID: 24154841 DOI: 10.1177/1367493513504834

Adolescence is the potential period for growth and optimal functioning, but developmental issues like time of transition from childhood to adulthood will create stress and affect the adolescent's quality of life (QOL). However, there is a lack of research tool for measuring adolescent's QOL in Malaysia. The aim of the study was to determine the validity and reliability of the self-report Malay version of the pediatric QOL (PedsQL™) 4.0 Generic Core Scales in assessing the QOL of Malaysian adolescents. A cross-sectional study design using the 23-item self-report Malay version of the PedsQL 4.0 Generic Core Scales was administered on a convenient cluster sampling (n = 297 adolescent) from a secondary school. The internal consistency reliability had Cronbach's α values ranging from .70 to .89. Factor analysis reported a six-factor structure via principal axis factor analysis. In conclusion, the self-report Malay version of the pediatric QOL 4.0 Generic Core Scales is a reliable and valid tool to measure the QOL of multiethnic Malaysian adolescents.
Cross-cultural adaptation and validation of the Malay language version of the TZO-AZL Preschool Children Quality of Life questionnaire: A health-related quality of life instrument for preschool children

Tay CG, Jalaludin MY, Low WY, Lim CT

J Child Health Care, 2015 Jun;19(2):167-81.
PMID: 24154842 DOI: 10.1177/1367493513503583

The aim of this study is to evaluate the psychometric properties of the translated Malay language version of TZO-AZL Preschool Children Quality of Life (TAPQOL) questionnaire in preschool children. Preterm children and term children aged between two and five years were enrolled into the study. The Malay language version of TAPQOL and a set of questions regarding the child's health status were answered by the caregivers. The internal consistency, Spearman's correlation coefficients and principal component analysis (PCA) with Varimax rotation and Mann-Whitney U test for group comparison were employed to evaluate the psychometric properties of this instrument. A total of 258 children (120 preterm children and 138 term children) were recruited to this study with a response rate of 94%. All (sub)domains except one had Cronbach's α coefficients of more than .7. The Spearman's correlation coefficients between 12 subdomains were generally low. PCA supported the structural unidimensionality of the items in the instrument. Preterm children had lower quality of life scores than that of term children. Malay version of TAPQOL has multidimensional construct. It is a reliable and valid instrument for preschool children, with almost similar psychometric properties to the original version.
Lactobacillus fermentum FTDC 8312 combats hypercholesterolemia via alteration of gut microbiota

Lye HS, Kato T, Low WY, Taylor TD, Prakash T, Lew LC, et al.

J Biotechnol, 2017 Sep 19.
PMID: 28935567 DOI: 10.1016/j.jbiotec.2017.09.007

In this study, hypercholesterolemic mice fed with Lactobacillus fermentum FTDC 8312 after a seven-week feeding trial showed a reduction in serum total cholesterol (TC) levels, accompanied by a decrease in serum low-density lipoprotein cholesterol (LDL-C) levels, an increase in serum high-density lipoprotein cholesterol (HDL-C) levels, and a decreased ratio of apoB100:apoA1 when compared to those fed with control or a type strain, L. fermentum JCM 1173. These have contributed to a decrease in atherogenic indices (TC/HDL-C) of mice on the FTDC 8312 diet. Serum triglyceride (TG) levels of mice fed with FTDC 8312 and JCM 1173 were comparable to those of the controls. A decreased ratio of cholesterol and phospholipids (C/P) was also observed for mice fed with FTDC 8312, leading to a decreased number of spur red blood cells (RBC) formation in mice. Additionally, there was an increase in fecal TC, TG, and total bile acid levels in mice on FTDC 8312 diet compared to those with JCM 1173 and controls. The administration of FTDC 8312 also altered the gut microbiota population such as an increase in the members of genera Akkermansia and Oscillospira, affecting lipid metabolism and fecal bile excretion in the mice. Overall, we demonstrated that FTDC 8312 exerted a cholesterol lowering effect that may be attributed to gut microbiota modulation.
DIFFERENTIALS IN SEXUAL AND REPRODUCTIVE HEALTH KNOWLEDGE AMONG EAST MALAYSIAN ADOLESCENTS

Awang H, Low WY, Tong WT, Tan LY, Cheah WL, Benedict Lasimbang H, et al.

J Biosoc Sci, 2019 03;51(2):282-291.
PMID: 29978769 DOI: 10.1017/S0021932018000214

The aim of this study was to assess the knowledge of East Malaysian adolescents on sexual and reproductive health issues. Data were collected in March-July 2015 from 2858 adolescents aged 13-18 years from selected East Malaysian secondary schools using a self-administered questionnaire. Twelve items relating to sexual and reproductive health were used to measure respondents' knowledge based on their responses 'True', 'False' or 'Don't know', with the proportion of correct answers being the variable of interest. Cronbach's alpha for the twelve items was 0.761 and the mean knowledge score was 6.8. While the majority of the respondents knew that a woman can get pregnant if she has sex with a man and that HIV and AIDS can be transmitted through sexual intercourse, knowledge about Malaysia's abortion laws, that a woman can get pregnant if she has sex only once and that people with sexually transmitted infections may look healthy was poor. Older respondents and those from urban schools reported significantly higher knowledge than younger respondents and those from rural schools, respectively. More emphasis should be given in schools to the specific topics for which low levels of sexual and reproductive health knowledge were found, with greater attention being given to younger adolescents and those in rural areas.
Fulltext Knowledge of sexually transmitted diseases and sexual behaviours among Malaysian male youths

Awang H, Wong LP, Jani R, Low WY

J Biosoc Sci, 2014 Mar;46(2):214-24.
PMID: 23480474 DOI: 10.1017/S0021932013000114

This study examines the knowledge of sexually transmitted diseases (STDs) among male youths in Malaysia. A self-administered survey was carried out on a sample of 952 never-married males aged 15-24 years. The respondents were asked about their knowledge of STDs, how these diseases get transmitted and their sexual behaviours. The data showed that 92% of the respondents knew of at least one STD (syphilis, gonorrhoea, chlamydia, herpes, genital warts, yeast infection, trichomoniasis or HIV/AIDS). About 95% of them knew of at least one method of STD transmission. Urban and tertiary-educated male youths showed a substantially higher proportion of awareness of STDs and transmission methods compared with their rural and less-educated counterparts. The data also indicated that 10% of the study sample admitted to having had sexual experiences. There were still a large proportion of the respondents who were not aware of STDs other than syphilis and HIV/AIDS and the means of transmission, such as multiple sex partners, including those who claimed to be sexually active. Thus there is a need for more concerted efforts to disseminate information on STDs and transmission methods to a wider audience in Malaysia, especially youths in rural areas.
Effect of treating lower urinary tract symptoms on anxiety, depression and psychiatric morbidity: a one-year study

Quek KF, Razack AH, Chua CB, Low WY, Loh CS

Int J Urol, 2004 Oct;11(10):848-55.
PMID: 15479289

The present study aimed to evaluate the effects of treating lower urinary tract symptoms (LUTS) on anxiety, depression and psychiatric morbidity following one year of follow-up.
Construction of the Mandarin version of the International Prostate Symptom Score inventory in assessing lower urinary tract symptoms in a Malaysian population

Quek KF, Chua CB, Razack AH, Low WY, Loh CS

Int J Urol, 2005 Jan;12(1):39-45.
PMID: 15661053 DOI: 10.1111/j.1442-2042.2004.00988.x

The purpose of the present study was to validate the Mandarin version of the International Prostate Symptom Score (Mand-IPSS) in a Malaysian population.
Fulltext Non-communicable diseases in the Asia-Pacific region: Prevalence, risk factors and community-based prevention

Low WY, Lee YK, Samy AL

Int J Occup Med Environ Health, 2015;28(1):20-6.
PMID: 26159943 DOI: 10.2478/s13382-014-0326-0

Non-communicable diseases (NCDs) lead to substantial mortality and morbidity worldwide. The most common NCDs are cardiovascular diseases (CVD), diabetes, cancer and chronic respiratory diseases. With the rapid increase in NCD-related deaths in Asia Pacific countries, NCDs are now the major cause of deaths and disease burden in the region. NCDs hamper achievement of the Millennium Development Goals (MDG). People in the low socio-economic group are most affected by NCDs as they have poor access to policies, legislations, regulations and healthcare services meant to combat NCDs. This results in loss of productivity by a decreasing labor force with implications at the macroeconomic level. The 3 major NCDs in the Asia Pacific region are CVDs, cancer and diabetes due to the increasing loss of disability adjusted life years (DALYs). The 4 major behavioral risk factors for NCDs are: tobacco use, alcohol consumption, inadequate physical activity and unhealthy diet. The underlying risk factors are urbanization, globalization, sedentary lifestyle, obesity and hypertension. Strategies to combat NCDs in the Asia Pacific region are as follows: population-based dietary salt reduction, health education, psychological interventions, i.e., cognitive behavioral therapy and motivational-interviewing, taxation and bans on tobacco-related advertisements, implementing smoke-free zones and surveillance by the World Health Organization. Control measures must focus on prevention and strengthening inter-sectorial collaboration.
Factors influencing decision-making role preferences: A qualitative study of Malaysian patients with type 2 diabetes during insulin initiation

Lee YK, Low WY, Lee PY, Ng CJ

Int J Nurs Pract, 2015 May;21 Suppl 2:125-31.
PMID: 24804909 DOI: 10.1111/ijn.12355

Patient decision-making role preference (DMRP) is a patient's preferred degree of control when making medical decisions. This descriptive qualitative study aimed to explore Malaysian patients' views on their DMRP. Between January 2011 and March 2012, 22 individual face-to-face in-depth interviews were conducted with patients with type 2 diabetes who were deciding about insulin initiation. The interviews were audio-recorded and analysed using a thematic approach. The age range of participants was 28-67 years old with 11 men. Ten patients preferred to make the decision themselves, six patients indicated that the clinician should make the decision and only one patient expressed a preference for a collaborative role. The following factors influenced DMRP: trust in clinicians, responsibility for diabetes care, level of knowledge and awareness, involvement of family and personal characteristics. In conclusion, the concept of shared decision-making is still alien, and a more participative communication style might help to facilitate patients' expression of DMRP.
Study site: Public university hospital-based primary care clinic, Public health-care clinics (Klinik Kesihatan), Private specialist clinic, Malaysia
Fulltext Malaysian cultural differences in knowledge, attitudes and practices related to erectile dysfunction: focus group discussions

Low WY, Wong YL, Zulkifli SN, Tan HM

Int J Impot Res, 2002 Dec;14(6):440-5.
PMID: 12494275

This qualitative study aimed to examine cultural differences in knowledge, attitudes and practices related to erectile dysfunction (ED) utilizing focus group discussion. Six focus groups consisting of 66 men, 45-70-y-old were conducted-two Malay groups (n=18), two Chinese groups (n=25) and two Indian groups (n=23). Participants were purposely recruited from the general public on a voluntary basis with informed consent. Transcripts were analyzed using qualitative data analysis software ATLASti. The Malay and Chinese traditional remedies for preventing or treating ED are commonly recognized among all races. Many have a negative perception of someone with ED. Malay and Chinese men tended to blame their wife for their problem and thought that the problem might lead to extra-marital affairs, unlike the Indian men who attributed their condition to fate. Malays would prefer traditional medicine for the problem. The Chinese felt they would be more comfortable with a male doctor whilst this is not so with the Malays or Indians. Almost all prefer the doctor to initiate discussion on sexual issues related to their medical condition. There is a need for doctors to consider cultural perspectives in a multicultural society as a lack of understanding of this often contributes to an inadequate consultation.
Fulltext Reliability and validity of the Malay version of the International Index of Erectile Function (IIEF-15) in the Malaysian population

Quek KF, Low WY, Razack AH, Chua CB, Loh CS

Int J Impot Res, 2002 Aug;14(4):310-5.
PMID: 12152122

The objective of this study was to validate the Malay version of the International Index of Erectile Function (IIEF-15) in patients with lower urinary tract symptoms. Reliability and validity was assessed by using the test-retest while Cronbach's alpha was used to assess internal consistency. Effect size 5was evaluated to assess the sensitivity to change in the pre-transurethral resection of the prostate (TURP) vs post-TURP. Internal consistency was excellent. A high degree of internal consistency was observed for each of the 15 items and five domains (Cronbach's alpha value=0.56 and higher and 0.74 and higher, respectively). Test-retest correlation coefficient for the 15 items and domains scores showed no significant changes. Intraclass correlation coefficient for 15 items and domains were high (ICC=0.59 and above). It can be concluded that the Mal-IIEF-15 is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.
Fulltext The role of general practitioners in the management of erectile dysfunction-a qualitative study

Ng CJ, Low WY, Tan NC, Choo WY

Int J Impot Res, 2004 Feb;16(1):60-3.
PMID: 14963472 DOI: 10.1038/sj.ijir.3901141

The objective of this study was to explore the roles and perceptions of general practitioners (GPs) in the management of erectile dysfunction (ED). This qualitative study used focus group discussions and in-depth interviews. This study was conducted based on 28 GPs from an urban area in Malaysia who had managed patients with ED and prescribed anti-ED drugs. Main outcome measures included the roles of GPs in managing patients with ED (active or passive), perceptions regarding ED and the treatment, and factors influencing their decision to prescribe. Majority of the GPs assumed a passive role when managing patients with ED. This was partly due to their perception of the disease being nonserious. Some also perceived ED as mainly psychological in nature. The anti-ED drugs were often viewed as a lifestyle drug with potentially serious side effects. The fear of being perceived by patients as 'pushing' for the drug and being blamed if the patients were to develop serious side effects also hampered the management of this disease. GPs who participated in this study remained passive in identifying and treating patients with ED and this was attributed to their perception of the disease, drug treatment and patient's background.

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