Food borne diseases increase worldwide and contamination of food contact surfaces serves as one of the reasons for their occurrence. The aim of this study was to determine the microbiological quality of spoons at selected restaurants in Klang Valley, Malaysia. Five restaurants were selected therein for the study. They were respectively labelled A, B, C, D and E. A total of 150 cleaned spoons (30 spoons from each restaurants) that were ready to be used by customers at the restaurants were examined. Total plate counts (CFU/cm2) of the spoons were determined; the presumptive and confirmatory tests for the presence of Escherichia coli on the spoons were also conducted. The samples were collected by surface swabbing. The result showed that restaurant C and B had the highest and lowest total plate counts (TPC), respectively. Samples from 3 of the 5 selected restaurants (restaurants C, D and E) showed positive results for the presence of E. coli mainly due to poor dishware cleansing. On the contrary, negative results for the presence of E. coli at restaurant A and B were associated with the advance cleaning procedure, which used more hygienic method with dishwashers.
Citation: Mohamad Noh K, Jaafar S. Health in all policies: The primary health care approach in Malaysia. 50-years experience in addressing social determinants of health through Intersectoral Action for Health. World Conference on Social Determinants of Health. 19-21 October 2011, Rio de Janeiro, Brazil.
At Independence in 1957, Malaysia inherited a rural urban divide and racial identification of specific economic functions. Thus, the government’s welfarist policy was on growth with equity. This entailed the formulation of national social policies to reduce poverty and at the same time to restructure society by addressing economic imbalances and eventually eliminating racial identification of specific economic functions. The poverty reduction approaches placed a strong emphasis on rural socio-economic development addressing the social determinants of health. This approach has served Malaysia well over the decades but since the 1990s Malaysia has been caught in a middle income trap. Realising that achieving a high income nation status by 2020 is not possible at the present economic trajectory, Malaysia has now embarked on a national transformation agenda based on the four pillars of inculcating the cultural and societal values under the 1Malaysia Concept and the twin commitments of people first in all policies & projects and performance now; a government transformation programme (GTP); macroeconomic policies under the economic transformation programme (ETP); and the operationalisation of these policies through the 10th Malaysia Plan. The highest political commitment is given to the implementation of these national policies by the various agencies, orchestrated and coordinated by a central planning process which cascades down to the state and district administrative levels of the government machinery. The health policies follow these national policies and the thrust of the Malaysian health care system is primary health care, supported by an inclusive referral system to decentralized secondary care and regionalized tertiary care. This model of comprehensive public primary health care delivers promotive, preventive, curative and rehabilitative care across the life course. The network of static health facilities is organized into a two-tier system which includes outreach services for remote areas. Community participation is encouraged through village health promoters, health volunteers and advisory panels. The primary health care approach has delivered increased access to health care at a relatively low-cost. This has translated into health gains for the Malaysian population comparable with countries of similar economic development. As Malaysia moves towards a high income nation status, as demographic and epidemiological transitions continue, and as new health technology develops, the demand for health care by the - Draft Background Paper 7 - 2 population will continue to rise with increasing expectations for more care of even higher quality, and at ever increasing cost. This is especially challenging as Malaysia’s open economy is yet to recover fully from the Asian financial crisis of 1997. The government transformation programme, with its focus on a whole-of-government approach, is a natural progression for the primary health care approach to addressing the social determinants of health as a vehicle for social justice to reduce health inequalities.
Public health nursingis a specialized nursing combining both nursing and public health principles with the primary focus of improving the health of the whole community rather than just an individual. Its documented history started in the 1800s and has evolved from home visiting to the varied settings that public health nurses find themselves working in as members of public health teams in clinics, schools, workplaces and government health departments.Public health nursing has been a critical component of the country’s health care system, uplifting of the health status of Malaysians and playing a dominant role in the fight against communicable diseases, and is set to face the challenges of the 21st century with public health nurses practising to the full capacity of their training in a restructured Malaysian health system – 1Care for 1Malaysia. The health sector reform allows for optimisation of scarce health care resources to deliver expansion of quality services based on needs, appropriateness, equity &allocative efficiency. The proposed model will be better than the current system, preserving the strengths of the current system but able to respond to increasing population health needs and expectations. There will be increased autonomy for healthcare providers with incentives in place for greater performance. Some of the implications of reform include allowing public- private integration, a slimmer Ministry of Health with a stronger governance role, enhancing the gatekeeping role of the primary care providers and the autonomous management of the public healthcare providers. In this restructured health system, the roles of the public health nurses are no less important than in the current one. In fact, with the increasing emphasis placed on prevention and primary care as the hub of community care with nurses as part of the primary care team delivering continuous comprehensive person-centered care,public health nurses in the future will be able to meet the challenge of refocusing on the true mission of public health: to look at the health problems of a community as a whole and work with the community in alleviating those problems by applying the nursing process to improve health, not just as providers of personal care only.
The tenth edition of this extraordinary dermatologic congress was held in the Crowne Plaza Hotel in the magnificent Kuwait City on April 23-25, 2019, thanks to the patronage of His Excellency, the Honorable Dr. Basel H Al-Sabah, Minister of Health, Kuwait. It was organized and shepherded by the renowned Chairman of the Dermatology Council in Kuwait, Professor Nawaf Al-Mutairi, FRCP Edin This article is protected by copyright. All rights reserved.
Citation: National Antimicrobial Guideline, Third Edition. Petaling Jaya: Ministry of Health, Malaysia; 2019
Older version:
National Antibiotic Guideline, Second Edition. Petaling Jaya: Ministry of Health, Malaysia; 2014. https://www.pharmacy.gov.my/v2/sites/default/files/document-upload/national-antibiotic-guideline-2014-full-versionjun2015_1.pdf
National Antibiotic Guideline. Petaling Jaya: Ministry of Health, Malaysia; 2008
Aims: The aim of this study was to determine the depth of knowledge about osteoporosis (OP) among the public in Malaysia. Methods: A self-administered questionnaire was distributed to attendees of selected health-related public forums in the Klang Valley and Seremban between the months of May to October 2005. Results: 483 questionnaires were returned from 600 given out (80.5%). There were 139 (28.8%) male, 338 (70%) female respondents and 6 (1.2%) not stated. 87.1% respondents had heard of OP. Significantly more women than men had heard of OP (p = 0.015). Mean age was 50.15 ± 14.6 years, 56.7% in the range of 45-64 years. There was no significant difference in the ages of those who had heard of OP and those who had not. 180/338 (53.3%) were postmenopausal females. Those with >10 years of schooling were more likely to have heard of OP (p RM 1000/month (US$270) were more likely to have heard of OP (p =0.022). 22.6% had a positive family history of OP. 63.1% exercised regularly at an average of 4.26 ± 2.78 hours/week. 4.8% were smokers with a median of 10 cigarettes/day. 24.4% drank alcohol with a median of 1 drink/week. However, 70.9% of respondents said that OP led to falls. 89.6% were concerned about osteoporosis. 90.7% agreed that osteoporosis would make daily activities more difficult. The majority obtained their information about osteoporosis from the printed word; newspapers 55.7%, magazines 46.4%, posters/brochures 30.2%, followed by public talks 30%, relatives 29.6%, television 22.8%, medical clinic 22.6% and internet 11.4%. The majority would ask for more information on osteoporosis from their general practitioner 30.6%, followed by other medical specialists such as orthopaedic surgeons 28.4%, hospital specialists 23.8%, rheumatologists 22.4%, followed by friends 15.9%, relatives 14.3% and pharmacists 11.4%. In this self-selected population, knowledge of OP was better among women, the better educated and those earning a higher level of income. Almost 90% of respondents were concerned about getting OP. Their knowledge of OP was obtained from the printed word, which is an important consideration when considering health promotion activities. General practitioners and orthopaedic surgeons need to have a good knowledge of OP.
An estuarine species of Nereididae (Annelida), Neanthesglandicincta (Southern, 1921) has been newly recorded on the eastern coast of Peninsular Malaysia located in the South China Sea based on 23 specimens collected from three estuaries (Tumpat, Kelantan Delta, Kelantan; Setiu Lagoon, Terengganu; Kuala Ibai, Terengganu). The morphological characteristics of the Malaysian specimens agree well with those of the previous original description and the redescription of N.glandicincta based on Indian, Myanmar and Singapore specimens. The number of paragnaths in all groups on the proboscis of our Malaysian specimens is within the range of the intraspecific variation of N.glandicincta as shown in the previous descriptions. An identification key to species of the Neanthesglandicincta species complex, which includes two morphologically similar species, is provided.
Osteoporosis only became a 'disease' entity in the 20th century. After the initial observations and definitions of osteoporosis based on Caucasian populations, systematic research in Asian populations started in the 1980s. Significant variations between different ethnic groups with respect to the rate of osteoporotic fractures, bone mineral density and disease risk factors emerged from the data; this article highlights some of the earlier important findings and the dissimilarities. Osteoporosis is therefore not a homogeneous disease across the world.
The measurement of this data aims to evaluate the wind shear variability at three selected sites in Malaysia. The sites are Kudat in Sabah, Kijal in Terengganu and Langkawi in Kedah. Both sites in Kudat and Kijal is located in coastal areas with few buildings or trees, while the site in Langkawi is a coastal area with many buildings or trees. The variables were measured using the sensors that mounted on the wind mast with the maximum height from 55 m to 70 m from ground level. The variables measured were wind speed, wind direction, temperature, and pressure, while the wind shear data were directly generated using the power law equation. The averaged wind shear based on measured multiple height wind speed at selected sites is larger than the 1/7 law (0.143). Also, the value of wind shear was higher in order Langkawi > Kudat > Kijal. Ultimately, the wind shear data are essential and can be reused in the wind energy potential study, especially for data extrapolation to desired wind turbine hub height.
Palm oil mill effluent (POME) is a serious and expensive environmental problem in Malaysia. In this paper, CaFe2O4 is introduced as a novel photocatalyst for the degradation of POME under visible light irradiation. Two synthesis routes, auto-combustion and co-precipitation, and two calcination temperatures 550 °C and 700 °C were used to produce four CaFe2O4 catalysts AC550, AC700, CP550 and CP700. CP550 exhibited the greatest photocatalytic degradation at 56% chemical-oxygen-demand (COD) removal after 8 h of irradiation which dropped to 49% after three consecutive cycles indicating reasonable conversion and high recyclability. BET analysis indicated CP550 had the highest SBET (27.28 m2/g) and pore volume (0.077 cm3/g) which dropped precipitously for CP700 upon increasing the calcination temperature to an SBET of 9.73 m2/g and pore volume of 0.025 cm3/g due to annealing which created a smoother surface area as evidenced by the SEM images. UV-Vis DRS indicated CP550 had the highest band-gap (1.52 eV) which is likely due to the presence of a highly crystalline pure CaFe2O4 phase compared to the other products which existed as a mixture of Fe oxidation states evidenced by the XRD data. The PL spectra for all catalysts indicated significantly lower recombination rate for both CP550 and CP700. Introduction of IPA into the reaction mixture to eliminate hydroxyl radicals resulted in a diminishing of COD removal from 56% to 7% proving hydroxyl radicals to be the primary reactive species responsible for photodegradation of POME.
Health care services are not often accessible and available for all people in one country due to multiple reasons such as the geographical barrier, affordability, etc. The aim of this study was to analyse willingness to pay (WTP) for healthcare services user fees among Malaysian population and determine its’ influencing factors. Structured interviews were conducted involving 774 households in 4 states represents Peninsular Malaysia. Validated questionnaires with open ended, followed by bidding games were applied to elicit maximum amount of WTP. The study was analysed descriptively and with multivariate regression method to adjust for potential confounding factors. More than half of respondents WTP more than current fee for the government clinic outpatient registration fee with mean MYR3.76 (SD2.71). Majority of respondents not WTP more than usual for private clinic simple outpatient treatment charges with the mean MYR38.76 (SD5.45). Factors that were found to have significant associations with WTP for both government and private clinic were income and having health insurance. Community willing to pay for healthcare services user fees and charges but at certain amount. The healthcare services user fees and charges can be increased up to community WTP level to avoid from catastrophic expenditure.
BACKGROUND: Epidemiological studies conducted in various parts of the world have clearly demonstrated that metabolic syndrome (MetS) is an increasing global health problem, not only in Western societies but also in Asian populations. Web-based and mobile phone-based self-management applications have been proven to be effective in improving self-management behaviour of patients with MetS components (i.e., diabetes or hypertension). However, evidence is lacking in terms of their effectiveness specifically for patients with MetS. The aim of this pilot study is to evaluate the feasibility and potential effectiveness of the EMPOWER-SUSTAIN Self-Management e-Health Intervention in improving activation and self-management behaviours among patients with MetS. This paper presents the study protocol.
METHODS: A pilot randomised controlled trial will be conducted in a university primary care clinic. A total of 232 patients aged 18-60 years with MetS will be recruited; 116 will be randomised to receive the EMPOWER-SUSTAIN intervention for 6 months, and another 116 patients will continue with usual care. The EMPOWER-SUSTAIN intervention is a multifaceted chronic disease management strategy based on the Chronic Care Model and persuasive technology theory. It consists of training primary care physicians, nurses and patients to use the EMPOWER-SUSTAIN web-based self-management mobile app, strengthening the patient-physician relationship and reinforcing the use of relevant clinical practice guidelines to guide management and prescribing. The primary outcome is the mean change in patient activation score using the Patient Activation Measure short form Malay version (PAM-13-M) questionnaire. The secondary outcomes include the changes in waist circumference, body mass index, blood pressure, patient physical activity level, eating behaviour, perception of chronic illness care, satisfaction with patient-physician interaction, and perceived absolute 10-year cardiovascular disease risk. Feasibility of implementing the intervention will be evaluated. This includes acceptability of the intervention, estimating the likely rate of participant recruitment and retention, appropriateness of the outcome measures, calculation of sample size, and the intervention's potential effectiveness.
CONCLUSION: To our knowledge, this is the first study in Malaysia that aims to determine the feasibility of a multifaceted e-health intervention, as well as to indicate more useful aspects of this intervention for further exploration in a larger trial.
TRIAL REGISTRATION: ClinicalTrials.gov, NCT04120779. Registered on 9 October 2019, protocol version 1.
This report describes Thismia belumensis Siti-Munirah & Suhaimi-Miloko, a novel species of achlorophyllous herb discovered in the Royal Belum State Park, Peninsular Malaysia. This new species is unlike any previously described species of Thismia. In particular, T. belumensis possesses a unique annulus, which has been expanded and modified into a cucullate (hood-like) structure. This structure covers the apical floral tube and has an opening on one side facing a thickened part of the annulus, and the off-centre floral aperture confers a zygomorphic symmetry to the flower, indicating T. belumensis is more similar to Thismia labiata J.J.Sm. This morphological detail makes this new species distinct from all other described species of Thismia. In this report, we provide descriptions, illustrations, colour plates, and the provisional conservation status of Thismia belumensis.
The technical feasibility of TiO2-photocatalysis towards palm oil mill effluent (POME) treatment is well-proven in previous studies. As a continuity, current study evaluated the strengths, weaknesses, opportunities and threats (SWOT) in a concise manner, subsequently discussed its practicality in palm oil industry of Malaysia. Indeed, TiO2-photocatalysis displays a promising technical feasibility in treating POME, but its wide application is economically-suppressed. It is positing that biological-based treatments (including the existing open-ponding system) are more likely to be employed as the major treating approach for POME over TiO2-photocatalysis. This is particularly true as biological-based treatments offer better performance index for concentrated POME with comparatively lower treatment cost and technicality needed. Furthermore, it is also prevailed with high biogas generability, therefore being irreplaceably benchmarked for POME treatment in Malaysia. Instead of replacing biological treatment entirely, the adoption of TiO2-photocatalysis as complementing tertiary treatment for biological-treated-POME is more practical, bestowed to its robust organic-mineralizing feature for low concentration POME. Such integrated system is expected to augment the POME degradation efficiency, hence effectively preserve the environment from POME pollution.
Ethics is a philosophical branch of inquiry that reasons between what is right and wrong. The moral philosophy of Socrates, Aristotle, and Plato from ancient Greek became the basis of most of the western ethics. These days, ethics can be divided based on its inquiries for example, normative, descriptive, metaethics, and applied ethics or based on its theories like utilitarianism, emotivism, and universal ethics. In context with applied ethics that examines issues involving emerging technologies, this study will look into the ethics of Malaysian stem cell technology based on written literature. It was mainly to identify Malaysian literature on stem cell ethics through conventional search since the mainstream international database indicated an obvious shortage. The critical review of this literature will facilitate in the understanding of unique position of Malaysia towards stem cell and its ethics in reference to the limited number. Despite the limitation, this can be a preliminary study urging for more inquiries and exploration to fulfil the multiple perspectives in ethics such as the diversity of Malaysian ethics, the impact of ethics in stem cell regulation in Malaysia, and if western contemporary ethics influences Malaysian ethics particularly involving stem cell technology.
Conference abstract:
Hypertension is the leading cause of mortality worldwide. It is highly prevalent throughout the world. Even in regions liike South-East Asia (SEA) which has been perceived to be less prone to cardiovascular diseases, the prevalence of hypertension has been reported to be around 35% (1). Awareness and control of hypertension in SEA is also low, both being less than 50% each (2).Control of hypertension is an interplay between patients, doctors and system factors. One of the reasons for poor control of hypertension is resistant hypertension. Resistant hypertension is defined as blood presure that remains above goal despite being on three concurrent anti-hypertensive medications preferbaly one of which is a diuretic (3).True resistant hypertension should be differiented from secondary hypertension and pseudo-resistant hypertension. Resistant hypertension is almost always multi-factorial in aetiology. The exact prevalence of resistant hypertenion even in developed countries is not known It has been estimated that it is as high as 20-30% in clinical trial patients (4)Not many studies about resistant hypertension have been done in SEA but one done in an outpatient clinic in Thailand found it to be 7.82% Another study also done in a primary care clinc in Malaysia on 1217 patients with hypertension found the prevalence of resistant hypertension to be 8.8%. (6) Here it was found that the presence of chronic kidney disease was more likely to be associated with resistant hypertension (odds ratio [OR] 2.89, 95% confidence interval [CI] 1.56-5.35). Other factors like increasing age, female gender, presence of diabetes, obesity and left ventricular hypertrophyage which have been found to be predictors of resistant hypertension in other studies in the west were not seen in this study. There are various reasons for these findingsBut whatever the factors are that are associated with uncontrolled hypertension, the task is to sort out true resistant hypertension from pseudo-resistant hypertension and secondary casues of hypertension which may be treatable. A concerted effort is needed to reduce the BP in resistant hypertension. Failure to do so would mean a substantal increase in CV risk for the patient.