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Psychometric Properties of the Iowa Infant Feeding Attitude Scale among a Multiethnic Population during Pregnancy

Lau Y, Htun TP, Lim PI, Ho-Lim SS, Klainin-Yobas P

J Hum Lact, 2016 May;32(2):315-23.
PMID: 26151966 DOI: 10.1177/0890334415591813

BACKGROUND: The Iowa Infant Feeding Attitude Scale (IIFAS) was developed to measure maternal attitudes toward infant feeding, but a number of validated studies on the IIFAS found that it was subject to methodological limitations.
OBJECTIVE: The purpose of this study was to evaluate the psychometric properties of the IIFAS among a multiethnic population in Singapore.
METHODS: A cross-sectional research design was used on a sample of 417 antenatal women. The internal consistency and stability of the IIFAS were evaluated using Cronbach's α and test-retest reliability. Known-group comparisons discriminated certain group differences in a predictable way. A series of exploratory factor analyses (EFAs) was conducted to test the factor structure of the IIFAS using the maximum likelihood and principal axis factoring. The number of factors was selected according to theoretical and statistical considerations. A confirmatory factor analysis (CFA) was further performed to validate the factor structure constructed in the prior EFA.
RESULTS: The IIFAS had a Cronbach's α and Pearson correlation of 0.79 and 0.85, respectively. The known-group comparisons among certain groups were supported. The EFA results showed that the 3-factor structure produced the most interpretable and theoretical sense. A second-order CFA was conducted to confirm the construct dimensionality of the 15-item IIFAS, with satisfactory fit indices found.
CONCLUSION: The 15-item IIFAS is a psychometrically sound measurement tool that health care professionals can use to understand the diverse infant feeding attitudes and knowledge among different ethnic groups in order to provide breastfeeding interventions that are culturally sensitive.

Matched MeSH terms: India/ethnology
Determinants of Breastfeeding Practices and Success in a Multi-Ethnic Asian Population

Pang WW, Aris IM, Fok D, Soh SE, Chua MC, Lim SB, et al.

Birth, 2016 Mar;43(1):68-77.
PMID: 26643773 DOI: 10.1111/birt.12206

BACKGROUND: Many countries in Asia report low breastfeeding rates and the risk factors for early weaning are not well studied. We assessed the prevalence, duration, and mode of breastfeeding (direct or expressed) among mothers of three Asian ethnic groups.
METHODS: Participants were 1,030 Singaporean women recruited during early pregnancy. Data collected included early breastfeeding experiences, breastfeeding duration, and mode of breastfeeding. Full breastfeeding was defined as the intake of breast milk, with or without water. Cox regression models were used to identify factors associated with discontinuation of any and full breastfeeding. Logistic regression analyses assessed the association of ethnicity with mode of breastfeeding.
RESULTS: At 6 months postpartum, the prevalence of any breastfeeding was 46 percent for Chinese mothers, 22 percent for Malay mothers, and 41 percent for Indian mothers; prevalence of full breastfeeding was 11, 2, and 5 percent, respectively. More Chinese mothers fed their infants expressed breast milk, instead of directly breastfeeding them, compared with the other two ethnic groups. Duration of any and full breastfeeding were positively associated with breastfeeding a few hours after birth, higher maternal age and education, and negatively associated with irregular breastfeeding frequency and being shown how to breastfeed. Adjusting for maternal education, breastfeeding duration was similar in the three ethnic groups, but ethnicity remained a significant predictor of mode of breastfeeding.
CONCLUSIONS: The low rates and duration of breastfeeding in this population may be improved with breastfeeding education and support, especially in mothers with lower education. Further work is needed to understand the cultural differences in mode of feeding and its implications for maternal and infant health.

Matched MeSH terms: India/ethnology
Fulltext Views and experiences of Malaysian older persons about falls and their prevention-A qualitative study

Loganathan A, Ng CJ, Low WY

BMC Geriatr, 2016;16:97.
PMID: 27153989 DOI: 10.1186/s12877-016-0274-6

BACKGROUND: Few studies on falls interventions have been conducted in South East Asia. Despite its population ageing rapidly, the acceptability of interventions among the older population in this region remains variable. This study aims to explore views and experiences regarding falls and their prevention among older persons at high risk of falls.
METHOD: Sixteen individuals aged 60 years and over with at least one fall in the preceding 12 months were recruited from our Primary Care clinics. A qualitative study using semi-structured interviews among individuals and focus-groups was conducted. Thematic analyses were conducted on transcriptions of audio-taped interviews using the WeftQDA software. The interviews ceased when data saturation was achieved.
RESULTS: The three themes included older persons' views on falls, help-seeking behaviour and views on falls interventions. Many older persons interviewed did not perceive falls as a serious problem, some reported a stigma surrounding falls, while others felt they had not sustained more serious injuries due to God's grace. Older persons sought traditional medicine and other alternative treatments for pain relief and other fall-related symptoms. Accessibility of healthcare facilities often prevented older persons from receiving physiotherapy or eye tests.
CONCLUSION: The delivery of complex interventions for a multifactorial condition such as falls in the older persons in our setting is inhibited by various cultural barriers, falls perceptions as well as logistic difficulties. Efforts to establish a multi-disciplinary intervention among our older population will need to include strategies to overcome these issues.
KEYWORDS: Accidental falls; Aged; Falls interventions; Falls preventions; Older adults; Qualitative study

Study site: Primary Care Clinics at University of Malaya Medical Centre (UMMC)

Matched MeSH terms: India/ethnology
Fulltext Relationship between demographic and clinical factors with physical functioning of stroke patients. [Hubungan antara faktor demografik dan klinikal dengan kefungsian fizikal pesakit strok]

Ghazali SE, Mohd Zulkifly MF, Che Din N, Desa A, Ali RA

Jurnal Sains Kesihatan Malaysia, 2016;14(2):23-30.
MyJurnal

Stroke is a causal factor that commonly caused physical impairments and activity limitations among patients to perform daily activities until at certain level stroke patients will experience disability. The aim of this study is to examine the relationship of each demographic and clinical factors that is believed to associate with physical functioning of patients
those who experienced stroke. This present study also try to compare physical functioning of patients with associated factors and then examine the correlation between those factors with physical functioning. A total of 147 respondents that pass for cognitive screening test involved in this study. Barthel Index (ADL) was administered to the respondents after 6 weeks of stroke attack in order to measure their physical functioning status. Results found that there was a significant difference [F(3, 143) = 4.06; p < 0.01] between level of educations with physical functioning of patients. With respect to clinical factors also showed a significant difference (p < 0.01) was higher in physical functioning when stroke attack
occurred at right hemisphere of brain. There was a significant difference (p < 0.01) in physical functioning with respect to belief of recovery. Furthermore, number of stroke attack also showed a significant difference [F(1, 145) = 11.19; [p < 0.01] in physical functioning of patients. Correlation test that was carried out found a positive significant correlation
(r = 0.24; p < 0.01) between physical functioning with respect to the affected lesion side. In conclusion, demographic and clinical factors also played the roles to determine level of physical functioning among stroke patients and thus these factors should be considered in any studies that intended to enhance physical functioning of patients in future.
Keywords: stroke; physical functioning; disability; physical impairment

Matched MeSH terms: India/ethnology
Experience of menopause in aboriginal women: a systematic review

Chadha N, Chadha V, Ross S, Sydora BC

Climacteric, 2016;19(1):17-26.
PMID: 26653073 DOI: 10.3109/13697137.2015.1119112

Every woman experiences the menopause transition period in a very individual way. Menopause symptoms and management are greatly influenced by socioeconomic status in addition to genetic background and medical history. Because of their very unique cultural heritage and often holistic view of health and well-being, menopause symptoms and management might differ greatly in aboriginals compared to non-aboriginals. Our aim was to investigate the extent and scope of the current literature in describing the menopause experience of aboriginal women. Our systematic literature review included nine health-related databases using the keywords 'menopause' and 'climacteric symptoms' in combination with various keywords describing aboriginal populations. Data were collected from selected articles and descriptive analysis was applied. Twenty-eight relevant articles were included in our analysis. These articles represent data from 12 countries and aboriginal groups from at least eight distinctive geographical regions. Knowledge of menopause and symptom experience vary greatly among study groups. The average age of menopause onset appears earlier in most aboriginal groups, often attributed to malnutrition and a harsher lifestyle. This literature review highlights a need for further research of the menopause transition period among aboriginal women to fully explore understanding and treatment of menopause symptoms and ultimately advance an important dialogue about women's health care.

Matched MeSH terms: India/ethnology
Factors associated with health literacy among type 2 diabetes mellitus patients attending a government health clinic, 2016

Azreena E, Suriani I, Juni MH, Fuziah P

International Journal of Public Health and Clinical Sciences, 2016;3(6):50-64.

Background: Despite the numerous health education programmes provided to the type 2 diabetes patients worldwide, the outcome of the diabetic management remains a challenge globally. Health literacy plays an important role in determining the outcomes from the diabetes management.
Materials and Methods: This study was aimed to determine the level of health literacy and its associated factors among type 2 diabetes mellitus patients attending a government health clinic. This study also aimed to determine the association between the associated factors, such as sociodemographic, socioeconomic characteristics, type of treatment, diabetes duration, and knowledge on diabetes and the level of health literacy as well as the predictors of the level of health literacy. This was a cross-sectional study that was conducted from 1st February 2016 to 30th July 2016. A total of 360 participants were randomly selected from a government health clinic through a systematic random sampling method. A validated, self-administered questionnaire incorporating sociodemographic characteristics, socioeconomic characteristics, history of type 2 diabetes, diabetes knowledge and health literacy level was used in this study. Data was analysed using IBM Statistical Package for Social Science Version 22.0. Chi square test, Fisher’s Exact test and simple logistic regression were used to measure the association between the associated factors and health literacy level. Multiple logistic regression analysis was used to analyse the predictors influencing health literacy level among type 2 diabetes mellitus patients.
Result: The response rate was 80%. Majority of the respondents have limited health literacy level (85.8%). There were significant association between ethnic group and health literacy level (χ2=6.317, P=0.042), level of education and health literacy level (χ2=6.304, P=0.043) and diabetes knowledge score and health literacy level [Odds Ratio (OR)=1.254, 95% Confidence Interval (CI) (1.063,1.479)]. Finally, the significant predictors for adequate health literacy level were the Chinese ethnic group [Adjusted OR (AOR)=4.441, 95% CI (1.472,13.392)] and diabetes knowledge score [AOR=1.238, 95% CI (1.031,1.488)].
Conclusion: In conclusion, level of health literacy among type 2 diabetes mellitus patients was significantly associated with the ethnic group, level of education and diabetes knowledge score. It can also be concluded that Chinese ethnic group and diabetes knowledge score were the significant predictors for adequate health literacy level among type 2 diabetes mellitus patients.

Matched MeSH terms: India/ethnology
Fulltext Natural history of asymptomatic gallstones: differential behaviour in male and female subjects

Sood S, Winn T, Ibrahim S, Gobindram A, Arumugam AA, Razali NC, et al.

Med J Malaysia, 2015 Dec;70(6):341-5.
PMID: 26988206 MyJurnal

OBJECTIVE: The natural history of asymptomatic (silent) gallstones has been inadequately studied. Existing information derives from studies based on oral cholecystography or relatively small sample sizes. We planned a retrospective cohort study in subjects with gallstones to determine conversion rates from asymptomatic to symptomatic.
METHODS: We extracted data from computerised databases of one government hospital and two private clinics in Malaysia. Files were scrutinised to ensure that criteria for asymptomatic gallstones were fulfilled. Patients were called on telephone, further questioned to confirm that the gallstones at detection were truly asymptomatic, and asked about symptoms that were consistent with previously defined criteria for biliary colic. Appropriate ethical clearances were taken.
RESULTS: 213 (112 males) patients fulfilled the criteria for asymptomatic gallstones and could be contacted. 23 (10.8%) developed pain after an average follow up interval of 4.02 years (range 0.1-11 years). Conversion rates from asymptomatic to symptomatic gallstones were high in the first two years of follow up, averaging 4.03±0.965 per year. Over time the conversion rates slowed, and by year 10 the annual conversion rate averaged only 1.38±0.29. Conversion rates were much higher for females compared to males (F:M hazard ratio 3.23, SE 1.54, p>z 0.014). The lifetime risks for conversion approached 6.15% for males, and 22.1% for females.
CONCLUSION: In conclusion, asymptomatic gallstones are much more likely to convert to symptomatic in females than in males. Males in whom asymptomatic stones are discovered should be advised conservative treatment. Surgery may be preferable to conservative management if the subject is a young female.
m radiology records of Hospital
Study site: Computerised database, Hospital Selayang, Selangor; private clinics, Kuala Lumpur, Malaysia

Matched MeSH terms: India/ethnology
Use of Alternative Medications for Menopause-Related Symptoms in Three Major Ethnic Groups of Ipoh, Perak, Malaysia

Ohn Mar S, Malhi F, Syed Rahim SH, Chua CT, Sidhu SS, Sandheep S

Asia Pac J Public Health, 2015 Nov;27(8 Suppl):19S-25S.
PMID: 25972428 DOI: 10.1177/1010539515586457

This cross-sectional study investigated the use of alternative medications to alleviate menopause-related symptoms among Malay, Chinese, and Indian women of Ipoh city. The prevalence, types, effectiveness, and associated factors were determined. The prevalence of alternative medication use was 41.4%. Evening primrose oil (EPO) was the most popular medication used (18.1%), followed by soy-based products (12.3%), green tea (6.8%), and gingko (5.8%). The medication was reported to be highly effective by 58.3% of soya bean diet users and 41.1% of EPO users. Significant variables associated with the use were Chinese or Indian ethnicity (P < .001), age between 50 and 54 years (P < .01), lower self-health rating (P < .05), education level of diploma or professional degree (P < .05), employment as professionals or entrepreneurs (P < .05), and the use of hormone replacement therapy (P < .05). Regression analysis showed that Chinese and Indians had significantly higher odds for the use than Malays (Chinese: odds ratio [OR] = 4.33, 95% confidence interval [CI] = 2.392-7.837; Indians: OR = 3.248, 95% CI = 1.586-6.654).

Matched MeSH terms: India/ethnology
Ethnic disparity in central arterial stiffness and its determinants among Asians with type 2 diabetes

Zhang X, Liu JJ, Sum CF, Ying YL, Tavintharan S, Ng XW, et al.

Atherosclerosis, 2015 Sep;242(1):22-8.
PMID: 26162317 DOI: 10.1016/j.atherosclerosis.2015.06.019

OBJECTIVE: We previously reported ethnic disparity in adverse outcomes among Asians with type 2 diabetes (T2DM) in Singapore. Central arterial stiffness can aggravate systemic vasculopathy by propagating elevated systolic and pulse pressures forward, thereby accentuating global vascular injury. We aim to study ethnic disparity in central arterial stiffness and its determinants in a multi-ethnic T2DM Asian cohort.
METHODS: Arterial stiffness was estimated by carotid-femoral pulse wave velocity (PWV) and augmentation index (AI) using applanation tonometry method in Chinese (N = 1045), Malays (N = 458) and Indians (N = 468). Linear regression model was used to evaluate predictors of PWV and AI.
RESULTS: PWV was higher in Malays (10.1 ± 3.0 m/s) than Chinese (9.7 ± 2.8 m/s) and Indians (9.6 ± 3.1 m/s) (P = 0.018). AI was higher in Indians (28.1 ± 10.8%) than Malays (25.9 ± 10.1%) and Chinese (26.1 ± 10.7%) (P < 0.001). Malays remain associated with higher PWV (β = 0.299, P = 0.048) post-adjustment for age, gender, duration of diabetes, hemoglobin A1c, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), soluble receptor for advanced glycation end-products, urinary albumin-to-creatinine ratio, and insulin usage, which were all independent predictors of PWV. Indians remain associated with higher AI (β = 2.776, P < 0.001) post-adjustment for age, gender, BMI, SBP, DBP, and height, which were independent predictors of AI. These variables explained 27.7% and 33.4% of the variance in PWV and AI respectively.
CONCLUSIONS: Malays and Indians with T2DM have higher central arterial stiffness, which may explain their higher risk for adverse outcomes. Modifying traditional major vascular risk factors may partially alleviate their excess cardiovascular risk through modulating arterial stiffness.
KEYWORDS: Arterial stiffness; Augmentation index; Pulse wave velocity; Type 2 diabetes

Matched MeSH terms: India/ethnology
Chronic kidney disease, cardiovascular disease and mortality: A prospective cohort study in a multi-ethnic Asian population

Lim CC, Teo BW, Ong PG, Cheung CY, Lim SC, Chow KY, et al.

Eur J Prev Cardiol, 2015 Aug;22(8):1018-26.
PMID: 24857889 DOI: 10.1177/2047487314536873

BACKGROUND: Few studies have examined the impact of chronic kidney disease (CKD) on adverse cardiovascular outcomes and deaths in Asian populations. We evaluated the associations of CKD with cardiovascular disease (CVD) and all-cause mortality in a multi-ethnic Asian population.
DESIGN: Prospective cohort study of 7098 individuals who participated in two independent population-based studies involving Malay adults (n = 3148) and a multi-ethnic cohort of Chinese, Malay and Indian adults (n = 3950).
METHODS: CKD was assessed from CKD-EPI estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR). Incident CVD (myocardial infarction, stroke and CVD mortality) and all-cause mortality were identified by linkage with national disease/death registries.
RESULTS: Over a median follow-up of 4.3 years, 4.6% developed CVD and 6.1% died. Risks of both CVD and all-cause mortality increased with decreasing eGFR and increasing albuminuria (all p-trend <0.05). Adjusted hazard ratios (HR (95% confidence interval)) of CVD and all-cause mortality were: 1.54 (1.05-2.27) and 2.21 (1.67-2.92) comparing eGFR <45 vs ≥60; 2.81 (1.49-5.29) and 2.34 (1.28-4.28) comparing UACR ≥300 vs <30. The association between eGFR <60 and all-cause mortality was stronger among those with diabetes (p-interaction = 0.02). PAR of incident CVD was greater among those with UACR ≥300 (12.9%) and that of all-cause mortality greater among those with eGFR <45 (16.5%).
CONCLUSIONS: In multi-ethnic Asian adults, lower eGFR and higher albuminuria were independently associated with incident CVD and all-cause mortality. These findings extend previously reported similar associations in Western populations to Asians and emphasize the need for early detection of CKD and intervention to prevent adverse outcomes.

Matched MeSH terms: India/ethnology
Seroepidemiology of dengue virus infection in the adult population in tropical Singapore

Ang LW, Cutter J, James L, Goh KT

Epidemiol Infect, 2015 Jun;143(8):1585-93.
PMID: 25245094 DOI: 10.1017/S0950268814002507

To assess the impact of past dengue epidemics in Singapore, we undertook a national seroepidemiological study to determine the prevalence of past dengue virus (DENV) infection in the adult population in 2010 and make comparisons with the seroprevalence in 2004. The study involved residual sera from 3293 adults aged 18-79 years who participated in a national health survey in 2010. The overall prevalence of anti-DENV IgG antibodies was 56·8% (95% confidence interval 55·1-58·5) in 2010. The seroprevalence increased significantly with age. Males had significantly higher seroprevalence than females (61·5% vs. 53·2%). Among the three major ethnic groups, Malays had the lowest seroprevalence (50·2%) compared to Chinese (57·0%) and Indians (62·0%). The age-standardized seroprevalence in adults was significantly lower in 2010 (54·4%) compared to 2004 (63·1%). Older age, male gender, Indian ethnicity, permanent residency and being home-bound were independent risk factors significantly associated with seropositivity. About 43% of the Singapore adult resident population remain susceptible to DENV infection as a result of the successful implementation of a comprehensive nationwide Aedes surveillance and control programme since the 1970s. Vector suppression and concerted efforts of all stakeholders in the community remain the key strategy in the prevention and control of dengue.

Matched MeSH terms: India/ethnology
Steroid-induced diabetes mellitus in systemic lupus erythematosus patients: analysis from a Malaysian multi-ethnic lupus cohort

Shaharir SS, Gafor AH, Said MS, Kong NC

Int J Rheum Dis, 2015 Jun;18(5):541-7.
PMID: 25294584 DOI: 10.1111/1756-185X.12474

OBJECTIVE:
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease and glucocorticoid is the mainstay of treatment in SLE. The reported incidence of steroid-induced diabetes mellitus (SDM) ranged between 1-53%. We sought to investigate the prevalence and associated factors of SDM in patients with SLE.

METHODOLOGY:
A total of 100 SLE patients attending the Nephrology/SLE and Rheumatology Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC) who received corticosteroid treatment were recruited. The diagnosis of diabetes mellitus was based on the 2010 American Diabetes Association's criteria. Prevalent cases of SDM were also included. Statistical analysis was performed to determine the factors associated with SDM.

RESULTS:
Thirteen of them (13%) developed SDM, with the median onset of diagnosis from commencement of glucocorticoid treatment being 8 years (range 0.5-21 years). Although only seven Indians were recruited into the study, three of them (42.9%) had SDM compared to Malays (9.3%) and Chinese (12.8%) (P ≤ 0.05). Univariate and multivariate analysis showed that higher numbers of system or organ involvement in SLE, abdominal obesity, hypertriglyceridemia and daily prednisolone of ≥ 1 mg/kg/day were the important associated factors of SDM (P ≤ 0.05). Meanwhile, hydroxychloroquine (HCQ) use was associated with reduced SDM prevalence (P < 0.05).

CONCLUSION:
The prevalence of SDM among SLE patients was 13% and Indians were more prone to develop SDM compared to other races. Higher numbers of system involvement, abdominal obesity, hypertriglyceridemia and the use of oral prednisolone of ≥ 1 mg/kg/day were associated with SDM, while HCQ use potentially protects against SDM.

© 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

KEYWORDS:
SLE drug treatment; clinical aspects; systemic lupus erythematous

Matched MeSH terms: India/ethnology
A first study on the incidence and prevalence of IBD in Malaysia--results from the Kinta Valley IBD Epidemiology Study

Hilmi I, Jaya F, Chua A, Heng WC, Singh H, Goh KL

J Crohns Colitis, 2015 May;9(5):404-9.
PMID: 25744112 DOI: 10.1093/ecco-jcc/jjv039

Inflammatory bowel disease [IBD] is known to be rare in the Asia Pacific region but epidemiological studies are scarce.

Matched MeSH terms: India/ethnology
Subthreshold and threshold DSM-IV generalized anxiety disorder in Singapore: Results from a nationally representative sample

Lee SP, Sagayadevan V, Vaingankar JA, Chong SA, Subramaniam M

J Anxiety Disord, 2015 May;32:73-80.
PMID: 25863827 DOI: 10.1016/j.janxdis.2015.03.008

Previous nationally representative studies have reported prevalence of DSM-IV generalized anxiety disorder (GAD). However, subthreshold and threshold GAD expressions remain poorly understood. The current study examined the prevalence, correlates and co-morbidity of a broader diagnosis of GAD in Singapore. The Singapore Mental Health Study (SMHS) was an epidemiological survey conducted in the population (N=6616) aged 18 years and older. The Composite International Diagnostic Interview version 3.0 (CIDI 3.0) was used to establish mental disorder diagnoses. The lifetime prevalence for subthreshold GAD (2.1%) and threshold GAD (1.5%) in the current sample was found to be lower than in Western populations. Younger age group, Indian ethnicity, previously married, chronic physical conditions, and being unemployed were associated with higher odds of having more severe expression of generalized anxiety. The relatively lower prevalence rate of subthreshold GAD expression suggests possible cultural interferences in the reporting and manifestation of anxiety symptomatology. Despite the low prevalence, significant impacts on functioning and comorbidity among subthreshold generalized anxiety cases indicate the importance of early treatment to ensure a better prognosis.

Matched MeSH terms: India/ethnology
Fulltext Antihypertensive drugs for elderly patients: a cross- sectional study

Lim KK, Sivasampu S, Khoo EM

Singapore Med J, 2015 May;56(5):291-7.
PMID: 25597751 DOI: 10.11622/smedj.2015019

As the population ages, the prevalence of hypertension also increases. Although primary care is usually the patient's first point of contact for healthcare, little is known about the management of hypertension among elderly patients at the primary care level. This study aimed to determine the antihypertensive prescription trend for elderly patients, the predictors of antihypertensive use and any inappropriate prescribing practices in both public and private primary care settings.

Matched MeSH terms: India/ethnology
Glycaemic control and quality of life among ethnically diverse Malaysian diabetic patients

Daher AM, AlMashoor SA, Winn T

Qual Life Res, 2015 Apr;24(4):951-8.
PMID: 25352036 DOI: 10.1007/s11136-014-0830-5

PURPOSE: To assess the relationship between glycaemic control and quality of life (QoL) among a sample of Malaysians with type 2 diabetes mellitus.

METHODS: This study is a cross-sectional hospital-based study involving 256 patients from three major ethnic groups in Malaysia. Data about QoL were collected with the 18-item Audit of Diabetes Dependent QoL questionnaire. Other data about putative predictors of QoL including personal characteristics and disease-related factors were also collected. Hierarchical multiple linear regression was used to determine factors associated with QoL and to control for confounding variables.

RESULTS: The mean age of participants was 56.79 years. Participants were mostly women, employed and married and had attained secondary education. More than a third of the patients had a disease duration of more than 10 years, and about two-thirds had HbA1c ≥ 6.5 %. Those with desired glycaemic control had poorer QoL than those with less than desired glycaemic control moderated by the use of insulin. Hierarchical multiple linear regression showed that desired glycaemic control (HbA1c), diabetes worry, use of insulin, more than 10 years' duration of diabetes, neuropathy and retinopathy were associated with poor QoL, whereas being satisfied with waiting time for consultation was associated with better QoL.

CONCLUSIONS: The results of this study show that diabetes was associated with negative impact on quality of life. The use of insulin to achieve desired glycaemic control was particularly associated with negative impact on QoL.

Matched MeSH terms: India/ethnology
Materialism and life satisfaction: the role of religion

Rakrachakarn V, Moschis GP, Ong FS, Shannon R

J Relig Health, 2015 Apr;54(2):413-26.
PMID: 25811060

This study examines the role of religion and religiosity in the relationship between materialism and life satisfaction. The findings suggests that religion may be a key factor in understanding differences in findings of previous studies regarding the inverserelationship found in the vast majority of previous studies. Based on a large-scale study in Malaysia—a country comprised of several religious subcultures (mainly Muslims, Buddhists, and Hindus), the findings suggest that the influence of religiosity on materialism and life satisfaction is stronger among Malays than among Chinese and Indians, and life satisfaction partially mediates the relationship between religiosity and materialism. The paper discusses implications for theory development and further research.

Matched MeSH terms: India/ethnology
Liver cancer in Malaysia: epidemiology and clinical presentation in a multiracial Asian population

Goh KL, Razlan H, Hartono JL, Qua CS, Yoong BK, Koh PS, et al.

J Dig Dis, 2015 Mar;16(3):152-8.
PMID: 25512092 DOI: 10.1111/1751-2980.12223

Hepatocellular carcinoma (HCC) is an important cancer in Malaysia. This study aimed to determine the epidemiological characteristics and clinical presentations of patients in a multiracial population consisting of three major Asian races: Malays, Chinese and Indians.

Matched MeSH terms: India/ethnology
Social support and glycemic control in adult patients with type 2 diabetes mellitus

Chew BH, Khoo EM, Chia YC

Asia Pac J Public Health, 2015 Mar;27(2):NP166-73.
PMID: 22199159 DOI: 10.1177/1010539511431300

INTRODUCTION: The purpose of this study is to examine the prevalence of social support and its association with glycemic control in patients with type 2 diabetes mellitus (T2D) in an urban primary care center within an academic institution. Social support is important in the management of chronic diseases. However, its association with glycemic control has been controversial.
METHODS: This was part of a study examining religiosity in T2D patients. Nonsmoking patients with T2D for at least 3 years and aged 30 years and above were recruited. Social support was measured using The Social Support Survey-Medical Outcomes Study (SS), a self-administered questionnaire; the scores range from 19 to 95, and a high score indicates better social support. Glycemic control was measured using the 3 most recent glycosylated hemoglobin (HbA1c) levels within the past 3 years.
RESULTS: A total of 175 participants completed the SS survey (response rate 79.0%). The mean age was 62.7 (standard deviation [SD] = 10.8) years, and the mean duration of diabetes was 11.74 (SD = 6.7) years. The mean HbA1c level was 8.15 (SD = 1.44). The mean SS score was 68.1. The prevalence of high and low social support were 29.7% and 24.0 %, respectively. A significant correlation was found between SS score and number of social supporters (n = 167). No significant correlation was found between the self-reported number of social supporters or the SS score and the mean HbA1c level.
CONCLUSIONS: Social support was not associated with glycemic control in adult patients with T2D in this primary care setting.

Study site: Primary care clinic, Universiti Malaya Medical Centre (UMMC)

Matched MeSH terms: India/ethnology
Time to achieve first blood pressure control after diagnosis among hypertensive patients at primary health care clinics: a preliminary study

Cheong AT, Mohd Said S, Muksan N

Asia Pac J Public Health, 2015 Mar;27(2):NP485-94.
PMID: 23343640 DOI: 10.1177/1010539512472361

This study aimed to examine the duration to achieve first blood pressure (BP) control after the diagnosis of hypertension. This was a retrospective cohort study on 195 hypertensive patients' (age ≥18 years) records from a primary health care clinic. The median time to achieve first BP control was 7.2 months (95% confidence interval [CI] = 4.99-9.35). Cox proportional hazards regression results showed female patients were 1.5 times more likely to achieve BP control when compared with male patients (hazard ratio [HR] = 1.50, 95% CI 1.09-2.09, P = .013). Those with monotherapy were 2 times more likely (HR = 2.09, 95% CI = 1.39-3.13, P < 0.001) and those on 2 drugs were 3.5 times more likely (HR = 3.49, 95% CI = 1.65-7.40, P = .001) to achieve BP control than those with nonpharmacological treatment. The median time to achieve BP control was longer than the recommended time. Doctors may need to consider starting the pharmacological treatment early and be more aggressive in hypertensive management for male patients.

Matched MeSH terms: India/ethnology

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