Displaying publications 81 - 100 of 506 in total

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  1. Towards universal health coverage: governance and organisational change in ministries of health
    Berman P, Azhar A, Osborn EJ
    BMJ Glob Health, 2019;4(5):e001735.
    PMID: 31637026 DOI: 10.1136/bmjgh-2019-001735
    Countries have implemented a range of reforms in health financing and provision to advance towards universal health coverage (UHC). These reforms often change the role of a ministry of health (MOH) in traditionally unitary national health service systems. An exploratory comparative case study of four upper middle-income and high-income countries provides insights into how these reforms in pursuit of UHC are likely to affect health governance and the organisational functioning of an MOH accustomed to controlling the financing and delivery of healthcare. These reforms often do not result in simple transfers of responsibility from MOH to other actors in the health system. The resulting configuration of responsibilities and organisational changes within a health system is specific to the capacities within the health system and the sociopolitical context. Formal prescriptions that accompany reform proposals often do not fully represent what actually takes place. An MOH may retain considerable influence in financing and delivery even when reforms appear to formally shift those powers to other organisational units. MOHs have limited ability to independently achieve fundamental system restructuring in health systems that are strongly subject to public sector rules and policies. Our comparative study shows that within these constraints, MOHs can drive organisational change through four mechanisms: establishing a high-level interministerial team to provide political commitment and reduce institutional barriers; establishing an MOH 'change team' to lead implementation of organisational change; securing key components of systemic change through legislation; and leveraging emerging political change windows of opportunity for the introduction of health reforms.
    Matched MeSH terms: Government
  2. Fulltext Moral philosophy, pragmatism, and the larger cause: why "war" metaphors are needed during pandemics
    Bhaumik S, Dash S, Kakkar K
    Indian J Med Ethics, 2020 12 10;V(3):219-221.
    PMID: 33295290 DOI: 10.20529/IJME.2020.067
    Coronavirus disease (Covid-19), which originated in China, is now a full-blown pandemic which has thrown governments and societies off-track in an unprecedented manner. War metaphors have been used widely to describe the scenario, but many critics decry them as harmful narratives. In this piece, we discuss the utility of the war metaphor to build solidarity and fraternity, which will be essential to get through the crisis. We also explain how concerns regarding increased authoritarianism and state excesses due to the use of these narratives are misplaced. We then tease out the colonial era concept of war that guides the arguments against the use of war metaphors in pandemics. We argue that in the post-modern world and in South Asian and African philosophies, wars are seen through the prism of the larger cause of dharma or ubuntu and that individual losses or gains in these contexts are part of a larger cause. The use of war metaphors reflects the need to get together for a societal cause. These metaphors are largely understood across societies while other alternatives are exclusionary, poetic and tangential in nature.

    Keywords : Covid-19, pandemics, war metaphors, communication, philosophy, SARS-CoV-2

    .
    Matched MeSH terms: Government
  3. Public health care provisions: access and equity
    Bin Juni MH
    Soc Sci Med, 1996 Sep;43(5):759-68.
    PMID: 8870140
    Within the current exercise of reforming the health care system, underlying all issues, is the reassessment of the role of government. It is a government's responsibility and concern that the health sector be accessible and equitable to the population, and more important that the health sector be more efficient and affordable. Many governments in the world attempt to provide universal health care services to their population through public health care provisions. This paper reviews and analyses the experience of the Malaysian health system, focusing on the performance of the system in relation to access and equity. The performance of the Malaysian health system has been impressive. At minimum cost it has achieved virtually accessible and equitable health care to the entire population. This is evident by analysing almost all the commonly used indicators. These clearly show that when matched to comparable countries, health outcome is even better than predicted value.
    Matched MeSH terms: Financing, Government
  4. Government public health policy: three cautionary tales from Malaysia, South Africa and the United States
    Blum J, Carstens P, Talib N
    Med Law, 2007 Dec;26(4):615-42.
    PMID: 18284107
    Three authors describe problematic scenarios of health policy in their respective countries. These examples illustrate the role of government influences in determining resource allocation, legislation, health provision and health outcomes in very different situations. These outcomes are affected not only by attitudes to public health, but also by the legal systems in the countries which are the subjects of this study. The authors draw conclusions about the use and abuse of public health regulation.
    Matched MeSH terms: Government Regulation
  5. Nanomedicines for cancer therapy: current status, challenges and future prospects
    Bor G, Mat Azmi ID, Yaghmur A
    Ther Deliv, 2019 02;10(2):113-132.
    PMID: 30678550 DOI: 10.4155/tde-2018-0062
    The emergence of nanomedicine as an innovative and promising alternative technology shows many advantages over conventional cancer therapies and provides new opportunities for early detection, improved treatment, and diagnosis of cancer. Despite the cancer nanomedicines' capability of delivering chemotherapeutic agents while providing lower systemic toxicity, it is paramount to consider the cancer complexity and dynamics for bridging the translational bench-to-bedside gap. It is important to conduct appropriate investigations for exploiting the tumor microenvironment, and achieving a more comprehensive understanding of the fundamental biological processes in cancer and their roles in modulating nanoparticle-protein interactions, blood circulation, and tumor penetration. This review provides an overview of the current cancer nanomedicines, the major challenges, and the future opportunities in this research area.
    Matched MeSH terms: Government Regulation
  6. Fulltext Human papillomavirus immunisation of adolescent girls: improving coverage through multisectoral collaboration in Malaysia
    Buang SN, Ja'afar S, Pathmanathan I, Saint V
    BMJ, 2018 Dec 07;363:k4602.
    PMID: 30530626 DOI: 10.1136/bmj.k4602
    Matched MeSH terms: Government
  7. Fulltext Effect of Psychological and Institutional Factors on Student’s Entrepreneurial Intention: An Application of TPB, CSE and TT
    Bukar Ali, Bularafa, Abdul Rashid, Abdullah
    The Pertanika Journal of Scholarly Research Reviews, 2019;5(1):1-9.
    MyJurnal
    Unemployment and poverty are seriously issue of concern globally, especially in developing countries like Nigeria. Unemployment and poverty among university graduates in Nigeria, the trends on rising every year, major corporations are cutting down jobs and graduates who were interested to work can’t seem to find a job. However, entrepreneurship and business formation have been recognised around the World as a remedy for unemployment and pivotal for economies to grow. Therefore, promotion of entrepreneurial activity becomes the most top priority on the government agenda. Despite the unique role played by entrepreneurship to the economy as a whole and to the person that established business, in Nigeria, the rate of university graduates in entrepreneurship is far below expected. This led to many research efforts on factors that are having an effect on student’s entrepreneurial intentions. This review paper proposed the intention to be an entrepreneur can be explained by Ajzen, (1991) theory of planned behaviour, institutional, and core self-evaluation theories. Psychological (self-efficacy, risk-taking propensity, locus of control, innovativeness, need for achievement) and institutional (university environment, government support programmes) factors will have an effect on attitudes, subjective norms, perceived behavioural control. Consequently, the study predicted the entrepreneurial intentions of the Nigerian university students.
    Matched MeSH terms: Government
  8. The nexus between government spending, economic growth, and tourism under climate change: testing the CEM model for the USA
    Bulut U, Ongan S, Dogru T, Işık C, Ahmad M, Alvarado R, et al.
    Environ Sci Pollut Res Int, 2023 Aug;30(36):86138-86154.
    PMID: 37400702 DOI: 10.1007/s11356-023-28319-w
    This study examines the impact of government spending, income, and tourism consumption on CO2 emissions in the 50 US states through a novel theoretical model derived from the Armey Curve model and the Environmental Kuznets Curve hypothesis. The findings of this research are essential for policymakers to develop effective strategies for mitigating environmental pollution. Utilizing panel cointegration analysis, the study provides valuable insights into whether continued increases in government spending contribute to higher pollution levels. By identifying the threshold point of spending as a percentage of GDP, policymakers can make informed decisions to avoid the trade-off between increased spending and environmental degradation. For instance, the analysis reveals that Hawaii's tipping point is 16.40%. The empirical results underscore the importance of adopting sustainable policies that foster economic growth while minimizing environmental harm. These findings will aid policymakers in formulating targeted and efficient approaches to tackle climate change and promote long-term environmental sustainability in the United States. Moreover, the impact of tourism development on CO2 emissions varies across states, with some US states experiencing a decrease while others see an increase.
    Matched MeSH terms: Government
  9. Accreditation of medical schools in Ireland: standards and procedures
    Bury G
    Med J Malaysia, 2005 Aug;60 Suppl D:11-9.
    PMID: 16315617
    The Irish Medical Council has undertaken accreditation inspections of Irish medical schools on a regular basis since 1996. This document is a summary of the accreditation standards, a guide to the process for those involved and an overview of the complexity of the many elements involved in educating a doctor. It should be read in conjunction with previous Medical Council publications on medical education. It also provides the basis for the Evaluation System for Visitors 2003. The Medial Council's prime role is the protection of the public interest in relation to the practice of medicine. The Medical Council scrutinises medical schools. It has an important advocacy role with government, with the universities which operate medical schools and with the professionals involved to improve the standards and delivery of medical education.
    Matched MeSH terms: Government
  10. Fulltext Moving Towards Optimized Noncommunicable Disease Management in the ASEAN Region: Recommendations from a Review and Multidisciplinary Expert Panel
    Castillo-Carandang NT, Buenaventura RD, Chia YC, Do Van D, Lee C, Duong NL, et al.
    Risk Manag Healthc Policy, 2020;13:803-819.
    PMID: 32765135 DOI: 10.2147/RMHP.S256165
    Introduction: Noncommunicable diseases (NCDs) are the leading cause of morbidity and mortality in the Association of Southeast Asian Nations (ASEAN) member states. Progress has been slow despite the World Health Organization action plan for the prevention and control of NCDs in the region. This paper presents recommendations focused on practical strategies for optimizing NCD management in the ASEAN region.

    Methods: A multidisciplinary group of experts from six ASEAN member states convened for two face-to-face meetings to discuss barriers and possible recommendations for optimizing NCD management, focused on cardiovascular diseases and mental disorders, in the region. Multiple approaches, ie, analysis of insights from the meetings and a review of existing literature on NCD programs in the ASEAN region were followed. The proposed recommendations were also based on selected successful interventions in ASEAN member states, thus providing actionable strategies.

    Results: The gaps identified in NCD management for cardiovascular diseases and mental disorders in the ASEAN region were classified into gaps relating to policies and to clinical and public health practice. The proposed solutions addressing policy gaps include fostering multisectoral public-private partnerships, employing "whole-of-government" and "whole-of-society" approaches and promoting "health-in-all policies approach" to manage issues with financing, accessibility, efficiency and quality of health services. Whereas proposed solutions to bridge clinical and public health practice gaps entail strengthening primary care services, building the capacity of trained healthcare workers and employing collaborative care for holistic management of patients.

    Conclusion: The scale of premature and preventable deaths from NCDs in the ASEAN region remains a serious public health concern and requires a "whole-of-system approach". The interventions proposed in this paper build on regional collaborations and knowledge sharing to help develop a concerted and targeted response to NCDs.

    Matched MeSH terms: Government
  11. Cost Analysis of Using a Closed-System Transfer Device (CSTD) for Antineoplastic Drug preparation in a Malaysian Government-Funded Hospital
    Chan HK, Lim YM
    Asian Pac J Cancer Prev, 2016 11 01;17(11):4951-4957.
    PMID: 28032722
    Background: Apart from reducing occupational exposure to cytotoxic hazards, the PhaSeal® closed-system transfer device (CSTD) can extend the beyond-use dates (BUDs) of unfinished vials of antineoplastic drugs for up to 168 hours (seven days). In this study, the total material cost incurred by its use in a Malaysian government-funded hospital was calculated. Methods: A list of vial stability following initial needle punctures of 29 commonly-used antineoplastic drugs was compiled. The amount of the materials used, including drugs, infusion bottles, the PhaSeal® CSTD and other consumables, was recorded on a daily basis for three months in 2015. The total cost was calculated based on the actual acquisition costs, and was compared with that of a hypothetical scenario, whereby conventional syringe-needle sets were used for the same amounts of preparations. Results: The use of the PhaSeal® CSTD incurred a cost of MYR 383,634.52 (USD 92,072.28) in three months, representing an average of MYR 170.5 (USD 40.92) per preparation or an estimated annual cost of MYR 1,534,538.08 (USD 368,289.14). Compared with conventional syringe-needle approach, it is estimated to lead to an additional spending of MYR 148,627.68 (USD 35,670.64) yearly. Conclusion: Although there was a reduction of drug wastage achieved by extending BUDs of unfinished vials using the PhaSeal® CSTD, cost saving was not observed, likely attributable to the wide use of lower-priced generic drugs in Malaysia. Future studies should further evaluate the possibility of cost saving, especially in health settings where branded and high-cost antineoplastic drugs are more commonly used.
    Matched MeSH terms: Government
  12. Streamlined life cycle CO2 emission assessment of sewage treatment in Taiwan
    Chang Ys
    Sains Malaysiana, 2015;44:1715-1720.
    Sewage treatment is an important issue in a country for public health and environmental protection. The treatment
    process not only consumes energy but also emits CO2
    . In this research, the idea of streamlined life cycle assessment was
    applied. The CO2
    emission from sewage treatment was assessed from direct energy consumption of four major sewage
    treatment plants in Taiwan. The results showed that the CO2
    emission at in-plant sewage treatment stage takes more
    than 95% of total CO2
    emission for most plants. The results suggested that CO2
    emission of sewage treatment can be
    calculated from energy consumption at in-plant sewage treatment stage to simplify the calculation. The CO2
    emission
    of sewage treatment was then assessed from sewage plants in Taiwan using in-plant electricity consumption. The unit
    CO2
    emission of sewage treatment in Taiwan is 0.216 kg-CO2
    /m3
    . This database will be an important reference for water
    resource research and future government environmental policies.
    Matched MeSH terms: Government
  13. Fulltext Smart technology for healthcare: Exploring the antecedents of adoption intention of healthcare wearable technology
    Chau KY, Lam MHS, Cheung ML, Tso EKH, Flint SW, Broom DR, et al.
    Health Psychol Res, 2019 Mar 11;7(1):8099.
    PMID: 31583292 DOI: 10.4081/hpr.2019.8099
    Technological advancement and personalized health information has led to an increase in people using and responding to wearable technology in the last decade. These changes are often perceived to be beneficial, providing greater information and insights about health for users, organizations and healthcare and government. However, to date, understanding the antecedents of its adoption is limited. Seeking to address this gap, this cross-sectional study examined what factors influence users' adoption intention of healthcare wearable technology. We used self-administrated online survey to explore adoption intentions of healthcare wearable devices in 171 adults residing in Hong Kong. We analyzed the data by Partial least squares - structural equation modelling (PLS-SEM). The results reveal that perceived convenience and perceived irreplaceability are key predictors of perceived usefulness, which in turn strengthens users' adoption intention. Additionally, the results also reveal that health belief is one of the key predictors of adoption intention. This paper contributes to the extant literature by providing understanding of how to strengthen users' intention to adopt healthcare wearable technology. This includes the strengthening of perceived convenience and perceived irreplaceability to enhance the perceived usefulness, incorporating the extensive communication in the area of healthcare messages, which is useful in strengthening consumers' adoption intention in healthcare wearable technology.
    Matched MeSH terms: Government
  14. Blood pressure profile for children aged 5 to 6 years and its associated factors - a cross-sectional study in Kuching district, Sarawak
    Cheah WL, Edmund Shin CV, Ayu Akida AR
    Malays Fam Physician, 2019;14(1):2-9.
    PMID: 31289625
    Introduction: This study aimed to determine the blood pressure profile for preschool children in Kuching Sarawak and its relationship with sociodemographic characteristics, nutritional status and parental hypertension.

    Methods: This was a cross sectional study conducted in a government preschool in Kuching district from January to June 2017. Data were collected using questionnaire as well as anthropometric and blood pressure measurements. Data were entered into and analyzed using SPSS Version 22.

    Results: A total of 229 preschool children participated in this study (response rate of 81%). About 9.7% of the respondents were at risk for hypertension. The mean systolic blood pressure was 95.6 mmHg (SD=8.36), and the mean diastolic blood pressure was 59.9 mmHg (SD=6.09). Ten percent of the children were overweight and 7.4% were obese. Binary logistics regression analysis indicated that gender (Male: OR = 3.085, p< 0.05), parent's education level (comparing primary education and below with secondary education: OR = 4.88, p<0.05; comparing primary education and below tertiary education: OR = 7.63, p<0.05) and ethnicity (comparing Malay with Chinese: OR = 0.10, p< 0.01) were significantly associated with being at risk for hypertension.

    Conclusion: The study showed that 9.7% of the children were at risk for hypertension and that 17.4% had abnormal body weights. Identifying and tackling the factors leading to these issues will help to improve and ensure a better quality of non-communicable disease programs offered in primary health clinics and school health programs.

    Matched MeSH terms: Government
  15. Fulltext A randomised controlled trial of a facebook-based physical activity intervention for government employees with metabolic syndrome
    Chee, H.P., Hazizi, A.S., Barakatun Nisak, M.Y., Mohd Nasir, M.T.
    Malays J Nutr, 2014;20(2):165-181.
    MyJurnal
    Introduction: This study aimed to ascertain the effects of a Facebook-based physical activity intervention on improvements in step counts and metabolic syndrome. Methods: Government employees with metabolic syndrome were randomly assigned by cluster to the Facebook group (n = 44) or the control group (n = 103). All participants were asked to complete self-administered questionnaires at baseline, after the first and second phases. Data from anthropometric (weight, body mass index, fat mass, body fat percentage, waist circumference, hip circumference and waist-to-hip ratio), biochemical (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides and fasting glucose) and clinical examinations (systolic blood pressure and diastolic blood pressure) were collected. The number of steps per day was determined by a Lifecorder e- STEP accelerometer. Results: A significant difference in the number of steps per day between the baseline and the first phase (p
    Matched MeSH terms: Government
  16. Fulltext Determinants of metabolic syndrome among Malaysian government employees
    Chee, Huei Phing, Hazizi Abu Saad, Barakatun Nisak Mohd Yusof, Mohd Nasir Mohd Taib
    International Medical Journal Malaysia, 2018;17(1):87-92.
    MyJurnal
    Introduction: The metabolic syndrome comprises a collection of cardiovascular disease risks, which has been demonstrated to predict type 2 diabetes mellitus and cardiovascular disease. Metabolic syndrome is a crucial health concern in Malaysia, with a prevalence of about 42.5% in the general population based on the ‘Harmonized’ definition. The aim of this study was to ascertain the association between socioeconomic status among Malaysian government employees with metabolic syndrome, compared with those without metabolic syndrome. Furthermore, this study also aimed to ascertain the associated obesity indicators for metabolic syndrome among employees—explicitly body mass index, waist circumference, waist-to-hip ratio, body fat percentage, fat mass index, and waist-to-height ratio. Methods: This cross-sectional study was
    undertaken at government agencies in Putrajaya, Malaysia, via multi-stage random sampling. A total of 675 government employees were randomly sampled from a list of 3,173 government employees working in five government agencies under five geographical areas. Data on socioeconomic status, anthropometric, biochemical, and clinical assessments were collected. Results: Employees who were males had higher metabolic syndrome prevalence compared to their counterparts (p=0.019). In addition, employees aged between 20 to younger than 30 years had lowest metabolic syndrome prevalence (p=0.002). The risk of having metabolic syndrome was almost 10 times more likely in men with a waist-to-hip ratio of ≥0.90 compared to men with a waist-to-hip ratio of
    Matched MeSH terms: Government Agencies; Government Employees
  17. Fulltext Editorial: on whom and how shall we spend our dollars?
    Chen PCY
    Med J Malaysia, 1980 Dec;35(2):102-8.
    PMID: 6790916
    Matched MeSH terms: Financing, Government
  18. Plasmodium vivax drug resistance markers: Genetic polymorphisms and mutation patterns in isolates from Malaysia
    Cheong FW, Dzul S, Fong MY, Lau YL, Ponnampalavanar S
    Acta Trop, 2020 Jun;206:105454.
    PMID: 32205132 DOI: 10.1016/j.actatropica.2020.105454
    Transmission of Plasmodium vivax still persist in Malaysia despite the government's aim to eliminate malaria in 2020. High treatment failure rate of chloroquine monotherapy was reported recently. Hence, parasite drug susceptibility should be kept under close monitoring. Mutation analysis of the drug resistance markers is useful for reconnaissance of anti-malarial drug resistance. Hitherto, information on P. vivax drug resistance marker in Malaysia are limited. This study aims to evaluate the mutations in four P. vivax drug resistance markers pvcrt-o (putative), pvmdr1 (putative), pvdhfr and pvdhps in 44 isolates from Malaysia. Finding indicates that 27.3%, 100%, 47.7%, and 27.3% of the isolates were carrying mutant allele in pvcrt-o, pvmdr1, pvdhfr and pvdhps genes, respectively. Most of the mutant isolates had multiple point mutations rather than single point mutation in pvmdr1 (41/44) and pvdhfr (19/21). One novel point mutation V111I was detected in pvdhfr. Allelic combination analysis shows significant strong association between mutations in pvcrt-o and pvmdr1 (X2 = 9.521, P < 0.05). In the present study, 65.9% of the patients are non-Malaysians, with few of them arrived in Malaysia 1-2 weeks before the onset of clinical manifestations, or had previous history of malaria infection. Besides, few Malaysian patients had travel history to vivax-endemic countries, suggesting that these patients might have acquired the infections during their travel. All these possible imported cases could have placed Malaysia in a risk to have local transmission or outbreak of malaria. Six isolates were found to have mutations in all four drug resistance markers, suggesting that the multiple-drugs resistant P. vivax strains are circulating in Malaysia.
    Matched MeSH terms: Government
  19. Fulltext Psychological insulin resistance: do individual factors play an important role among type 2 diabetes patients?
    Chia Yee Kang, Salmiah Md Said, Rosliza Abdul Manaf
    Malaysian Journal of Medicine and Health Sciences, 2019;15(104):79-79.
    MyJurnal
    Introduction: Psychological insulin resistance is the reluctance of diabetes patients or physicians to initiate or in-tensify insulin therapy. The insulin usage among Malaysian type 2 diabetes mellitus (T2DM) patients is low, only 21.4% of audited T2DM patients were on insulin therapy despite 76.2% of the audited T2DM patients had poorly controlled diabetes with HbA1c ≥ 6.5% in year 2012. This study aims to identify the predictors of psychological insulin resistance (PIR) among insulin naïve T2DM patients. Methods: A cross-sectional study using interviewer assisted questionnaires was conducted among adult insulin naïve T2DM patients in government health clinics at a district of Penang, Malaysia. Insulin Treatment Appraisal Scale (ITAS) was used to assess the dependent variable (PIR) and validated self-developed questionnaires were used for assess the independent variables (socio-demographic characteristics, diabetes profile, and individual factors). Multiple linear regression analysis was performed to identify the predictors of PIR. Results: As high as 72.7% out of 385 participants were reluctant to initiate insulin therapy. Emotional factors (fears), perceived personal failure and perceived severity significantly predicted higher PIR whereas perceived benefit and self-efficacy significantly predicted lower PIR. Total 49.8% variability of PIR was explained by the entire individual predictors (R2=49.8%, p = 0.001). Emotional factor was the strongest predictor. Conclusion: This study revealed a high level of PIR among Malaysian T2DM patients. It is vital to tackle the predictors that predict high PIR and strengthen the predictors that lead to low PIR in our health education and health intervention programs.
    Matched MeSH terms: Government
  20. Fulltext Drug abuse, relapse, and prevention education in malaysia: perspective of university students through a mixed methods approach
    Chie QT, Tam CL, Bonn G, Wong CP, Dang HM, Khairuddin R
    Front Psychiatry, 2015;6:65.
    PMID: 25999867 DOI: 10.3389/fpsyt.2015.00065
    In recent years, there have been increasing accounts of illegal substance abuse among university students and professional groups in Malaysia. This study looks at university students' perceptions about this phenomenon. Students from Malaysian universities were asked for their impressions about drug availability and abuse, as well as factors contributing to drug abuse and relapse. The questionnaire also inquired into their knowledge and views regarding government versus private rehabilitation centers, as well as their exposure to, and views about, school-based drug-prevention education. Participants were 460 university students from five Malaysian states: Penang, Selangor, Kuala Lumpur, Sabah, and Sarawak. Results showed gender differences in perceptions of relapse prevention strategies, as well as factors leading to drug abuse and relapse. Students also believed that drug education would be more effective if initiated between the ages of 11 and 12 years, which is slightly older than the common age of first exposure, and provided suggestions for improving existing programs. Implications of student perceptions for the improvement of current interventions and educational programs are discussed.
    Matched MeSH terms: Government
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