Displaying publications 101 - 120 of 265 in total

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  1. Development and evaluation of a digital, community-based intervention to reduce noncommunicable disease risk in a low-resource urban setting in Malaysia: a research protocol
    Kataria I, Ngongo C, Lim SC, Kocher E, Kowal P, Chandran A, et al.
    Implement Sci Commun, 2020;1:87.
    PMID: 33033807 DOI: 10.1186/s43058-020-00080-y
    Background: Noncommunicable disease burden is rising in Malaysia, accounting for 72% of all deaths. Urbanization and globalization have contributed to changing patterns of diet and physical activity, creating an obesogenic environment that increases noncommunicable disease risk, especially in low-income populations. Community-based and technological interventions can play an important role in addressing structural determinants that influence noncommunicable disease burden. The Better Health Programme Malaysia aims to co-create and develop a community-based digital intervention for low-income populations to enable community stakeholders to address obesogenic environments and improve people's knowledge, attitudes, and practices related to noncommunicable disease risk.

    Methods: This quasi-experimental study will assess community member and community health volunteer knowledge, attitudes, and practices on noncommunicable disease prevention, risk factors, and health-seeking behavior in three geographical areas of Kuala Lumpur, each representing a different ethnicity (Malay, Indian, and Chinese). Assessment will take place before and after a 9-month intervention period, comparing intervention areas with matched control geographies. We plan to engage 2880 community members and 45 community health volunteers across the six geographic areas. A digital health needs assessment will inform modification of digital health tools to support project aims. Intervention co-creation will use a discrete choice experiment to identify community preferences among evidence-based intervention options, building from data collected on community knowledge, attitudes, and practices. Community health volunteers will work with local businesses and other stakeholders to effect change in obesogenic environments and NCD risk. The study has been approved by the Malaysian Ministry of Health Medical Research Ethical Committee.

    Discussion: The Better Health Programme Malaysia anticipates a bottom-up approach that relies on community health volunteers collaborating with local businesses to implement activities that address obesogenic environments and improve community knowledge, attitudes, and practices related to NCD risk. The planned co-creation process will determine which interventions will be most locally relevant, feasible, and needed. The effort aims to empower community members and community health volunteers to drive change that improves their own health and wellbeing. The learnings can be useful nationally and sub-nationally in Malaysia, as well as across similar settings that are working with community stakeholders to reduce noncommunicable disease risk.

    Trial registration: National Medical Research Register, Malaysia; NMRR-20-1004-54787 (IIR); July 7, 2020.

    Matched MeSH terms: Poverty
  2. Assessing the impacts of climate change in cities and their adaptive capacity: Towards transformative approaches to climate change adaptation and poverty reduction in urban areas in a set of developing countries
    Filho WL, Balogun AL, Olayide OE, Azeiteiro UM, Ayal DY, Muñoz PDC, et al.
    Sci Total Environ, 2019 Nov 20;692:1175-1190.
    PMID: 31539949 DOI: 10.1016/j.scitotenv.2019.07.227
    Many cities across the world are facing many problems climate change poses to their populations, communities and infrastructure. These vary from increased exposures to floods, to discomfort due to urban heat, depending on their geographical locations and settings. However, even though some cities have a greater ability to cope with climate change challenges, many struggle to do so, particularly in cities in developing countries. In addition, there is a shortage of international studies which examine the links between climate change adaptation and cities, and which at the same time draw some successful examples of good practice, which may assist future efforts. This paper is an attempt to address this information need. The aim of this paper is to analyse the extent to which cities in a sample of developing countries are attempting to pursue climate change adaptation and the problems which hinder this process. Its goal is to showcase examples of initiatives and good practice in transformative adaptation, which may be replicable elsewhere. To this purpose, the paper describes some trends related to climate change in a set of cities in developing countries across different continents, including one of the smallest capital cities (Georgetown, Guyana) and Shanghai, one the world's most populous cities. In particular, it analyses their degree of vulnerability, how they manage to cope with climate change impacts, and the policies being implemented to aid adaptation. It also suggests the use of transformative approaches which may be adopted, in order to assist them in their efforts towards investments in low-carbon and climate-resilient infrastructure, thereby maximizing investments in urban areas and trying to address their related poverty issues. This paper addresses a gap in the international literature on the problems many cities in developing countries face, in trying to adapt to a changing climate.
    Matched MeSH terms: Poverty
  3. Changing NAFLD Epidemiology in China
    Lee HW, Wong VW
    Hepatology, 2019 Jul 12.
    PMID: 31298746 DOI: 10.1002/hep.30848
    In Factfulness, the late Dr. Hans Rosling illustrated how most people grossly underestimated education, income, life expectancy, and vaccination rates in low-income countries.(1) It is natural human psychology to have fixed images about the developing world. Nonetheless, the world is changing. According to the latest World Bank figures, 184 of 218 (84%) countries or regions are now classified as middle-income or high-income economies.(2) Many countries previously labeled as developing countries (such as Armenia, Colombia, Malaysia, and Serbia) are now classified as upper-middle-income economies. Although many problems remain and deserve our attention, Dr. Rosling emphasized that it is equally important to recognize that there is progress and many policies do work. Otherwise, we risk dismissing useful strategies and impeding their implementation. This article is protected by copyright. All rights reserved.
    Matched MeSH terms: Poverty
  4. Survey-based data on food security, nutrition and agricultural production shocks among rural farming households in northern Uganda
    Mwungu CM, Shikuku KM, Atibo C, Mwongera C
    Data Brief, 2019 Apr;23:103818.
    PMID: 31372462 DOI: 10.1016/j.dib.2019.103818
    Climate change, degradation of natural resources, conflict or civil war, diseases and poverty are among the key threats that impact agriculture, human nutrition, food security and food safety among rural households in developing countries. Sustainability of food systems and livelihoods will thus crucially depend on not only the ability to accommodate or recover from these threats but also to tap into opportunities for strengthening long-term capabilities. One approach to enhancing resilience to enhance food security and nutrition is building an evidence base to better understand the various types of smallholders, threats to agriculture production and the associated risks to food security and nutrition and household food preferences. Unfortunately, such data in many African countries is still unavailable or has not been shared publicly. In this paper, we describe data that were collected in Nwoya district, Northern Uganda in December 2017. These data can be used to assess the relationship between resilience of farm households to climatic risks and their food and nutrition security.
    Matched MeSH terms: Poverty
  5. Fulltext Follow-Up Care for Breast and Colorectal Cancer Across the Globe: Survey Findings From 27 Countries
    Mollica MA, Mayer DK, Oeffinger KC, Kim Y, Buckenmaier SS, Sivaram S, et al.
    JCO Glob Oncol, 2020 09;6:1394-1411.
    PMID: 32955943 DOI: 10.1200/GO.20.00180
    PURPOSE: The purpose of this study was to describe follow-up care for breast and colorectal cancer survivors in countries with varying levels of resources and highlight challenges regarding posttreatment survivorship care.

    METHODS: We surveyed one key stakeholder from each of 27 countries with expertise in survivorship care on questions including the components/structure of follow-up care, delivery of treatment summaries and survivorship care plans, and involvement of primary care in survivorship. Descriptive analyses were performed to characterize results across countries and variations between the WHO income categories (low, middle, high). We also performed a qualitative content analysis of narratives related to survivorship care challenges to identify major themes.

    RESULTS: Seven low- or /lower-middle-income countries (LIC/LMIC), seven upper-middle-income countries (UMIC), and 13 high-income countries (HICs) were included in this study. Results indicate that 44.4% of countries with a National Cancer Control Plan currently address survivorship care. Additional findings indicate that HICs use guidelines more often than those in LICs/LMICs and UMICs. There was great variation among countries regardless of income level. Common challenges include issues with workforce, communication and care coordination, distance/transportation issues, psychosocial support, and lack of focus on follow-up care.

    CONCLUSION: This information can guide researchers, providers, and policy makers in efforts to improve the quality of survivorship care on a national and global basis. As the number of cancer survivors increases globally, countries will need to prioritize their long-term needs. Future efforts should focus on efforts to bridge oncology and primary care, building international partnerships, and implementation of guidelines.

    Matched MeSH terms: Poverty
  6. Fulltext Current and future trends in socio-economic, demographic and governance factors affecting global primate conservation
    Estrada A, Garber PA, Chaudhary A
    PeerJ, 2020;8:e9816.
    PMID: 32884865 DOI: 10.7717/peerj.9816
    Currently, ~65% of extant primate species (ca 512 species) distributed in 91 countries in the Neotropics, mainland Africa, Madagascar, South Asia and Southeast Asia are threatened with extinction and 75% have declining populations as a result of deforestation and habitat loss resulting from increasing global market demands, and land conversion for industrial agriculture, cattle production and natural resource extraction. Other pressures that negatively impact primates are unsustainable bushmeat hunting, the illegal trade of primates as pets and as body parts, expanding road networks in previously isolated areas, zoonotic disease transmission and climate change. Here we examine current and future trends in several socio-economic factors directly or indirectly affecting primates to further our understanding of the interdependent relationship between human well-being, sustainable development, and primate population persistence. We found that between 2001 and 2018 ca 191 Mha of tropical forest (30% canopy cover) were lost as a result of human activities in the five primate range regions. Forty-six percent of this loss was in the Neotropics (Mexico, Central and South America), 30% in Southeast Asia, 21% in mainland Africa, 2% in Madagascar and 1% in South Asia. Countries with the greatest losses (ca 57% of total tree cover loss) were Brazil, Indonesia, DRC, China, and Malaysia. Together these countries harbor almost 50% of all extant primate species. In 2018, the world human population was estimated at ca 8bn people, ca 60% of which were found in primate range countries. Projections to 2050 and to 2100 indicate continued rapid growth of the human populations in these five primate range regions, with Africa surpassing all the other regions and totaling ca 4bn people by the year 2100. Socioeconomic indicators show that, compared to developed nations, most primate range countries are characterized by high levels of poverty and income inequality, low human development, low food security, high levels of corruption and weak governance. Models of Shared Socioeconomic Pathway scenarios (SSPs) projected to 2050 and 2100 showed that whereas practices of increasing inequality (SSP4) or unconstrained growth in economic output and energy use (SSP5) are projected to have dire consequences for human well-being and primate survivorship, practices of sustainability-focused growth and equality (SSP1) are expected to have a positive effect on maintaining biodiversity, protecting environments, and improving the human condition. These results stress that improving the well-being, health, and security of the current and future human populations in primate range countries are of paramount importance if we are to move forward with effective policies to protect the world's primate species and promote biodiversity conservation.
    Matched MeSH terms: Poverty
  7. Neglected diseases and ethnic minorities in the Western Pacific Region exploring the links
    Schratz A, Pineda MF, Reforma LG, Fox NM, Le Anh T, Tommaso Cavalli-Sforza L, et al.
    Adv Parasitol, 2010;72:79-107.
    PMID: 20624529 DOI: 10.1016/S0065-308X(10)72004-2
    Ethnic minority groups (EMGs) are often subject to exclusion, marginalization and poverty. These characteristics render them particularly vulnerable to neglected diseases, a diverse group of diseases that comprise bacteria, ecto-parasites, fungi, helminths and viruses. Despite the health policy relevance, only little is known of the epidemiological profile of neglected diseases among EMGs. We reviewed country data from Australia, Cambodia, Lao People's Democratic Republic, Malaysia, the Philippines and Vietnam and found several overlaps between regions with high proportions of EMG population and high prevalence rates of neglected diseases (infections with soil-transmitted helminths, filarial worms, schistosomes, food-borne trematodes and cestodes). While the links are not always clearly evident and it is impossible to establish correlations among highly aggregated data without control variables-such as environmental factors-there appear indeed to be important linkages between EMGs, socio-economic status and prevalence of neglected diseases. Some determinants under consideration are lack of access to health care and general health status, poverty and social marginalization, as well as education and literacy. Further research is needed to deepen the understanding of these linkages and to determine their public health and socio-economic significance. In particular, there is a need for more data from all countries in the Western Pacific Region that is disaggregated below the provincial level. Selected case studies that incorporate other control variables-such as risk factors from the physical environment-might be useful to inform policy makers about the feasibility of prevention and control interventions that are targeted at high-risk EMGs.
    Matched MeSH terms: Poverty
  8. Systemic Solutions for Addressing Non-Communicable Diseases in Low- and Middle-Income Countries
    Ganju A, Goulart AC, Ray A, Majumdar A, Jeffers BW, Llamosa G, et al.
    J Multidiscip Healthc, 2020;13:693-707.
    PMID: 32801732 DOI: 10.2147/JMDH.S252300
    Non-communicable diseases (NCDs) have been on the rise in low- and middle-income countries (LMICs) over the last few decades and represent a significant healthcare concern. Over 85% of "premature" deaths worldwide due to NCDs occur in the LMICs. NCDs are an economic burden on these countries, increasing their healthcare expenditure. However, targeting NCDs in LMICs is challenging due to evolving health systems and an emphasis on acute illness. The major issues include limitations with universal health coverage, regulations, funding, distribution and availability of the healthcare workforce, and availability of health data. Experts from across the health sector in LMICs formed a Think Tank to understand and examine the issues, and to offer potential opportunities that may address the rising burden of NCDs in these countries. This review presents the evidence and posits pragmatic solutions to combat NCDs.
    Matched MeSH terms: Poverty
  9. Fulltext Impact of socio-economic status on access and outcome of kidney transplantation in Malaysia
    Peter Gan Kim Soon, Sanjay Rampal, Lim Soo Kun, Tin Tin Su
    Malaysian Journal of Medicine and Health Sciences, 2019;15(106):33-33.
    MyJurnal
    Introduction: Low socio-economic status (SES) has been associated with poorer access and worse outcome in kid-ney transplantation (KT) for high-income countries. In contrast, relatively little is known about the KT access and outcome between the socio-economic gradient in Malaysia, which is a low- and middle-income country. The aim is to determine the association of SES with access and outcome of kidney transplantation in Malaysia. Methods: We examined the Malaysian National Renal Registry for kidney transplant candidates listed between 2002 to 2011. Cox’s regression was used to assess associations of SES with transplant access and outcome (survival). Results: 1234 patients were transplanted in 2002-2011 after excluding pediatric patients and multiple transplantations. The mean age of patients was 42.3 ± 12.3 years, 789 (63.9%) were male and 797 (65.0%) were of Chinese ethnicity. After multivariate adjustment, the highest income group were 20% less likely to access KT compared the lowest income group (adjusted HR=0.80, CI: [0.62, 1.04] producing trend for P-Value = 0.001. While patient with highest education were 50% more likely to survive compared to patient with lowest education (adjusted HR=0.50, CI: [0.34, 0.73] producing trend for P-Value < 0.001. Conclusion: Even in a healthcare system that is almost achieving universal health coverage, disparities exist in both extremes of the socio-economic gradient for the access and outcomes for KT in Malaysia. Reducing the SES disparities in KT will require policy initiatives addressing the components of SES (income, education, and employment) as well as the pathways by which this affect the health of KT patient.
    Matched MeSH terms: Poverty
  10. Fulltext Implementation of colorectal cancer screening interventions in low-income and middle-income countries: a scoping review protocol
    Schliemann D, Matovu N, Ramanathan K, Muñoz-Aguirre P, O'Neill C, Kee F, et al.
    BMJ Open, 2020 06 11;10(6):e037520.
    PMID: 32532782 DOI: 10.1136/bmjopen-2020-037520
    INTRODUCTION: Colorectal cancer (CRC) imposes a significant global burden of disease. CRC survival rates are much lower in low-income and middle-income countries (LMICs). Screening tends to lead to an improvement in cancer detection and the uptake of available treatments and, in turn, to better chances of cancer survival. Most evidence on CRC screening interventions comes from high-income countries. The objective of this scoping review is to map the available literature on the implementation of CRC screening interventions in LMICs.

    METHODS AND ANALYSIS: We will conduct a scoping review according to the framework proposed by Arksey and O'Malley (2005). We will search MEDLINE, EMBASE, Web of Science and Google Scholar using a combination of terms such as "colorectal cancer", "screening" and "low-middle-income countries". Studies of CRC screening interventions/programmes conducted in the general adult population in LMICs as well as policy reviews (of interventions in LMICs) and commentaries on challenges and opportunities of delivering CRC screening in LMICs, published in the English language before February 2020 will be included in this review. The title and abstract screen will be conducted by one reviewer and two reviewers will screen full-texts and extract data from included papers, independently, into a data charting template that will include criteria from an adapted template for intervention description and replication checklist and implementation considerations. The presentation of the scoping review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews guidance.

    ETHICS AND DISSEMINATION: There are no ethical concerns. The results will be used to inform colorectal screening interventions in LMICs. We will publish the findings in a peer-reviewed journal and present them at relevant conferences.

    Matched MeSH terms: Poverty
  11. Survey dataset on the level of sustainable consumption of Malaysian households from the perspective of income and consumption expenditure
    Rashid NKA, Sulaiman NFC, Anang Z, Possumah BT, Muhamad S, Sa'at NH, et al.
    Data Brief, 2021 Apr;35:106743.
    PMID: 33553520 DOI: 10.1016/j.dib.2021.106743
    Unsustainable consumption promotes discouraging patterns of consumption with negative impacts on society. It also contributes to inequalities and poverty. Unsustainable patterns of production and consumption undermine development goals in terms of inefficiency and overconsumption. This research explores the level of sustainable consumption of Malaysian households from the perspective of income and consumption expenditure. The analysis is based on cross-sectional data obtained from questionnaires distributed to 635 Malaysian households in eight districts in Terengganu (urban and rural areas) using stratified random sampling. The findings show that the level of sustainable consumption expenditure of Muslim households in Terengganu is still low. Achieving sustainable consumption patterns is more technically and politically complex than changing production patterns because it raises important issues such as human values, equity and lifestyle choices.
    Matched MeSH terms: Poverty
  12. Fulltext Opportunities and Challenges of Economic Development in Malaysia’s Rural Areas
    ELLFRELSTERN ANAK EDIRIN
    Trends in Undergraduate Research, 2018;1(1):0-0.
    MyJurnal
    Rural areas play traditionally important role for our economy as well maintaining social stability. Most of the development is entirely dependent on natural resources in the area which is specialized in a limited number of industries such as agriculture, livestock, forestry, fisheries and local tourism. People that live in rural areas have fewer choices in the social and economic terms. They are facing many problems such as low income, unemployment, low quality of social services like education and healthcare. In addition, remoteness from major urban centres is also one of the problems which is implying the need for well-developed transport infrastructure to support economic development. As stated in the Eleventh Malaysia Plan, the Malaysian Government is committed to ensuring equitable opportunities for all segments of society.
    Matched MeSH terms: Poverty
  13. Fulltext Impact of social isolation on mortality and morbidity in 20 high-income, middle-income and low-income countries in five continents
    Naito R, Leong DP, Bangdiwala SI, McKee M, Subramanian SV, Rangarajan S, et al.
    BMJ Glob Health, 2021 03;6(3).
    PMID: 33753400 DOI: 10.1136/bmjgh-2020-004124
    OBJECTIVE: To examine the association between social isolation and mortality and incident diseases in middle-aged adults in urban and rural communities from high-income, middle-income and low-income countries.

    DESIGN: Population-based prospective observational study.

    SETTING: Urban and rural communities in 20 high income, middle income and low income.

    PARTICIPANTS: 119 894 community-dwelling middle-aged adults.

    MAIN OUTCOME MEASURES: Associations of social isolation with mortality, cardiovascular death, non-cardiovascular death and incident diseases.

    RESULTS: Social isolation was more common in middle-income and high-income countries compared with low-income countries, in urban areas than rural areas, in older individuals and among women, those with less education and the unemployed. It was more frequent among smokers and those with a poorer diet. Social isolation was associated with greater risk of mortality (HR of 1.26, 95% CI: 1.17 to 1.36), incident stroke (HR: 1.23, 95% CI: 1.07 to 1.40), cardiovascular disease (HR: 1.15, 95% CI: 1.05 to 1.25) and pneumonia (HR: 1.22, 95% CI: 1.09 to 1.37), but not cancer. The associations between social isolation and mortality were observed in populations in high-income, middle-income and low-income countries (HR (95% CI): 1.69 (1.32 to 2.17), 1.27 (1.15 to 1.40) and 1.47 (1.25 to 1.73), respectively, interaction p=0.02). The HR associated with social isolation was greater in men than women and in younger than older individuals. Mediation analyses for the association between social isolation and mortality showed that unhealthy behaviours and comorbidities may account for about one-fifth of the association.

    CONCLUSION: Social isolation is associated with increased risk of mortality in countries at different economic levels. The increasing share of older people in populations in many countries argues for targeted strategies to mitigate its adverse effects.

    Matched MeSH terms: Poverty
  14. Fulltext Global, regional, and national trends and patterns in physical activity research since 1950: a systematic review
    Ramírez Varela A, Cruz GIN, Hallal P, Blumenberg C, da Silva SG, Salvo D, et al.
    Int J Behav Nutr Phys Act, 2021 01 07;18(1):5.
    PMID: 33413479 DOI: 10.1186/s12966-020-01071-x
    BACKGROUND: National, regional and global scientific production and research capacity for physical activity - PA may contribute to improving public health PA policies and programs. There is an uneven distribution of research productivity by region and country income group, where countries with the highest burden of non-communicable diseases attributable to physical inactivity having low research productivity. A first step towards improving global research capacity is to objectively quantify patterns, trends, and gaps in PA research. This study describes national, regional and global trends and patterns of PA research from 1950 to 2019.

    METHODS: A systematic review using searches in PubMed, SCOPUS and ISI Web of Knowledge databases was conducted in August 2017 and updated between January and May 2020. The review was registered at the PROSPERO database number CRD42017070153. PA publications per 100,000 inhabitants per country was the main variable of interest. Descriptive and time-trend analyses were conducted in STATA version 16.0.

    RESULTS: The search retrieved 555,468 articles of which 75,756 were duplicates, leaving 479,712 eligible articles. After reviewing inclusion and exclusion criteria, 23,860 were eligible for data extraction. Eighty-one percent of countries (n = 176) had at least one PA publication. The overall worldwide publication rate in the PA field was 0.46 articles per 100,000 inhabitants. Europe had the highest rate (1.44 articles per 100,000 inhabitants) and South East Asia had the lowest (0.04 articles per 100,000 inhabitants). A more than a 50-fold difference in publications per 100,000 inhabitants was identified between high and low-income countries. The least productive and poorest regions have rates resembling previous decades of the most productive and the richest.

    CONCLUSION: This study showed an increasing number of publications over the last 60 years with a growing number of disciplines and research methods over time. However, striking inequities were revealed and the knowledge gap across geographic regions and by country income groups was substantial over time. The need for regular global surveillance of PA research, particularly in countries with the largest data gaps is clear. A focus on the public health impact and global equity of research will be an important contribution to making the world more active.

    Matched MeSH terms: Poverty
  15. Fulltext Infectious diseases and malnutrition status in Nepal: an overview
    Rai, Shiba Kumar, Hirai, Kazuko, Abe, Ayako, Ohno, Yoshimi
    Malays J Nutr, 2002;8(2):191-200.
    MyJurnal
    This paper sheds light on infectious diseases and the status of malnutrition in Nepal, a Himalayan country located in South Asia. In spite of efforts by both Government and non-government sectors, infectious diseases are rampant in the countries constituting a major cause of morbidity and mortality, which in turn, impose a socio-economic and public health burden for the country. Intestinal parasitic infection has been implicated in the causation of malnutrition. Malnutrition associated with child mortality is more common among children aged less than five years. Nepalese women suffer from chronic malnutrition. People in rural areas are more affected by malnutrition than those in urban areas. This has been attributed to poverty, lack of education, and rampant infectious diseases.
    Matched MeSH terms: Poverty
  16. The Impact of Quality Improvement Interventions in Improving Surgical Infections and Mortality in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis
    Jin J, Akau Ola S, Yip CH, Nthumba P, Ameh EA, de Jonge S, et al.
    World J Surg, 2021 10;45(10):2993-3006.
    PMID: 34218314 DOI: 10.1007/s00268-021-06208-y
    BACKGROUND: Morbidity and mortality in surgical systems in low- and middle-income countries (LMICs) remain high compared to high-income countries. Quality improvement processes, interventions, and structure are essential in the effort to improve peri-operative outcomes.

    METHODS: A systematic review and meta-analysis of interventional studies assessing quality improvement processes, interventions, and structure in developing country surgical systems was conducted according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they were conducted in an LMIC, occurred in a surgical setting, and measured the effect of an implementation and its impact. The primary outcome was mortality, and secondary outcomes were rates of rates of hospital-acquired infection (HAI) and surgical site infections (SSI). Prospero Registration: CRD42020171542.

    RESULT: Of 38,273 search results, 31 studies were included in a qualitative synthesis, and 28 articles were included in a meta-analysis. Implementation of multimodal bundled interventions reduced the incidence of HAI by a relative risk (RR) of 0.39 (95%CI 0.26 to 0.59), the effect of hand hygiene interventions on HAIs showed a non-significant effect of RR of 0.69 (0.46-1.05). The WHO Safe Surgery Checklist reduced mortality by RR 0.68 (0.49 to 0.95) and SSI by RR 0.50 (0.33 to 0.63) and antimicrobial stewardship interventions reduced SSI by RR 0.67 (0.48-0.93).

    CONCLUSION: There is evidence that a number of quality improvement processes, interventions and structural changes can improve mortality, HAI and SSI outcomes in the peri-operative setting in LMICs.

    Matched MeSH terms: Poverty
  17. Fulltext Assessment of physical inactivity and its associated factors among type 2 diabetes mellitus patients in a university primary clinic in Kuala Lumpur
    Azmawati, M.N., Siti Norbayah, Y.
    Malays J Nutr, 2014;20(3):339-349.
    MyJurnal
    Introduction: The prevalence of type 2 diabetes mellitus (T2DM) is on the rise in Malaysia. Physical inactivity is common among T2DM patients and is an important aspect that warrants action as it may lead to poor glycemic control. The objective of this cross-sectional study was to assess the prevalence of physical inactivity and its associated factors among T2DM patients.
    Methods: The sample consisted of 121 T2DM patients aged 18 to 65 years who attended the UKMMC primary clinic for routine follow up. A questionnaire consisting of three sections was used to collect the data: (i) socio-economic and diabetes-related factors; (ii) physical inactivity using shortened International Physical Activity Questionnaire (IPAQ); and (iii) five domains leading to physical inactivity.
    Results: The mean age of the sample was found to be 56.2 ± 8.5 years; 55% were physically inactive; 76% had low education; 55.4% had low income; 76% had poor glycemic control; and mean duration of illness was 7.8 ± 6.9 years. Factors significantly associated with physical inactivity were presence of health complications (x2 = 5.89; p=0.015) and factor domains of 'respondent's current physical health' (t=5.88, p<0.001), 'availability of facility' (t=3.45, p<0.001), 'availability of time' (t=3.57, p<0.001) and 'respondent's perception of possibility of sustaining pain and injury during physical activity' (t=3.64, p<0.001). Using multiple logistic regression, only factors of 'physical health factor' (Adjusted OR: 1.58, confidence interval 95% (CI 95%): 1.31-1.92, p<0.001) and 'time' (adjusted OR: 1.27, CI 95%: 1.12-1.45, p<0.001) were found to be associated with higher odds for physical inactivity.
    Conclusion: The results indicate that facility availability, time management and better management of health complications could increase physical activity among T2DM patients.
    Key words: Physical inactivity, type 2 diabetes
    Study site: Pusat Perubatan Universiti Kebangssan Malaysia (PPUKM) primary care clinic, Cheras, Kuala Lumpur, Malaysia
    Matched MeSH terms: Poverty
  18. Fulltext Asian men’s health: gender disparity and life expectancy
    Ho, Christopher C.K., Teo, C.H., Ng, C.J., Zulkifli, M.Z., Tan, M.H.
    Journal of Surgical Academia, 2014;4(2):5-8.
    MyJurnal
    The aim of this review was to analyze the gender disparities found as well as the life expectancies in Asia. An analysis of the data on gender disparities as well as life expectancies of the different Asian countries was done based on the World Health Organization (WHO) Global Health Observatory Data Repository as well as the regional government databases. Middle Eastern countries have the highest male to female population ratio. The results show that in terms of population pyramid, Asia is moving towards a more geriatric population. Qatar has the highest life expectancy for men and is the only country in Asia where men live longer than women (difference of 2 years). In general, women in Asia live longer than men. High income countries like Hong Kong, Japan and Singapore have higher life expectancies as compared to those on the lower income nations. The life expectancy of Asian men still lags women. Men’s health care needs to be addressed urgently. The disparity in income-status reflecting the lifespan of men is an impetus for us to narrow the gap of health in Asian countries.
    Matched MeSH terms: Poverty
  19. Fulltext Breastfeeding practices in a rural community in Kedah
    Yadav, H.
    JUMMEC, 2010;13(1):38-44.
    MyJurnal
    Breast feeding has been actively encouraged in Malaysia in the last few years in all public hospitals. This study proposes to find out the prevalence of breast feeding in three villages in a rural community in Kedah, Malaysia. This was a cross sectional study on breastfeeding practices in Kubang Pasu, a district of Kedah. Majority of the mothers initiated breast feeding but exclusive breastfeeding was only 21% for four months and predominant breastfeeding was about 12.6%. The breastfeeding practice was more prevalent among women from the higher educational strata and higher income than those from the lower strata and lower income (p
    Matched MeSH terms: Poverty
  20. Fulltext Systems perspectives in agricultural education, research and development: A vision for sustaining food security in Asia
    C. Devendra
    ASM Science Journal, 2013;7(2):152-165.
    MyJurnal
    Systems perspectives are fundamental in driving technological improvements and yield-enhancing strategies that improve agricultural productivity. These can resolve farmerʼs problems and are important pathways for sustaining food and nutritional security for human welfare in Asia. The essential determinants of this objective are the capacity to efficiently manage the natural resource base (land, crops, animals, and water) to resolve constraints to farming systems, and notably the integration of multiple research and development (R&D) issues through all levels of formal and non-formal learning systems. Both formal and informal education systems are important, with the former relating more to universities and colleges, and the latter to the intermediate level. Graduates from this level have the primary responsibility of introducing improved technologies and change to farmers, mainly along production and disciplinary pathways.The traditional research–extension–farmer model for technology delivery is no longer acceptable, due to “top down” extension functions and prescriptions, ineffectiveness to cope with the dynamics of production systems, complex interactions within the natural resources, effects of climate change and globalisation. There are also reservations on the technical capacity and skills of extension agents, constraints identification, methods for technology diffusion and dissemination, and innovative use of beneficial technological improvements that can directly respond to the needs of small farmers, and impact on subsistence agriculture. Agricultural education and systems perspectives are therefore an overriding compelling necessity which transcends prevailing limitations to waning agriculture and rural growth. Their wider recognition and applications provides an important means to maximise efficiency in the potential use; of the natural resources, increase engagement and investments in agriculture, promote ways to become more self-reliant in the development of crucial new technologies and intensification. These together can meet the challenges of the future and overcome the legacy of continuing poverty, food and nutritional insecurity. Asian farming systems, with their diversity of crops and animals, traditional methods, multiple crop-animal interactions, numerous problems of farmers present increasingly complex issues of natural resource management (NRM) and the environment. Many if not all of these can only be resolved by interdisciplinary R&D, which overcomes a major weakness of many R&D programmes presently and in the past. Improved education and training is a powerful and important driver of community-based participation aimed at enhancing sustainable food security, poverty reduction and social equity in which the empowerment of women in activities that support organising themselves is also an important pathway to enhance self-reliance and their contribution to agriculture. A vision for the future in which improved agricultural education in a systems context can provide the pathway to directly benefit the revitalisation of agriculture and agricultural development is proposed with a three-pronged strategy as follows:
    Define policy for the development of appropriate curricular for formal agricultural education that provides strong multi-disciplinary orientation and improved understanding of the natural resources (land, crops, animals and water) and their interactions
    Organise formal degree education and specialisation at the university level that reflects strong training in understanding of agricultural systems; systems perspectives, methodologies and their application, and
    Define non-formal education and training needs that can be intensified at different levels, including the trainin of trainers as agents of change.
    Matched MeSH terms: Poverty
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