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Fulltext Food consumption and expenditures in Singapore: implications to Malaysia’s agricultural exports

Tey, Y.S., Suryani, D., Emmy, F.A., Illisriyani, I.

International Food Research Journal, 2009;16(2):119-126.
MyJurnal

Imports are the only source of food supply to Singapore. Such condition offers a very attractive proposition for agricultural oriented countries. The dependence on type of food imports is determined by consumer demand. This study intends to do an exploratory study on the current conditions of Singaporean food consumption and expenditures with implications on Malaysia as an important agricultural exporting country to Singapore. It is identified that Singaporean consumers tend to demand for high quality poultry, pork, seafood, vegetables, and fruits in future, particularly in response to income growth. At the mean time, Malaysia is seemingly rich in the production of these food commodities and commits to exports for the excess of the supplies. While facing competition from various countries, Malaysia still possesses various competitive advantages over the other countries.

Matched MeSH terms: Income
Forfeiture of the profits and proceeds derived from drug trafficking: thoughts on future action in Malaysia

Vohrah KC

Bull Narc, 1984 Oct-Dec;36(4):31-41.
PMID: 6570698

While the Dangerous Drugs Act 1952 of Malaysia has been amended to take into account changing patterns of drug abuse and trafficking, it lacks provisions for the mandatory forfeiture of proceeds derived from drug trafficking. Nor do the general powers of forfeiture in the Criminal Procedure Code of the country extend to such proceeds. To meet further changing patterns of drug trafficking involving criminal syndicate leaders, who rarely incriminate themselves through overt and detectable acts, Malaysia has a bill in Parliament the purpose of which, when it becomes law, is to detain without trial, upon cogent evidence, persons who have been associated with any activity relating to or involving drug trafficking, and to prevent them from further committing drug crimes. In addition, serious thinking has been given to the possibility of adopting, within the constraints of the Malaysian Constitution, a law on forfeiture of the proceeds derived from drug trafficking. There are, in this respect, several problems to be resolved, such as the secrecy of bank accounts and taxpayers' returns, which might make it difficult to trace proceeds and to keep track of tainted money being remitted abroad, although it is believed that such problems could be overcome by domestic measures. A more serious problem is the lack of international co-operation for investigations to be carried out outside national borders to trace, seize, freeze and secure the forfeiture of the proceeds of drug crimes located abroad.

Matched MeSH terms: Income*
Fulltext Fostering global primary care research: a capacity-building approach

Ponka D, Coffman M, Fraser-Barclay KE, Fortier RDW, Howe A, Kidd M, et al.

BMJ Glob Health, 2020 07;5(7).
PMID: 32624501 DOI: 10.1136/bmjgh-2020-002470

The Alma Ata and Astana Declarations reaffirm the importance of high-quality primary healthcare (PHC), yet the capacity to undertake PHC research-a core element of high-quality PHC-in low-income and middle-income countries (LMIC) is limited. Our aim is to explore the current risks or barriers to primary care research capacity building, identify the ongoing tensions that need to be resolved and offer some solutions, focusing on emerging contexts. This paper arose from a workshop held at the 2019 North American Primary Care Research Group Annual Meeting addressing research capacity building in LMICs. Five case studies (three from Africa, one from South-East Asia and one from South America) illustrate tensions and solutions to strengthening PHC research around the world. Research must be conducted in local contexts and be responsive to the needs of patients, populations and practitioners in the community. The case studies exemplify that research capacity can be strengthened at the micro (practice), meso (institutional) and macro (national policy and international collaboration) levels. Clinicians may lack coverage to enable research time; however, practice-based research is precisely the most relevant for PHC. Increasing research capacity requires local skills, training, investment in infrastructure, and support of local academics and PHC service providers to select, host and manage locally needed research, as well as to disseminate findings to impact local practice and policy. Reliance on funding from high-income countries may limit projects of higher priority in LMIC, and 'brain drain' may reduce available research support; however, we provide recommendations on how to deal with these tensions.

Matched MeSH terms: Income
Fulltext Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study

Miller V, Mente A, Dehghan M, Rangarajan S, Zhang X, Swaminathan S, et al.

Lancet, 2017 Nov 04;390(10107):2037-2049.
PMID: 28864331 DOI: 10.1016/S0140-6736(17)32253-5

BACKGROUND: The association between intake of fruits, vegetables, and legumes with cardiovascular disease and deaths has been investigated extensively in Europe, the USA, Japan, and China, but little or no data are available from the Middle East, South America, Africa, or south Asia.
METHODS: We did a prospective cohort study (Prospective Urban Rural Epidemiology [PURE] in 135 335 individuals aged 35 to 70 years without cardiovascular disease from 613 communities in 18 low-income, middle-income, and high-income countries in seven geographical regions: North America and Europe, South America, the Middle East, south Asia, China, southeast Asia, and Africa. We documented their diet using country-specific food frequency questionnaires at baseline. Standardised questionnaires were used to collect information about demographic factors, socioeconomic status (education, income, and employment), lifestyle (smoking, physical activity, and alcohol intake), health history and medication use, and family history of cardiovascular disease. The follow-up period varied based on the date when recruitment began at each site or country. The main clinical outcomes were major cardiovascular disease (defined as death from cardiovascular causes and non-fatal myocardial infarction, stroke, and heart failure), fatal and non-fatal myocardial infarction, fatal and non-fatal strokes, cardiovascular mortality, non-cardiovascular mortality, and total mortality. Cox frailty models with random effects were used to assess associations between fruit, vegetable, and legume consumption with risk of cardiovascular disease events and mortality.
FINDINGS: Participants were enrolled into the study between Jan 1, 2003, and March 31, 2013. For the current analysis, we included all unrefuted outcome events in the PURE study database through March 31, 2017. Overall, combined mean fruit, vegetable and legume intake was 3·91 (SD 2·77) servings per day. During a median 7·4 years (5·5-9·3) of follow-up, 4784 major cardiovascular disease events, 1649 cardiovascular deaths, and 5796 total deaths were documented. Higher total fruit, vegetable, and legume intake was inversely associated with major cardiovascular disease, myocardial infarction, cardiovascular mortality, non-cardiovascular mortality, and total mortality in the models adjusted for age, sex, and centre (random effect). The estimates were substantially attenuated in the multivariable adjusted models for major cardiovascular disease (hazard ratio [HR] 0·90, 95% CI 0·74-1·10, ptrend=0·1301), myocardial infarction (0·99, 0·74-1·31; ptrend=0·2033), stroke (0·92, 0·67-1·25; ptrend=0·7092), cardiovascular mortality (0·73, 0·53-1·02; ptrend=0·0568), non-cardiovascular mortality (0·84, 0·68-1·04; ptrend =0·0038), and total mortality (0·81, 0·68-0·96; ptrend<0·0001). The HR for total mortality was lowest for three to four servings per day (0·78, 95% CI 0·69-0·88) compared with the reference group, with no further apparent decrease in HR with higher consumption. When examined separately, fruit intake was associated with lower risk of cardiovascular, non-cardiovascular, and total mortality, while legume intake was inversely associated with non-cardiovascular death and total mortality (in fully adjusted models). For vegetables, raw vegetable intake was strongly associated with a lower risk of total mortality, whereas cooked vegetable intake showed a modest benefit against mortality.
INTERPRETATION: Higher fruit, vegetable, and legume consumption was associated with a lower risk of non-cardiovascular, and total mortality. Benefits appear to be maximum for both non-cardiovascular mortality and total mortality at three to four servings per day (equivalent to 375-500 g/day).
FUNDING: Full funding sources listed at the end of the paper (see Acknowledgments).

Matched MeSH terms: Income/trends
Gender differences in economic support and well-being of older Asians

Ofstedal MB, Reidy E, Knodel J

J Cross Cult Gerontol, 2004 Sep;19(3):165-201.
PMID: 15243197

This report provides a comprehensive analysis of gender differences in economic support and well-being in eight countries in Southern and Eastern Asia (Bangladesh, Malaysia, Indonesia, Singapore, Thailand, Vietnam, Philippines, and Taiwan). We examine multiple economic indicators, including sources of income, receipt of financial and material support, income levels, ownership of assets, and subjective well-being. Results show substantial variation in gender differences across indicators and provide an important qualification to widely held views concerning the globally disadvantaged position of older women. Whereas men tend to report higher levels of income than women, there is generally little gender difference in housing characteristics, asset ownership, or reports of subjective economic well-being. Unmarried women are economically advantaged compared to unmarried men in some respects, in part because they are more likely to be embedded in multigenerational households and receive both direct and indirect forms of support from family members.

Matched MeSH terms: Income/statistics & numerical data*
Fulltext Gender-based market constraints to informal fish retailing: Evidence from analysis of variance and linear regression

Murphy S, Arora D, Kruijssen F, McDougall C, Kantor P

PLoS One, 2020;15(3):e0229286.
PMID: 32231375 DOI: 10.1371/journal.pone.0229286

Over the last decade, Egypt's aquaculture sector has expanded rapidly, which has contributed substantially to per capita fish supply, and the growth of domestic fish markets and employment across the aquaculture value chain. Despite the growing importance of aquaculture sector in Egyptian labour force, only a few studies have explored the livelihoods of Egypt's women and men fish retailers. Even fewer studies have examined gender-based market constraints experienced by these informal fish retailers. This study uses sex-disaggregated data collected in 2013 in three governorates of Lower Egypt to examine the economic and social constraints to scale of enterprises between women (n = 162) and men informal fish retailers (n = 183). Specifically, we employ linear regression method to determine the correlates of enterprise performance. We found that both women and men retailers in the informal fish market earn low profits and face livelihood insecurities. However, women's enterprise performance is significantly lower than that of men even after controlling for individual socio-economic and retailing characteristics. Specifically, the burden of unpaid household work and lack of support therein impedes women's ability to generate higher revenues. These findings strengthen the argument for investing in understanding how gender norms and attitudes affect livelihood options and outcomes. This leads to recommendations on gender-responsive interventions that engage with both men and women and enhance the bargaining power and collective voice of fish retailers.

Matched MeSH terms: Income
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: Income
Fulltext Globalization and economic growth: empirical evidence on the role of complementarities

Samimi P, Jenatabadi HS

PLoS One, 2014;9(4):e87824.
PMID: 24721896 DOI: 10.1371/journal.pone.0087824

This study was carried out to investigate the effect of economic globalization on economic growth in OIC countries. Furthermore, the study examined the effect of complementary policies on the growth effect of globalization. It also investigated whether the growth effect of globalization depends on the income level of countries. Utilizing the generalized method of moments (GMM) estimator within the framework of a dynamic panel data approach, we provide evidence which suggests that economic globalization has statistically significant impact on economic growth in OIC countries. The results indicate that this positive effect is increased in the countries with better-educated workers and well-developed financial systems. Our finding shows that the effect of economic globalization also depends on the country's level of income. High and middle-income countries benefit from globalization whereas low-income countries do not gain from it. In fact, the countries should receive the appropriate income level to be benefited from globalization. Economic globalization not only directly promotes growth but also indirectly does so via complementary reforms.

Matched MeSH terms: Income
Fulltext Guideline implementation for breast healthcare in low- and middle-income countries: early detection resource allocation

Yip CH, Smith RA, Anderson BO, Miller AB, Thomas DB, Ang ES, et al.

Cancer, 2008 Oct 15;113(8 Suppl):2244-56.
PMID: 18837017 DOI: 10.1002/cncr.23842

A key determinant of breast cancer outcome in any population is the degree to which cancers are detected at early stages of disease. Populations in which cancers are detected at earlier stages have lower breast cancer mortality rates. The Breast Health Global Initiative (BHGI) held its third Global Summit in Budapest, Hungary in October 2007, bringing together internationally recognized experts to address the implementation of breast healthcare guidelines for early detection, diagnosis, and treatment in low- and middle-income countries (LMCs). A multidisciplinary panel of experts specifically addressed the implementation of BHGI guidelines for the early detection of disease as they related to resource allocation for public education and awareness, cancer detection methods, and evaluation goals. Public education and awareness are the key first steps, because early detection programs cannot be successful if the public is unaware of the value of early detection. The effectiveness and efficiency of screening modalities, including screening mammography, clinical breast examination (CBE), and breast self-examination, were reviewed in the context of resource availability and population-based need by the panel. Social and cultural barriers should be considered when early detection programs are being established, and the evaluation of early detection programs should include the use of well developed, methodologically sound process metrics to determine the effectiveness of program implementation. The approach and scope of any screening program will determine the success of any early detection program as measured by cancer stage at diagnosis and will drive the breadth of resource allocation needed for program implementation.

Matched MeSH terms: Income
Fulltext HOUSEHOLD FOOD SECURITY STATUS AND ITS ASSOCIATION WITH CHILD FEEDING PRACTICE AND CHILDREN’S WEIGHT STATUS AMONG LOW INCOME MOTHERS IN TERENGGANU

CHEAH PEI SHYUAN, HAYATI MOHD YUSOF, ASMA ALI, NOOR SALIHAH ZAKARIA

UMT Journal of Undergraduate Research, 2020;2(2):101-110.
MyJurnal

Food insecurity is normally associated with lower socioeconomic status and improper feeding practices which may consequently affect growth and development of young children. This study aims to assess household food security status and its association with child feeding practices and children’s weight status among low income mothers in Terengganu. A cross-sectional study using convenience sampling was conducted at four public maternal and child health clinics (MCH) located in Terengganu. A total of 107 of low-income mothers between ages of 18 to 45 years with net household income less than RM 3000 who has at least one child aged two years and above were recruited. The instruments used were Household Food Insecurity Access Scale (HFIAS), Child Feeding Questionnaire (CFQ) and weight-for-age child growth chart for children’ weight status at aged one year. Descriptive statistic and non-parametric tests were employed (SPSS 20). Majority of the households were food secure (85.0%). Yet, it is also important to note that about 15% of the household had experienced some degree of food insecurity. There was no significant correlation between household food security and all child feeding practice domains. Most of the mothers had children with normal weight (mean Z-score =-0.72+0.99). There was statistically significant association between household food security status and weight of children at one year of age (p=0.01). In conclusion, majority of the households experienced food secure. Household food security were associated with children’s weight status at early age but not correlated with parent’s child feeding practice.

Matched MeSH terms: Income
Haar wavelet method for constrained nonlinear optimal control problems with application to production inventory model

Waleeda Swaidan, Amran Hussin

Sains Malaysiana, 2016;45:305-313.

A new numerical method was proposed in this paper to address the nonlinear quadratic optimal control problems, with state and control inequality constraints. This method used the quasilinearization technique and Haar wavelet operational matrix to convert the nonlinear optimal control problem into a sequence of quadratic programming problems. The inequality constraints for trajectory variables were transformed into quadratic programming constraints using the Haar wavelet collocation method. The proposed method was applied to optimize the control of the multi-item inventory model with linear demand rates. By enhancing the resolution of the Haar wavelet, we can improve the accuracy of the states, controls and cost. Simulation results were also compared with other researchers' work.

Matched MeSH terms: Income
Health literacy in familial hypercholesterolemia: A cross-national study

Hagger MS, Hardcastle SJ, Hu M, Kwok S, Lin J, Nawawi HM, et al.

Eur J Prev Cardiol, 2018 06;25(9):936-943.
PMID: 29592531 DOI: 10.1177/2047487318766954

Background High rates of inadequate health literacy are associated with maladaptive health outcomes in chronic disease including increased mortality and morbidity rates, poor treatment adherence and poor health. Adequate health literacy may be an important factor in the effective treatment and management of familial hypercholesterolemia, and may also be implicated in genetic screening for familial hypercholesterolemia among index cases. The present study examined the prevalence and predictors of health literacy in familial hypercholesterolemia patients attending clinics in seven countries. Design Cross-sectional survey. Methods Consecutive FH patients attending clinics in Australia, Brazil, China, Hong Kong, Malaysia, Taiwan and the UK completed measures of demographic variables (age, gender, household income and highest education level) and a brief three-item health literacy scale. Results Rates of inadequate health literacy were lowest in the UK (7.0%), Australia (10.0%), Hong Kong (15.7%) and Taiwan (18.0%) samples, with higher rates in the Brazil (22.0%), Malaysia (25.0%) and China (37.0%) samples. Income was an independent predictor of health literacy levels, accounting for effects of age. Health literacy was also independently related to China national group membership. Conclusions Findings indicate non-trivial levels of inadequate health literacy in samples of familial hypercholesterolemia patients. Consistent with previous research in chronic illness, inadequate health literacy is related to income as an index of health disparities. Chinese familial hypercholesterolemia patients are more likely to have high rates of inadequate health literacy independent of income. Current findings highlight the imperative of education interventions targeting familial hypercholesterolemia patients with inadequate health literacy.

Matched MeSH terms: Income
Health-related quality of life and psychological distress among cancer survivors in a middle-income country

Subramaniam S, Kong YC, Chinna K, Kimman M, Ho YZ, Saat N, et al.

Psychooncology, 2018 09;27(9):2172-2179.
PMID: 29856903 DOI: 10.1002/pon.4787

OBJECTIVES: Quality of life and psychological well-being are important patient-centered outcomes, which are useful in evaluation of cancer care delivery. However, evidence from low-income and middle-income countries remains scarce. We assessed health-related quality of life (HRQoL) and prevalence of psychological distress (anxiety or depression), as well as their predictors, among cancer survivors in a middle-income setting.
METHODS: Through the Association of Southeast Asian Nations Costs in Oncology study, 1490 newly diagnosed cancer patients were followed-up in Malaysia for 1 year. Health-related quality of life was assessed by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and EuroQol-5 (EQ-5D) dimension questionnaires at baseline, 3 and 12 months. Psychological distress was assessed by using Hospital Anxiety and Depression Scale. Data were modeled by using general linear and logistic regressions analyses.
RESULTS: One year after diagnosis, the mean EORTC QLQ-C30 Global Health score of the cancer survivors remained low at 53.0 over 100 (SD 21.4). Fifty-four percent of survivors reported at least moderate levels of anxiety, while 27% had at least moderate levels of depression. Late stage at diagnosis was the strongest predictor of low HRQoL. Increasing age, being married, high-income status, hospital type, presence of comorbidities, and chemotherapy administration were also associated with worse HRQoL. The significant predictors of psychological distress were cancer stage and hospital type.
CONCLUSION: Cancer survivors in this middle-income setting have persistently impaired HRQoL and high levels of psychological distress. Development of a holistic cancer survivorship program addressing wider aspects of well-being is urgently needed in our settings.

Matched MeSH terms: Income/statistics & numerical data
Fulltext Heterogeneous Effect of Sectoral Composition on the Green Technology Innovations in Asia’s Middle-income Countries

Jain Yassin, Sing Yun, Wong, Herniza Roxanne Marcus

International Journal of Innovation and Industrial Revolution, 2021;3(6):13-26.
MyJurnal

This study examines the extent to which sectoral composition can affect green technology innovations in 20 selected Asia’s Middle-Income countries from 1995 until 2016. To measure the cross-sectional dependence among cross-sectional units and allows heterogeneous coefficients in a panel, this study will adopt the Dynamic Common Correlated Effect (DCCE). The results show that an increase in the proportion of industry and services sectors plays an important role in innovations of environmentally friendly technology. It is also knowing that the tourism sector and pollution level would be a prospect for green technology innovations. On the contrary, the increasing proportion of the agriculture sector may hinder green innovations. The finding of this study can be helpful for policymakers in middle-Income countries to promote a balance of green technology development in each sector for the sake of comprehensive sustainable development.

Matched MeSH terms: Income
Fulltext Homeownership affordability: an analysis of household socio‐economic

Norizan Rameli, Dani Salleh, Mazlan Ismail

Malaysian Journal of Social Sciences and Humanities, 2016;1(1):10-16.
MyJurnal

Homeownership affordability is not only the ability of households to pay the housing cost. But homeownership affordability is also involving the ability of households to pay housing costs as well as to maintain the basic needs in the continuity of life. Thus, affordability aspect is important in home ownership. Meanwhile, home ownership is the biggest decision for a household in a term. The combination of affordability and homeownership led to research on factors that affect the affordability of homeownership, especially in terms of socio-economic households inclusively. Socio-economic factors as discussed include income, household expenditures, job type, education level, number of dependents, monthly housing loan and financial savings. Each factor plays the role of its own to ensure the affordability level of homeownership. In fact, the factors that affect the homeownership affordability is different between households. Analysis of the socio-economic factors is necessary because homeownership affordability issues impact the quality life of mankind.

Matched MeSH terms: Income
Fulltext Hospitalized Patients' Awareness Of Their Rights-A Cross Sectional Survey In A Public And Private Tertiary Care Hospitals Of Punjab, Pakistan

Tabassum T, Ashraf M, Thaver I

J Ayub Med Coll Abbottabad, 2016 Jul-Sep;28(3):582-586.
PMID: 28712241

BACKGROUND: The awareness of patient's rights is negligible in developing countries where no legal framework is present to protect these rights and Pakistan is no exception. Not only is there an absence of legal structure for protection of patients' rights, but the enforcement and implementation for existing law is also questionable. Pakistan has an Islamic Charter of Medical and Health Ethics which includes the medical behaviour and physician's rights and duties towards the patients. Despite all these charters on patients' rights, there is little to no awareness regarding these rights and their practice remains low in healthcare system of Pakistan. This assessment of awareness among patients about their rights will guide in formulating recommendations to improve the existing system of healthcare delivery in the country.

METHODS: This descriptive cross-sectional comparative study was conducted in two hospitals in Lahore, each belonging to public and private sector. A structured questionnaire was used to collect data from patients. A total of 220 patients were selected to participate in the study, 110 belonging to each private and public hospital.

RESULTS: The findings indicate that most of the patients (64%) were not aware of their rights. The awareness level was better in patients seeking care from private hospital than those from public hospital. Education, monthly income and type of hospital utilized were found to be positively associated with the level of awareness. Most of the patients were not satisfied with the practices of their rights, especially in public hospitals.

CONCLUSIONS: The lack of awareness regarding the rights of a patient was more common in patients of public/government hospitals compared to private hospitals. A nation-wide healthcare education program is needed to increase awareness and practice of patients' rights in the country.

Matched MeSH terms: Income
Fulltext Household expenditure for dental care in low and middle income countries

Masood M, Sheiham A, Bernabé E

PLoS One, 2015;10(4):e0123075.
PMID: 25923691 DOI: 10.1371/journal.pone.0123075

This study assessed the extent of household catastrophic expenditure in dental health care and its possible determinants in 41 low and middle income countries. Data from 182,007 respondents aged 18 years and over (69,315 in 18 low income countries, 59,645 in 15 lower middle income countries and 53,047 in 8 upper middle income countries) who participated in the WHO World Health Survey (WHS) were analyzed. Expenditure in dental health care was defined as catastrophic if it was equal to or higher than 40% of the household capacity to pay. A number of individual and country-level factors were assessed as potential determinants of catastrophic dental health expenditure (CDHE) in multilevel logistic regression with individuals nested within countries. Up to 7% of households in low and middle income countries faced CDHE in the last 4 weeks. This proportion rose up to 35% among households that incurred some dental health expenditure within the same period. The multilevel model showed that wealthier, urban and larger households and more economically developed countries had higher odds of facing CDHE. The results of this study show that payments for dental health care can be a considerable burden on households, to the extent of preventing expenditure on basic necessities. They also help characterize households more likely to incur catastrophic expenditure on dental health care. Alternative health care financing strategies and policies targeted to improve fairness in financial contribution are urgently required in low and middle income countries.
Study name: World Health Survey (Malaysia is a study site)

Matched MeSH terms: Income*
Fulltext Household food insecurity and coping strategies in a poor rural community in Malaysia

Shariff ZM, Khor GL

Nutr Res Pract, 2008;2(1):26-34.
PMID: 20126362 DOI: 10.4162/nrp.2008.2.1.26

This cross-sectional study assessed household food insecurity among low-income rural communities and examined its association with demographic and socioeconomic factors as well as coping strategies to minimize food insecurity. Demographic, socioeconomic, expenditure and coping strategy data were collected from 200 women of poor households in a rural community in Malaysia. Households were categorized as either food secure (n=84) or food insecure (n=116) using the Radimer/Cornell Hunger and Food Insecurity instrument. T-test, Chi-square and logistic regression were utilized for comparison of factors between food secure and food insecure households and determination of factors associated with household food insecurity, respectively. More of the food insecure households were living below the poverty line, had a larger household size, more children and school-going children and mothers as housewives. As food insecure households had more school-going children, reducing expenditures on the children's education is an important strategy to reduce household expenditures. Borrowing money to buy foods, receiving foods from family members, relatives and neighbors and reducing the number of meals seemed to cushion the food insecure households from experiencing food insufficiency. Most of the food insecure households adopted the strategy on cooking whatever is available at home for their meals. The logistic regression model indicates that food insecure households were likely to have more children (OR=1.71; p<0.05) and non-working mothers (OR=6.15; p<0.05), did not own any land (OR=3.18; p<0.05) and adopted the strategy of food preparation based on whatever is available at their homes (OR=4.33; p<0.05). However, mothers who reported to borrow money to purchase food (OR=0.84; p<0.05) and households with higher incomes of fathers (OR=0.99; p<0.05) were more likely to be food secure. Understanding the factors that contribute to household food insecurity is imperative so that effective strategies could be developed and implemented.

Matched MeSH terms: Income
Fulltext How do health care professionals assess patients when initiating insulin therapy? A qualitative study

Lee PY, Lee YK, Khoo EM, Ng CJ

Prim Care Diabetes, 2014 Apr;8(1):49-55.
PMID: 24315732 DOI: 10.1016/j.pcd.2013.11.003

Aims: To explore how health care professionals (HCPs) assess patients when initiating insulintherapy in type 2 diabetes.
Methods: Focus group discussions and in-depth interviews were conducted with 41 healthcare professionals in Malaysia in 2010–2011. A semi-structured topic guide was used for theinterview. The interviews were transcribed verbatim and analysed using the Nvivo9 softwarebased on a thematic approach.
Results: HCPs were less likely to initiate insulin therapy in patients who were older, withirregular dietary patterns and poor financial status. They also assessed patients’ knowl-edge, views and misconceptions of insulin. However, there was a variation in how doctors assessed patients’ comorbidities before starting insulin therapy. Medical officers were more likely to initiate insulin therapy in patients with comorbidities and complications, whereas family medicine specialists were more cautious. In addition, most HCPs considered patients’ psychosocial status, including self-care ability, social support and quality of life.
Conclusions: HCPs’ assessment of patients’ need to start insulin therapy depends on their perception rather than objective evaluation of patients’ background, knowledge, perception and abilities. The background and the type of practice of HCPs influence their assessment.

Matched MeSH terms: Income
How does government efficiency affect carbon emission intensity? A comprehensive empirical study

Ding Y, Chin L, Taghizadeh-Hesary F, Abdul-Rahim AS, Deng P

Environ Sci Pollut Res Int, 2023 Dec;30(59):123067-123082.
PMID: 37979120 DOI: 10.1007/s11356-023-31069-4

This study utilized panel data from 132 countries spanning from 1996 to 2019 to examine the effect of government efficiency on carbon emission intensity. Using a fixed effect model, the study found that stronger government efficiency is associated with a significant decrease in carbon emission intensity. Robustness tests were performed, the results of which consistently supported the main findings. Additionally, the study investigated the mechanisms underlying the linkage between government efficiency and carbon emission intensity, revealing that improved government efficiency can inhibit carbon emission intensity by fostering environmental innovation and promoting renewable energy consumption. Finally, the study examined the moderating effects of national income level, economic freedom, democracy, and ruling party ideology on the nexus of government efficiency and carbon emission intensity, and found empirical evidence supporting these moderating effects. These results provide new insights for governments seeking to reduce carbon emission intensity.

Matched MeSH terms: Income

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