For estimating behavioral hearing thresholds, auditory steady state response (ASSR) can be reliably evoked by stimuli at low and high modulation frequencies (MFs). In this regard, little is known regarding ASSR thresholds evoked by stimuli at different MFs in female and male participants. In fact, recent data suggest that 40-Hz ASSR is influenced by estrogen level in females. Hence, the aim of the present study was to determine the effect of gender and MF on ASSR thresholds in young adults. Twenty-eight normally hearing participants (14 males and 14 females) were enrolled in this study. For each subject, ASSR thresholds were recorded with narrow-band chirps at 500, 1,000, 2,000, and 4,000 Hz carrier frequencies (CFs) and at 40 and 90 Hz MFs. Two-way mixed ANOVA (with gender and MF as the factors) revealed no significant interaction effect between factors at all CFs (p > 0.05). The gender effect was only significant at 500 Hz CF (p < 0.05). At 500 and 1,000 Hz CFs, mean ASSR thresholds were significantly lower at 40 Hz MF than at 90 Hz MF (p < 0.05). Interestingly, at 2,000 and 4,000 Hz CFs, mean ASSR thresholds were significantly lower at 90 Hz MF than at 40 Hz MF (p < 0.05). The lower ASSR thresholds in females might be due to hormonal influence. When recording ASSR thresholds at low MF, we suggest the use of gender-specific normative data so that more valid comparisons can be made, particularly at 500 Hz CF.
Although large international studies have found consistent patterns of sex differences in personality traits among adults (i.e., women scoring higher on most facets), less is known about cross-cultural sex differences in adolescent personality and the role of culture and age in shaping them. The present study examines the NEO Personality Inventory-3 (McCrae, Costa, & Martin, 2005) informant ratings of adolescents from 23 cultures (N = 4,850), and investigates culture and age as sources of variability in sex differences of adolescents' personality. The effect for Neuroticism (with females scoring higher than males) begins to take on its adult form around age 14. Girls score higher on Openness to Experience and Conscientiousness at all ages between 12 and 17 years. A more complex pattern emerges for Extraversion and Agreeableness, although by age 17, sex differences for these traits are highly similar to those observed in adulthood. Cross-sectional data suggest that (a) with advancing age, sex differences found in adolescents increasingly converge toward adult patterns with respect to both direction and magnitude; (b) girls display sex-typed personality traits at an earlier age than boys; and (c) the emergence of sex differences was similar across cultures. Practical implications of the present findings are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
BACKGROUND: Smoking is a primary risk factor for cancer development. While most research has focused on smoking cigarettes, the increasing popularity of shisha or water pipe smoking has received less attention. This study measured the prevalence and risk factors for shisha and cigarette smoking and related knowledge.
MATERIALS AND METHODS: This cross-sectional analytical study was conducted in Shah Alam, Malaysia. Participants aged ≥ 18 years were selected from restaurants. Data regarding demographic variables, smoking patterns, and knowledge about shisha smoking were collected in local languages. Logistic regression was performed to assess risk factors.
RESULTS: Of 239 participants, 61.9 % were male and 99.2% revealed their smoking status. Some 57.4% were smokers: 50.7% only cigarettes, 5.9% only shisha and 42% both. Mean age of starting cigarette smoking was 17.5 ± 2.4 years and for shisha smoking 18.7 ± 2.0 years. In a univariate model, male gender, age 33-52 years and monthly income > MYR 4,000 increased the risk and unemployment and being a student decreased the risk. In a multivariate model, male gender increased the risk of smoking, while being a student decreased the risk, adjusting for age and income. The perception of shisha being less harmful than cigarettes was present in 14.6% and 7.5% had the opinion that shisha is not harmful at all, while 21.7% said that it is less addictive than cigarettes, 39.7% said that shisha did not contain tar and nicotine, 34.3% said that it did not contain carbon monoxide and 24.3% thought that shisha did not cause health problems.
CONCLUSIONS: Prevalence of shisha and cigarette smoking is high in the general population in Malaysia and knowledge about shisha smoking is relatively low. The findings of our study might have implications for understanding similarities and differences in incidence of shisha and cigarette smoking in other cultural/geographic regions.
Previous research has suggested that the factor structure of Body Appreciation Scale (BAS), a widely-used measure of positive body image, may not be cross-culturally equivalent. Here, we used confirmatory factor analysis to evaluate the conceptual equivalence of a Chinese (Cantonese) translation of the BAS among women (n=1319) and men (n=1084) in Hong Kong. Results showed that neither the one-dimensional nor proposed two-dimensional factor structures had adequate fit. Instead, a modified two-dimensional structure, which retained 9 of the 13 BAS items in two factors, had the best fit. However, only one of these factors, reflective of General Body Appreciation, had adequate internal consistency. This factor also had good patterns of construct validity, as indicated through significant correlations with participant body mass index, self-esteem, and (among women) actual-ideal weight discrepancy. The present results suggest that there may be cultural differences in the concept and experience of body appreciation.
The aim of our study was to relate four modifiable lifestyle factors (smoking status, body mass index, physical activity and diet) to health expectancy, using quality-adjusted life years (QALYs) in a prospective cohort study. Data of the prospective EPIC-NL study were used, including 33,066 healthy men and women aged 20-70 years at baseline (1993-7), followed until 31-12-2007 for occurrence of disease and death. Smoking status, body mass index, physical activity and adherence to a Mediterranean-style diet (excluding alcohol) were investigated separately and combined into a healthy lifestyle score, ranging from 0 to 4. QALYs were used as summary measure of healthy life expectancy, combining a person's life expectancy with a weight for quality of life when having a chronic disease. For lifestyle factors analyzed separately the number of years living longer in good health varied from 0.12 year to 0.84 year, after adjusting for covariates. A combination of the four lifestyle factors was positively associated with higher QALYs (P-trend <0.0001). A healthy lifestyle score of 4 compared to a score of 0 was associated with almost a 2 years longer life in good health (1.75 QALYs [95% CI 1.37, 2.14]).
The maxillary incisive canal connects the roof of the oral cavity with the floor of nasal cavity and has the incisive and nasal foramina respectively at its two opposite ends. Its close proximity with the anterior incisors affects one's ability to place immediate implants in ideal position.
OBJECTIVE: We aimed to evaluate perceptions of a Royal College of Psychiatrists promotional film among Malaysian medical students.
METHODS: Year 3 (n=108) and Year 5 (n=108) students completed separate standard measures of attitudes to psychiatry: the ATP 30 and Balon scales, respectively. A questionnaire was also administered recording students' socio-demographic information, career preferences, perceptions of the film's effectiveness and its influence on career choice. Quantitative and qualitative analyses of responses were performed.
RESULTS: The overall response rate was 95.5%. Mean career preference ranking for psychiatry was higher for Year 5 than for Year 3 (p=0.025). For most Year 3 (64.8%) and Year 5 (58.3%) respondents the film conveyed a positive image of psychiatry. Fewer perceived it as influencing career choice: 31.4% for Year 3 and 27.2% for Year 5. Higher scores on both attitudinal scales correlated positively with increasing likelihood of students rating the film positively (Year 3: p=0.000; Year 5: p=0.003). Thematic content analysis suggested possible socio-cultural influences on students' perceptions.
CONCLUSIONS: Despite conveying a positive image of psychiatry, promotional films may have limited impact in changing students' attitudes towards psychiatry and in increasing interest in psychiatry as a career.
KEYWORDS: attitudes; medical students; psychiatry; stigma and discrimination; transcultural psychiatry
Dengue is a major public health problem in many tropical and sub-tropical countries. Vascular leakage and shock are identified as the major causes of deaths in patients with severe dengue. Studies have suggested the potential role of Fc gamma receptors I (FcγRI) in the pathogenesis of dengue. We hypothesized that the circulating level of Fcγ receptor I could potentially be used as an indicator in assisting early diagnosis of severe dengue.
BACKGROUND:
Infectious diseases are a great threat to humankind, and antibiotics are a viable proposition to numerous pathologies. However, antibiotic resistance is a global concern. Therefore, the aims of this survey were to explore the understanding and attitudes of pharmacy students regarding antibiotic use and resistance.
METHODS:
This is a cross-sectional study conducted on final-year undergraduate pharmacy students from 5 public universities. A validated, self-administered questionnaire written in English was used to collect data. It was made up of six domains and forty-five questions. Raosoft software was used to determine the minimum required sample size. Descriptive and inferential data analyses were carried out using SPSS version 20 software.
RESULTS:
Out of 346 students, only 59.5% showed a strong understanding of antibiotic usage, while 84.4% of students demonstrated a good level of understanding regarding the issue of antibiotic resistance. However, only 34.1% of students demonstrated a positive attitude toward this issue.
CONCLUSION:
This survey reveals that final-year pharmacy students at Malaysian public universities have a relatively good understanding of antibiotic resistance. However, their attitudes did not strongly correlate to their knowledge.
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.
Monitoring treatment response to anti-tuberculous therapy remains unsatisfactory in resource-limited countries where sophisticated and expensive tests are not readily available. Sputum culture for mycobacterium is desirable, but not obtainable in many developing countries. Sputum acid-fast bacilli (AFB) smear alone can be misinterpreted in the presence of unviable bacilli or non-tuberculous mycobacteria. Hence the search for a cheaper but reliable monitoring tool, or a combination of several tools, continues. Interesting reports from studies in third world nations have considered weight gain/loss as one such monitoring tool. Since pulmonary tuberculosis is endemic in this country, we take the opportunity to evaluate weight gain and chest radiograph, compared to sputum AFB smear in monitoring patient's response.
We report a rare case of homozygous familial hypercholesterolemia (HoFH), a 22-year-old Malay woman who presented initially with minor soft tissue injury due to a cycling accident. She was then incidentally found to have severe xanthelasma and hypercholesterolemia (serum TC 15.3 mmol/L and LDL-C 13.9 mmol/L). She was referred to the Specialized Lipid Clinic and was diagnosed with familial hypercholesterolemia (FH) based on the Simon Broome (SB) diagnostic criteria. There was a family history of premature coronary heart disease (CHD) in that three siblings had sudden cardiac death, and of consanguineous marriage in that her parents are cousins. DNA screening of LDLR and APOB genes was done by Polymerase Chain Reaction (PCR), followed by Denaturing High Performance Liquid Chromatography (DHPLC). Homozygous mutation C255S in Exon 5 of her LDLR gene was found. There was no mutation was found in Exon 26 and Exon 29 of the APOB gene. This report is to emphasize the importance of identifying patients with FH and cascade screening through established diagnostic criteria and genetic studies in order to ensure early detection and early treatment intervention to minimize the risk of developing CHD and related complications.
We report a patient with juvenile myoclonic epilepsy who subsequently developed temporal lobe epilepsy, which gradually became clinically dominant. Video telemetry revealed both myoclonic seizures and temporal lobe seizures. The temporal lobe seizures were accompanied by a focal recruiting rhythm with rapid generalisation on EEG, in which the ictal EEG pattern during the secondary generalised phase was morphologically similar to the ictal pattern during myoclonic seizures. The secondary generalised seizures of the focal epilepsy responded to sodium valproate, similar to the myoclonic epilepsy. In this rare case of coexistent Juvenile Myoclonic Epilepsy and Temporal lobe epilepsy, the possibility of focal epilepsy recruiting a generalised epileptic network was proposed and discussed.
OBJECTIVE:
To develop and validate a Mandarin version of the Leeds Dyspepsia Questionnaire (M-LDQ) in Asian patients with dyspepsia.
METHODS:
The M-LDQ was developed according to standardized methods. The validity, internal consistency, test-retest reliability and responsiveness of the instrument were evaluated in both primary and secondary care patients.
RESULTS:
A total of 184 patients (mean age 54.0 ± 15.8 years, of whom 59% were women and 72.3% of whom had at least secondary level education) were recruited between August 2012 and March 2013, from both primary (n = 100) and secondary care clinics (n = 84). Both the internal consistency of all components of the M-LDQ (Cronbach's α 0.79) and test-retest reliability (Spearman's correlation coefficient 0.78) were good. The M-LDQ was valid in diagnosing dyspepsia in primary care (area under the receiver operating characteristics curve 0.84) and was able to discriminate between secondary and primary care patients (median cumulative LDQ score 13.0 vs 3.0, P < 0.0001). Among eight patients with organic dyspepsia, the median M-LDQ score reduced significantly from 21.0 (pretreatment) to 9.5 (4 weeks post-treatment) (P < 0.0001).
CONCLUSION:
The M-LDQ is a valid and responsive instrument for assessing ethnic Chinese adults with dyspepsia.
The present study aims to explore the perceptions and understanding of future pharmacists towards volunteerism in health promotional activities. The study was designed as a cross sectional, descriptive survey. All pharmacy undergraduates (n = 293) from the first, second and third professional years enrolled at the School of Pharmaceutical Sciences, Universiti Sains Malaysia were targeted for the study. A pre validated, 15-itemed questionnaire was used for data collection and was analysed by using SPSS. Dichotomous groups were compared with Mann-Whitney U test. The Jonckheere-Terpstra test was used to evaluate the trend of association. Where significant associations were reported, effect size was calculated by using Kendall tau correlation coefficient. p value of <0.05 was considered to be of statistical significance. Out of 200 respondents, 185 completed the study with a response rate of 92.5 %. Agreement with mandatory status of volunteerism at community services was significant with gender (p = 0.003) and year of study (p = 0.045). Confidence in performing health promotional activities (p = 0.001, τ = 0.155) and needed communication skills during health promotional activities (p = 0.022, τ = 0.322) were also significantly associated with year of study with a moderate positive trend from junior to senior classes. Although pharmacy undergraduates showed positive interest and will to volunteer at the health promotional programs, certain issues were also highlighted. Therefore, in order to address these challenges, pharmacy curriculum needs to include a greater emphasis on role of pharmacists in public health. This can be achieved by having a dedicated core course as part of pharmacy curriculum.
Schizophrenia is associated with severe episodic retrieval impairment. The aim of this study was to investigate the possibility that schizophrenia patients could improve their familiarity and/or recollection processes by manipulating the semantic coherence of to-be-learned stimuli and using deep encoding. Twelve schizophrenia patients and 12 healthy controls of comparable age, gender, and educational level undertook an associative recognition memory task. The stimuli consisted of pairs of words that were either related or unrelated to a given semantic category. The process dissociation procedure was used to calculate the estimates of familiarity and recollection processes. Both groups showed enhanced memory performances for semantically related words. However, in healthy controls, semantic relatedness led to enhanced recollection, while in schizophrenia patients, it induced enhanced familiarity. The familiarity estimates for related words were comparable in both groups, indicating that familiarity could be used as a compensatory mechanism in schizophrenia patients.
Previous studies have reported equivocal findings concerning the impact of wearing a hijab, or Islamic head- and body-cover, on Muslim women's body image. Here, we sought to examine that impact using a larger sample of Muslim women than has been relied upon and a wider range of body image measures. A total of 587 British Muslim women completed a battery of scales assessing their frequency and conservativeness of hijab use, body image variables, attitudes towards the media and beauty ideals, importance of appearance, and religiosity. Preliminary results indicated that 218 women never used the hijab and 369 women used some form of the hijab at least rarely. Controlling for religiosity, women who wore the hijab had more positive body image, lower internalization of media messages about beauty standards, and placed less importance on appearance than women who did not wear the hijab. Among women who wore the hijab, hijab use significantly predicted weight discrepancy and body appreciation over and above religiosity. These results are discussed in terms of the possible protective impact among British Muslim women of wearing the hijab.
Objective: Adherence to medication is essential for maximising the outcomes of patients with schizophrenia as the consequences of poor adherence are devastating. The study aimed to compare medication adherence between patients with relapse schizophrenia and those attending psychiatric follow-up clinics, and to determine the factors affecting adherence.
Methods: This was a cross-sectional study involving 70 patients with schizophrenia who were divided equally into 2 groups. Medication adherence was assessed with the Medication Adherence Rating Scale. Appropriate instruments were used to measure insight, social support, and psychopathology. Various socio-demographic and clinical variables were explored to find associations with medication adherence.
Results: Medication adherence among patients with schizophrenia was poor; 51% of the patients did not adhere to a medication regimen. Adherence was better in outpatients with schizophrenia (61%) than in relapse cases (39%), although the difference was not statistically significant (t = 1.70; p = 0.09). Besides, relapse patients had significant higher number of admission (X2 = 22.95; p < 0.05) and severe psychopathology (t = –29.96; p < 0.05), while perceived social support was significantly better in outpatients with schizophrenia (t = 2.90; p < 0.05). Frequency of admission (adjusted b = –0.55; 95% confidence interval [CI], -0.99 to -0.10; p < 0.05) and psychopathology (adjusted b = –0.12; 95% CI, -0.24 to -0.01; p < 0.05) were also significantly associated with medication adherence.
Conclusion: Medication adherence among both groups of patients with schizophrenia was poor. If adherence is addressed appropriately, the number of admissions and severity of psychopathology could be improved.
Key words: Patient compliance; Psychopathology; Schizophrenia; Social support
Study site: Psychiatric clinic, Hospital Universiti Sains Malaysia (HUSM)
Level crossings are amongst the most complex of road safety issues, due to the addition of rail infrastructure, trains and train operations. The differences in the operational characteristics of different warning devices together with varying crossing, traffic or/and train characteristics, cause different driver behaviour at crossings. This paper compares driver behaviour towards two novel warning devices (rumble strips and in-vehicle audio warning) with two conventional warning devices (flashing light and stop sign) at railway level crossings using microsimulation modelling. Two safety performance indicators directly related to collision risks, violation and time-to-collision, were adopted. Results indicated the active systems were more effective at reducing likely collisions compared to passive devices. With the combined application of driving simulation and traffic microsimulation modelling, traffic safety performance indicators for a level crossing can be estimated. From these, relative safety comparisons for the different traffic devices are derived, or even for absolute safety evaluation with proper calibration from field investigations.