METHODS: A cross-sectional online survey was conducted in Selangor, Malaysia, using Google Forms among 202 Malaysian adults from January 1, 2021 to March 31, 2021. Descriptive statistics were used to analyse the socio-demographic characteristics and knowledge scores. The continuous variables were evaluated using the independent t-test, Mann-Whitney test, and one-way analysis of variance test. The Spearman correlation coefficient was employed to determine the correlation between socio-demographic characteristics and knowledge score levels.
RESULTS: The final analysis included 202 participants. The mean±standard deviation age was 49.03±12.65. Only 6.9% of participants had good knowledge of sarcopenia and were aware of sarcopenia's characteristics, consequences, and treatments. Post-hoc comparisons using the Dunnett T3 test showed statistical significance in mean knowledge score and age group (p=0.011) and education level (p≤0.001). The Mann-Whitney test revealed that gender (p=0.026) and current smoking status (p=0.023) significantly influenced knowledge scores.
CONCLUSIONS: The general public's knowledge of sarcopenia was found to be poor to moderate and associated with age and education status. Therefore, education and interventions by policymakers and healthcare professionals to improve public knowledge of sarcopenia in Malaysia are needed.
METHOD: A multi-centre cross-sectional survey was conducted in person among 409 kidney transplant recipients in six public hospitals in the Klang Valley, Malaysia. Catastrophic health expenditure is considered at 10% out-of-pocket payment from household income used for healthcare expenditure. The association of socioeconomic status with catastrophic health expenditure is determined via multiple logistic regression analysis.
RESULTS: 93 kidney transplant recipients (23.6%) incurred catastrophic health expenditures. Kidney transplant recipients in the Middle 40% (RM 4360 to RM 9619 or USD 1085.39 -USD 2394.57) and Bottom 40% (RM 9619 or > USD 2394.57) income group. Kidney transplant recipients in the Bottom 40% and Middle 40% income groups were more susceptible to catastrophic health expenditure at 2.8 times and 3.1 times compared to higher-income groups, even under the care of the Ministry of Health.
CONCLUSION: Universal health coverage in Malaysia cannot address the burden of out-of-pocket healthcare expenditure on low-income Kidney transplant recipients for long-term post-transplantation care. Policymakers must reexamine the healthcare system to protect vulnerable households from catastrophic health expenditures.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This cross-sectional study examined financial and nonfinancial conflicts of interest among all 142 authors of CKD guidelines issued by the Japanese Society of Nephrology using a personal payment database from all 92 major Japanese pharmaceutical companies between 2016 and 2019 and self-citations by guideline authors. Also, the quality of evidence and strength of recommendations underlying the guidelines and conflicts of interest policies of Japanese, US, and European nephrology societies were evaluated.
RESULTS: Among 142 authors, 125 authors (88%) received $6,742,889 in personal payments from 56 pharmaceutical companies between 2016 and 2019. Four-year combined median payment per author was $8258 (interquartile range, $2230‒$51,617). The amounts of payments and proportion of guideline authors with payments remained stable during and after guideline development. The chairperson, vice chairperson, and group leaders received higher personal payments than other guideline authors. Of 861 references in the guidelines, 69 (8%) references were self-cited by the guideline authors, and 76% of the recommendations were on the basis of low or very low quality of evidence. There were no fully rigorous and transparent conflicts of interest policies for nephrology guideline authors in the United States, Europe, and Japan.
CONCLUSIONS: Most of the Japanese CKD guideline recommendations were on the basis of low quality of evidence by the guideline authors tied with pharmaceutical companies, suggesting the need for better financial conflicts of interest management.
METHOD: A nationwide online cross-sectional convenience sampling survey from April 21, 2022 to June 3, 2022 was conducted. The study used descriptive statistics to inform about vaccine hesitancy among parents. Cross-tabulation was performed to calculate the frequency and percentage of vaccine hesitancy, quality of life, e-health literacy, and the 5C psychological antecedents of vaccination among parents with children 5-11 years in Malaysia. Graphical methods were used to portray the levels of e-health literacy and levels of 5C psychological antecedents of vaccination. The study used both bi-variate and multivariate analysis to understand the relationship between vaccine hesitancy and the socio-demo-economic factors, quality of life, e-health literacy and 5C psychological antecedents.
RESULTS: Of 382 participants, almost one-third (33%) of participants reported vaccine hesitancy for their children. For 5C's psychological antecedents of vaccination, around one quarter (26.96%) reported disagreement for confidence in vaccination, almost half (52.36%) reported disagreement for vaccination complacency, three-fifths (60.99%) reported vaccination constraint, one quarter (25.92%) reported calculation antecedent, and almost one-third reported disagreement over collective responsibility antecedent (25.92%). Chi-square test revealed that gender, employment status, and parents' COVID-19 vaccination status were significantly associated (p<0.05) with vaccine hesitancy among parents. Assessing the influence of transactional e-health literacy, only the communication component contained a significant association (p<0.05). Among the 5C psychological antecedents, confidence, calculation, and collective responsibility were significantly associated (p<0.05) with vaccine hesitancy. Parents with secondary [OR: 8.80; CI: 2.44-31.79, (p<0.05)], post-secondary [OR: 5.21; CI: 2.10-13.41, (p<0.05)], and tertiary education [OR: 6.77; CI: 2.25-20.35, (p<0.05)] had significantly higher likelihood of vaccine hesitancy than those with primary education.
CONCLUSION: Highly educated parents are more skeptical and are more likely to perceive the vaccine as unsafe and ineffective for their children. It is critical to disseminate the required information about the vaccine safety to the educated group.
METHODS: One hundred and nineteen (119) older adults, aged 60 and above, living in Klang Valley, Malaysia were recruited for this cross-sectional study. Participants were interviewed face-to-face to obtain sociodemographic data, health status (whether there were and, if yes, the number of comorbidities), outdoor mobility and transportation patterns, Instrumental Activity Daily Living (IADL) status and cognitive function. Participants' physical performance (dominant handgrip strength, 10-m walk, and timed up and go tests), hearing threshold (pure tone audiometry), and vision function (visual acuity, contrast sensitivity) were measured. Transportation patterns of older adults were categorized into three groups, that is, flexible (using public transport and/or private vehicles), using only private vehicles and restricted (relying on others or walking).
RESULTS: Further information is needed to enable such older adults as older women, those with comorbidities and poorer functional status to access transportation, especially to meet their health care needs.
DISCUSSION: The majority (51%) of participants were in the 'using only private vehicles' group, followed by the 'flexibles' (25%) and the 'restricted' (24%). Factors significantly associated with the restricted transportation group were: (a) being female (AdjOR 15.39, 95% CI 0.86-23.39, p
MATERIALS AND METHODS: This study used data from an online cross-sectional survey that was conducted from 24 June to 24 July 2021 in the Fire and Rescue Department of Malaysia. Firefighters were approached using the saturation sampling technique. They received online surveys via email through the Director of State and follow-up reminders through the Assistant Director of State Operations. A total of two filter questionnaires were employed i.e. type and duration of service. Firefighters stating that they were volunteer/auxiliary firefighters or had been in service for 2 years or less were excluded. In this study, data from 6041 out of 8581 firefighters were included for further analysis. The survey utilised the validated staff satisfaction index (SSI) and the happy career (HC) scale for in-service firefighters. SSI was a dual-dimension index consisting of welfare and protection against hazards at work, with 16 subdimensions. The HC is a five multi-dimensional items scale. Then, we used multiple linear regression to obtain the coefficient of determination while adjusting for age groups, gender, marital status, job grade, years of service and region of service.
RESULTS: A total of 6041 eligible data points were analysed in the study. The mean (±SD) age was 38.70 (8.97) years, of which 95.9% were male. The firefighters were in service for a median of 14 years (Q1, Q3: 8, 21). The firefighter reported higher life satisfaction (mean [SD] = 78.30 [9.15]) than happiness at work (mean [SD] = 77.22 [0.20]). The mean happiness scores differed significantly between years of service groups (p<0.001), region of service (p<0.001), marital status (p=0.029) and grade (p<0.001). Firefighters' satisfaction contributed 42.7% of workplace happiness (βadj=1.096 [95% CI: 1.064, 1.128]; p<0.001) after adjusting for frontline, married, the central region of service and male gender as control variables.
CONCLUSION: Firefighter satisfaction had a large effect size on happiness at work (42.7%). However, the interpretation of this effect size should be done with caution because happiness at work is inseparable from other life dimensions such as stability in matrimonial relationships and finances, involvement in leisure and religious activities and being mentally healthy.
OBJECTIVE: This scoping review aimed to map the factors influencing cardiopulmonary resuscitation skills retention among healthcare providers.
METHODS: A literature search was conducted using the Web of Sciences, Scopus, Cochrane, Google Scholar and PubMed electronic databases. The inclusion criteria were original publications published during the last five years (2018 - 2022), availability of full texts in English and evidence of the retention of pertinent cardiopulmonary resuscitation in terms of knowledge and abilities.
RESULTS: Three cross-sectional studies, two prospective studies, one each of prospective descriptive-analytical study, randomised controlled trial, intervention and prospective interventional study, prospective pre-post study, retrospective study, cluster randomised control trial and randomised education trial study comprise the 14 publications including in this study. The thematic analysis identified four major themes that influence the retention of cardiopulmonary resuscitation skills: experience, training type, training frequency and other factors. The final theme identified infrastructure access, evidence-based practice review meetings and healthcare providers' educational background.
CONCLUSION: To retain skills in cardiopulmonary resuscitation, healthcare providers must be regularly updated and trained on the latest cardiopulmonary resuscitation guidelines.
METHODS: A cross-sectional study of consecutive adult patients who underwent glucose hydrogen breath test was conducted. Factors associated with SIBO were evaluated. Symptom severity and HRQoL of IBS patients with and without SIBO were compared. The independent factors associated with severe IBS were explored.
RESULTS: A total of 160 patients were included (median age 40 years, males 31.3%). IBS was present among 53.8% of subjects, with 33.8% having diarrhea-predominant IBS (IBS-D). SIBO was diagnosed in 22.5% of the study population. Patients with SIBO were more commonly diagnosed with IBS-D than those without (50.0% vs 29.0%, P = 0.019). Severe IBS was associated with SIBO (36.4% vs 15.6%, P = 0.043). SIBO was associated with poorer HRQoL (Euroqol five-dimensional utility score: 0.73 vs 0.80, P = 0.024). SIBO (44.4% vs 20.6%, P = 0.043), anxiety (77.8% vs. 39.7%, P = 0.004), and depression (50.0% vs 19.1%, P = 0.011) were associated with severe IBS in the univariate analysis. However, SIBO was the only independent factor associated with severe IBS in the multivariate analysis (adjusted odds ratio 3.83, 95% confidence interval CI 1.02-14.34, P = 0.046).
CONCLUSIONS: There was a significant association between IBS-D and SIBO. The coexistence of SIBO had a significant negative impact on IBS patients.
METHODS: Following ethical approval and informed consent, 124 subjects were recruited into this cross-sectional study. Clinical oral examination assessed the number of Fordyce's granules and blood samples were collected to determine the serum cholesterol and ABO/Rh blood-group systems of individual subjects.
RESULTS: Blood group AB+ showed the highest mean of oral Fordyce's granules number and serum cholesterol level but this was not statistically significant compared to other blood groups. Female subjects in this study who were AB+ were had significantly higher serum cholesterol levels than males.
CONCLUSION: This study indicates an association between ABO blood group, serum cholesterol level and mean number of oral Fordyce's granules. A larger sample size in a future study is required to ascertain whether number of Fordyce's granules is an important measure of serum cholesterol, but the study does show that for AB+ individuals, females may have higher serum cholesterol than males.
METHODS: A cross-sectional study was conducted among 260 children admitted to general medical wards. SGNA and anthropometric measurements were used as references. Kappa agreement, diagnostic values, and area under the curve (AUC) were analyzed to evaluate the diagnostic ability of the AND/ASPEN malnutrition diagnosis tool. Logistic binary regression was performed to determine the predictive ability of each malnutrition diagnosis tool on the length of hospital stay.
RESULTS: The AND/ASPEN diagnosis tool detected the highest malnutrition rate (41%) among the hospitalized children in comparison with the reference methods. This tool demonstrated fair specificity of 74% and sensitivity of 70% compared with the SGNA. It obtained a weak agreement in determining the presence of malnutrition by kappa (0.06-0.42) and receiver operating characteristic curve analysis (AUC = 0.54-0.72). The use of the AND/ASPEN tool obtained an odds ratio of 0.84 (95% CI, 0.44-1.61; P = 0.59) in predicting the length of hospital stay.
CONCLUSIONS: The AND/ASPEN malnutrition tool is an acceptable nutrition assessment tool for hospitalized children in general medical wards.
OBJECTIVES: This study assessed the knowledge, attitude, and practice of female genital mutilation among female health care service providers in order to formulate appropriate policies and programs to eliminate this harmful practice.
DESIGN: Facility-based cross-sectional survey conducted in 2019 among female doctors and nurses working in Banadir Hospital, Mogadishu, Somalia.
METHODS: A total of 144 female health care service providers were randomly selected, and data were collected through a pre-tested, semi-structured questionnaire. Quantitative data were analyzed by using the statistical software SPSS (Version 21), and qualitative data were analyzed thematically in accordance with the objectives of the study.
RESULTS: The study found that about three-fifths of the respondents had undergone some forms of female genital mutilation during their life. An overwhelming majority believed that female genital mutilation practices were medically harmful, and a majority of them expressed their opinion against the medicalization of the practice of female genital mutilation. The study also observed a significant association between participants' age and their negative attitudes regarding the legalization of female genital mutilation.
CONCLUSION: Health care service providers' effort is critical to eliminating this harmful practice from the Somalian society. Strong policy commitment and a comprehensive health-promotion effort targeting the parents and community leaders are essential to avert the negative impact of female genital mutilation.
METHODS: A cross-sectional study was conducted among 123 medical students from a public university in Malaysia. Data on sociodemographic and educational characteristics were collected. The student's personality traits were determined using the Big Five Inventory (BFI), while grit was assessed using the validated 7-item Short Grit Scale (Grit-S). Grit was expressed as a mean score, ranging from 1 (not at all gritty) to 5 (extremely gritty). Multiple linear regression was used to determine the association between the predictors (personality, sociodemographic and educational characteristics) and grit among these students.
RESULTS: The mean grit score was 3.43 (SD 0.57). Based on the multiple linear regression analysis, the grit score was significantly predicted by three personality traits which were extraversion, b = 0.2 (95% CI: 0.07-0.32), agreeableness, b = 0.28 (95% CI: 0.12-0.44) and conscientiousness, b = 0.6 (95% CI: 0.42-0.77). A 1-point increase in the mean extraversion, agreeableness, and conscientiousness scores would independently increase these students' mean grit scores by 0.2, 0.28, and 0.6, respectively. The sociodemographic and educational characteristics did not significantly predict grit among Malaysian medical students.
CONCLUSIONS: The mean grit score among Malaysian medical students is comparable to other medical students in Asia. Extraversion, agreeableness, and conscientiousness personality traits were associated with higher grit. As grit is a dynamic trait, appropriate interventions should be implemented to foster and increase it among these students.
METHODS: This cross-sectional study recruited 201 patients. The Hospital Anxiety Depression Scale (HADS) was used to determine anxiety level. Subsequently, patients who had scored 8 and above on the HADS were interviewed using Mini International Neuropsychiatric Interview (M.I.N.I) to ascertain the diagnosis of GAD. Whilst the Numerical Rating Scale (NRS) assessed pain severity. Multiple logistic regression analysis was used to determine factors associated with GAD.
RESULTS: Among those patients with chronic pain, the prevalence of GAD was 18.9%. Gender (AOR:7.94; 95% CI:2.34, 26.93), duration of the pain (AOR:1.30; 95% CI:1.03,1.63) and pain severity (AOR:18.75; CI:1.23,285.13) were significant factors associated with GAD.
CONCLUSION: GAD is a prevalent condition among chronic pain patients.
METHODS: Articles published from 2012 to 2021 were searched through seven databases. Studies that established the relationship for risk factors of TB treatment interruption among adult Asian were included. Relevant articles were screened, extracted and appraised using Joanna Briggs Institute's checklists for cohort, case-control and cross-sectional study designs by three reviewers. Meta-analysis was performed using the random effect model in Review Manager software. The pooled prevalence and predictors of treatment interruption were expressed in ORs with 95% CIs; heterogeneity was assessed using the I2 statistic. The publication bias was visually inspected using the funnel plot.
RESULTS: Fifty eligible studies (658 304 participants) from 17 Asian countries were included. The overall pooled prevalence of treatment interruption was 17% (95% CI 16% to 18%), the highest in Southern Asia (22% (95% CI 16% to 29%)), followed by Eastern Asia (18% (95% CI 16% to 20%)) and South East Asia (16% (95% CI 4% to 28%)). Seven predictors were identified to increase the risk of treatment interruption, namely, male gender (OR 1.38 (95% CI 1.26 to 1.51)), employment (OR 1.43 (95% CI 1.11 to 1.84)), alcohol intake (OR 2.24 (95% CI 1.58 to 3.18)), smoking (OR 2.74 (95% CI 1.98 to 3.78)), HIV-positive (OR 1.50 (95% CI 1.15 to 1.96)), adverse drug reactions (OR 2.01 (95% CI 1.20 to 3.34)) and previously treated cases (OR 1.77 (95% CI 1.39 to 2.26)). All predictors demonstrated substantial heterogeneity except employment and HIV status with no publication bias.
CONCLUSION: The identification of predictors for TB treatment interruption enables strategised planning and collective intervention to be targeted at the high-risk groups to strengthen TB care and control in the Asia region.