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  1. Mahmud A, Islam MR
    Int J Community Wellbeing, 2021;4(3):315-321.
    PMID: 34723103 DOI: 10.1007/s42413-020-00071-w
    This commentary looks at the social stigma as a barrier to Covid-19 responses to community well-being in Bangladesh. The Covid-19 in Bangladesh particular the way the people respond this has many dimensions to view from sociological perspective. The main objective of this commentary is to analysis how this response is related to social stigma. Gathering information from the recent literature, results showed that there are number of causes around such stigma that include misinformation, feeling of insecurity, fear of responsibility, administrative malfunction, and lack of trust on treatment. These causes of stigma have number of forms such as humor-prone stigma, residential stigma, organizational stigma, community-stigma, and apathetical stigma. Results also show that there are many effects of stigma such as health-risks, harassment, discrimination, life-insecurity, psychological disorder, loss of social capital and emotional capital, shattering family bond and social solidarity that work as barrier to community well-being. This commentary recommends to overcome the barriers through strengthening and decentralization of the COVID-19 medical facilities including testing, tracing, formal quarantining, and special treatment for coronavirus in coronavirus hospitals by allocating a large figure of the state budget and also by taking initiatives of public-private partnership for health management.
  2. Mahmud A, Aljunid SM
    PLoS One, 2018;13(2):e0191764.
    PMID: 29389972 DOI: 10.1371/journal.pone.0191764
    Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent's residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40-74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8-112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60-78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0-340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40-240.00). Higher travel impedance was noted among those who lived in sub-urban and rural areas. In summary, availability of mammogram facilities was good in the central and west coast of the peninsula. The overall provider-to-population ratio was lower than recommended. Based on the travel impedance approach used, accessibility to subsidised mammogram screening among the respondents was good in urban areas but deprived in other areas. This study was a preliminary study with limitations. Nonetheless, the evidence suggests that actions have to be taken to improve the accessibility to opportunistic mammogram screening in Malaysia in pursuit of universal health coverage.
  3. Ismail S, Manaf RA, Mahmud A
    East Mediterr Health J, 2019 Jun 04;25(4):239-245.
    PMID: 31210344 DOI: 10.26719/emhj.19.011
    Background: Research on the health benefits of fasting is growing; this includes time-restricted feeding and Islamic fasting.

    Aims: This article aims to review and highlight the similarities and differences between time-restricted feeding and Islamic fasting during Ramadan.

    Methods: A scoping review was undertaken to identify relevant articles that answered the research question: what are the similarities and differences in characteristics of time-restricted feeding and Islamic fasting? MEDLINE/PubMed was searched using the terms: time-restricted feeding, and weight. Inclusion criteria were: original research and review articles; written in English; and published between the years 2000 and 2017.

    Results: A total of 25 articles that answered the research question were included in the review: 15 original research papers and 10 reviews. The findings suggest that Ramadan fasting is a form of time-restricted feeding in the contemporary context because of the period when eating is not allowed. The fasting duration reported in time-restricted feeding ranged from 4 to 24 hours, which is longer than that of Islamic fasting which is between 8 and 20 hours. Both time-restricted feeding and Islamic fasting have been found to have positive health effects, including weight reduction.

    Conclusion: Time-restricted feeding and Islamic fasting have many similar characteristics and reported positive health effects.

  4. Razali MF, Mahmud AS, Mokhtar N
    J Mech Behav Biomed Mater, 2018 Jan;77:234-241.
    PMID: 28954242 DOI: 10.1016/j.jmbbm.2017.09.021
    NiTi arch wires are used widely in orthodontic treatment due to its superelastic and biocompatibility properties. In brackets configuration, the force released from the arch wire is influenced by the sliding resistances developed on the arch wire-bracket contact. This study investigated the evolution of the forces released by a rectangular NiTi arch wire towards possible intraoral temperature and deflection changes. A three dimensional finite element model was developed to measure the force-deflection behavior of superelastic arch wire. Finite element analysis was used to distinguish the martensite fraction and phase state of arch wire microstructure in relation to the magnitude of wire deflection. The predicted tensile and bending results from the numerical model showed a good agreement with the experimental results. As contact developed between the wire and bracket, binding influenced the force-deflection curve by changing the martensitic transformation plateau into a slope. The arch wire recovered from greater magnitude of deflection released lower force than one recovered from smaller deflection. In contrast, it was observed that the plateau slope increased from 0.66N/mm to 1.1N/mm when the temperature was increased from 26°C to 46°C.
  5. Odu JO, Hamedon TR, Mahmud A, Baharudin R
    Med J Malaysia, 2023 May;78(3):308-317.
    PMID: 37271840
    INTRODUCTION: Studies have shown that a workplace safety culture (WSC) is lacking among the general workforce in Nigeria. Poor WSC can adversely impact workers' health and high remedial costs for employers. To improve WSC, workers need to improve related knowledge, attitude, and practices (KAP) towards WSC through effective health interventional programs at the workplace. The main objective of this study is to develop, implement and evaluate the effectiveness of the Work Safety Culture Health Education Module (WSCHEM). The specific goals are to improve KAP related to office ergonomics towards WSC among public sector administrative workers in Abeokuta, Nigeria MATERIALS AND METHODS: The study was a two-armed, singleblinded cluster randomised controlled trial (CRCT) involving 247 public sector administrative workers from clusters of 20 ministries in Abeokuta, Southwestern Nigeria. The intervention group was given WSCHEM, whereas the waitlist group received a seminar on team building and leadership skills and received the WSCHEM after the intervention program ended. The evaluation was done three times using the first formal validated, self-administered Work Safety Culture Questionnaire (WSCQ) among the administrative workers: first at baseline, second at 1 month, and third at 3 months post-intervention.

    RESULT: The results showed no statistically significant differences between groups regarding the respondents' characteristics (socio-demographic and occupational/officerelated ergonomic factors) and the outcome variables KAP towards WSC at baseline. For practices towards WSC, both intervention (β 6.8, 95%CI 4.85, 8.72) and time (β 6.2, 95%CI 4.49, 7.94) significantly improved the respondents' practices towards WSC in the per-protocol analysis. In the secondary outcomes, both knowledge of WSC, intervention (β 3.5, 95%CI 2.8, 4.2) and time (β 3.4, 95%CI 2.7, 5.9); and attitudes towards WSC, intervention (β1.7, 95%CI 1.25, 2.23) and time (β 2.3, 95%CI 1.92, 2.76) significantly improved the respondents' level of knowledge and attitudes respectively towards WSC.

    CONCLUSION: The intervention, WSCHEM, was effective in improving the administrative workers' KAP towards WSC, as demonstrated by the significance between and within-group differences.

  6. Krishna D, Mohd Zulkefli NA, Md Said S, Mahmud A
    BMC Public Health, 2019 Sep 18;19(1):1275.
    PMID: 31533790 DOI: 10.1186/s12889-019-7561-z
    BACKGROUND: Immunization is an effective public health intervention to reduce morbidity and mortality among children and it will become more effective if the child can receive the full course of recommended immunization doses. The objective of this study was to determine the prevalence of childhood immunization defaulters and its associated factors among children below 5 years attending registered child care centers in Petaling District, Selangor.

    METHODS: This was a cross-sectional survey among mothers with children below 5 years from 60 registered child care centers in District of Petaling, Selangor. Data was collected by a self-administered questionnaire from a total of 1015 mothers. Simple Logistic Regression, Chi-square or Fisher's exact test were performed to determine the association between individual categorical variables and childhood immunization defaulters. Multivariate logistic regression was used to determine the predictors of childhood immunization defaulters.

    RESULTS: The study showed that the prevalence rate for defaulting immunization was 20.7%. After adjusting all confounders, six statistically significant predictors of childhood immunization defaulters were determined. They were non-Muslims (aOR = 1.669, 95% CI = 1.173, 2.377, p = 0.004), mothers with diploma and below educational background (aOR = 2.296, 95% CI = 1.460, 3.610, p 

  7. Manaf RA, Mahmud A, Ntr A, Saad SR
    BMC Public Health, 2021 05 06;21(1):876.
    PMID: 33957870 DOI: 10.1186/s12889-021-10917-3
    BACKGROUND: The challenges faced by healthcare personnel in relation to dengue prevention and control are perennial but noticeably unexplored. It is often difficult to translate policies and decision making by the elite into astute management in consonance with the needs of rank-and-file personnel. In this study, we assess the impact of governance on dengue prevention and control activities in Malaysia as narrated by the elite.

    METHODS: A qualitative study using a case-study approach was conducted between January 2019 and November 2019 in the districts of Gombak and Klang, where the relevant key informants were located. Nineteen interviews were conducted among elite healthcare personnel from different divisions: management, vector, laboratory, inspectorate, health promotion and entomology. Semi-structured interviews were conducted. The sample size was determined through saturation point criteria. Purposive sampling techniques were used to recruit the participants. The interviews were audio recorded, and the transcribed text was analysed with deductive thematic analysis.

    RESULTS: Data analysis led to the development of 5 themes and 13 categories. The major principles of governance were embodied in a milieu of predicament, linked to constraints but also opportunities. The constraints resulted from inherent determinants of dengue outbreaks, the serviceability of governing policies and the macro-economics of budget allocation. The opportunities to sustain governance at the local operating level stem from a prevalent supportive internal management system, collaborative efforts among corresponding external government agencies and willingness to innovate and embrace novel technology.

    CONCLUSION: Elites are influential, often well-informed personnel tasked with making decisions that can reverberate across an organisation, impacting future plans and strategic policies. Political arrangements at higher levels will reflect in advance the tone of how governance in dengue prevention and control is operationalised by entities and individuals at lower levels of the health system. The prevailing centralised structure in the Malaysian health system will continue to entrench the position of the elite and intertwine it with governance and its predicaments.

  8. Lai SL, Tey NP, Mahmud A, Ismail N
    Int Q Community Health Educ, 2021 Jul;41(4):395-403.
    PMID: 33167794 DOI: 10.1177/0272684X20972864
    BACKGROUND: The private sector is playing an increasingly important role in family planning services globally. The active participation of private providers is associated with a higher contraceptive prevalence rate.

    OBJECTIVES: To examine the differentials and determinants of the utilization of private providers for family planning services.

    METHOD: This study used the 2014 Malaysian Population and Family Survey data. Cross-tabulations and logistic regression were performed on 1,817 current users of modern methods.

    RESULTS: Overall, 26% of modern method users obtained their supplies from private clinics/pharmacies and 15.2% from other sources, such as drug stores and sundry shops. The odds of utilizing the private sector for family planning services differ significantly across regions and socio-economic groups. The odds of obtaining supply from the private clinics/pharmacies were higher among the Chinese and urban women (AOR > 1), and it was lower among those from the eastern region (AOR = 0.47, 95% CI = 0.30-0.73). Non-Bumiputera, urban, higher educated, and working women, and those whose husbands decided on family planning had higher odds of obtaining the supply from the other sources (AOR > 1).

    CONCLUSION: The private sector complements and supplements the public sector in providing family planning services to the public.

  9. Almutairi R, Azuhairi AA, Mahmud A, Dablool AS
    Malays J Med Sci, 2023 Feb;30(1):185-197.
    PMID: 36875191 DOI: 10.21315/mjms2023.30.1.16
    BACKGROUND: Eating disorders (EDs) are characterised by an abnormal attitude towards food that causes someone to change their eating habits and behaviour. This study aimed to investigate the prevalence of EDs and their associated factors among female going-school adolescents in Jeddah, Saudi Arabia.

    METHODS: A cross-sectional study was conducted in five schools in Jeddah, Saudi Arabia, among a representative random sample of female adolescent students aged 13 years old-18 years old. A simple random sampling method was used to select the participants. An online self-administered questionnaire, the Arabic version of eating attitude test (EAT-26) and socio-cultural attitudes toward appearance questionnaire (SATAQ-4), was used.

    RESULTS: More than half (53.6%) of adolescent girls scored at or above the cut-off point of EAT-26. Around 45% of the participants had experienced family influence on their appearance and body shape, 36.7% had experienced peer influence on these factors, and 49.4% had experienced media influence. Family influence was significantly associated with EDs (P = 0.013).

    CONCLUSION: The high prevalence of EDs among female going-school adolescents in Jeddah, Saudi Arabia, is of great concern. To mitigate this problem, effective programmes must be designed to change their dietary habits while considering the effects of family, peer and media influence, as well as focusing on the importance of eating breakfast and practising physical activity.

  10. Rashizal Sazli MR, Syed Mohamed AF, Wan Mazuan WM, Ling SM, Mahmud A, Amin Nordin S
    Med J Malaysia, 2017 04;72(2):100-105.
    PMID: 28473672 MyJurnal
    INTRODUCTION: The increasing trend of extensively drugresistant gram negative bacteria responsible for nosocomial infections has prompted resurgence colistin usage. Colistin-induced nephrotoxicity is a concern with disparity in the reported rates between previous studies. This study aims to evaluate colistin-induced nephrotoxicity among Malaysian population.

    METHODS: The medical records of ICU patients receiving colistin therapy in Hospital Serdang and Hospital Sungai Buloh from 2010 to 2012 were retrospectively reviewed. Demographics data, treatment characteristic as well as culture result and creatinine level were documented. Nephrotoxicity was determined based on RIFLE criteria.

    RESULTS: A total of 100 patients were included. Median daily dose, cumulative dose and duration of colistin therapy were 3.0 MIU (IQR: 4, range 1-12), 17.8 MIU (IQR: 31.5, range 2-180) and seven days (IQR: 4, range 1-30). Nephrotoxicity was found in 23% of the study population. All cases were reversible but marginally associated with higher mortality. No statistical association exist between age, gender and race as well as administration routes with nephrotoxicity by univariable analysis. The association of dose and duration with nephrotoxicity was also not significant by univariable analysis. After adjustment for confounders, statistical association between the independent variables and dependent variable remains not significant.

    CONCLUSION: Lower dose and shorter duration in local settings contribute to lack of association between colistin therapy and nephrotoxicity in this study. Higher dosing regimen with loading dose application has been introduced in the latest National Antibiotic Guideline. Further evaluation of colistin-induced nephrotoxicity and potential risk factors is therefore warranted.

  11. Oluchi SE, Manaf RA, Ismail S, Kadir Shahar H, Mahmud A, Udeani TK
    PMID: 34501838 DOI: 10.3390/ijerph18179245
    Health-related quality of life (HRQOL) is an essential measure that is used to assess the effect of chronic disease management on the health status of an individual. Previous studies have identified various instruments used in the measuring of diabetes-specific health-related quality of life (HRQOL). The aim of this paper is to provide a systematic review of the various instruments used for the diabetes-specific measure of HRQOL, and place emphasis on its content and measurement properties. Methods Preferred Reporting Items for Systematic Reviews and Meta analyses (PRISMA) guidelines was used. A systematic search strategy was used to identify publications reporting diabetes HRQOL measures. The search terms used were: "diabetes quality of life", "measurements", and "instruments". The database that was searched includes PubMed, Science Direct, CINAHL, and Medline. Articles written in the English language and published from January 1990 to December 2020 were included. Those articles that did not measure HRQOL for diabetic patients were excluded. Results: A total of seventeen instruments met the inclusion criteria and included in the review. The appraisal of diabetes scale (ADS), Audit of Diabetes-Dependent QOL measure (ADDQOL), Diabetes Health Profile (DHP), and Problem Areas in Diabetes (PAID) are more suitable for single-scale questionnaires when investigating one or more specific aspects of diabetes-specific quality of life (QOL). The ADDQOL, ADS, Diabetes Impact Measurement Scales (DIMS), Diabetes Quality of Life Clinical Trial Questionnaire (DQLCTQ-R), Malay Version of Diabetes Quality of Life (DQOL), Iranian Diabetes Quality of Life (IRDQOL), Brief Clinical Inventory, and PAID are relevant measures of HRQOL for insulin dependent diabetes mellitus (IDDM) and non-insulin dependent diabetes mellitus (NIDDM) patients. The Asian Diabetes Quality of Life AsianDQOL, The Chinese Short Version of DQOL, Elderly Diabetes Burden Scale (EDBS), Malay Version of Diabetes Quality of Life (DQOL), are relevant measures of HRQOL for NIDDM patients. Only two instruments assess for responsiveness, namely PAID and DQLCTQ-R. In PAID, the effect sizes ranged from 0.32 to 0.65 for interventions. The DQLCTQ-R four domains were responsive to clinical change in metabolic control. Based on this review ADDQOL, DSQOLS, and EDBS psychometric properties are sufficient. Conclusion: Most studies did not check for responsiveness, and future studies should prioritize responsiveness to change, which was not included in the psychometric finding of the reviewed instruments.
  12. Chai CWE, Lau BT, Tee MKT, Al Mahmud A
    Digit Health, 2022 11 01;8:20552076221134457.
    PMID: 36339903 DOI: 10.1177/20552076221134457
    Objective: Childhood cancer patients need to have good treatment adherence. Unfortunately, treatment non-adherence often occurs due to high side-effect burdens of treatment and the lack of knowledge of one's illness and treatment. Therefore, a serious game intervention based on the Protection Motivation Theory (PMT) was designed and developed to motivate childhood cancer patients to undergo treatment and to motivate them to undergo treatment, perform daily self-care and educate them about their illness.

    Methods: Childhood cancer patients (6-17 years old) and their caregivers were recruited in a multi-centre, single-arm intervention in Malaysia. A total of 24 child-caregiver dyads have completed the study. This study used PMT-based surveys to collect quantitative data regarding children's motivation to adhere to treatment and perform daily self-care. Additionally, a 20-question multiple-choice quiz was used to determine children's knowledge levels. These surveys were conducted pre-test and post-test. Children's and caregivers' feedback were also gathered post-test as qualitative data.

    Results: The results showed that overall, the children's intention to undergo cancer treatment had increased significantly. A significant increase in the intention to perform daily self-care was found among younger children, while older children showed significant improvement in their cancer knowledge levels. The post-test feedback suggested that the game was liked by both children and caregivers and it provided various benefits to children with cancer.

    Conclusions: Findings suggest that the intervention has the potential to improve childhood cancer patients' motivation for treatment adherence and daily self-care, in addition to educating them about cancer and treatment.

  13. Assa'edah Mahmud A, Zakaria H, Zaliman Mohd Yusoff M, Ruzyanei Nik Jaafar N, Baharudin A, Mohd Tamil A
    Alpha Psychiatry, 2022 Sep;23(5):223-229.
    PMID: 36426271 DOI: 10.5152/alphapsychiatry.2022.21781
    BACKGROUND: The primary purpose of this study is to examine the feasibility of a short-term virtual reality exposure therapy among healthy working adults sample. The secondary aim is to measure the effect of virtual reality exposure therapy on negative and positive emotions by comparing it to the standard stress management program and the wait-list groups.

    METHODS: We enrolled 67 participants allocated into 3 groups to receive virtual reality exposure therapy, standard stress management, or wait-list group. The virtual reality exposure therapy group received a total of a 30-minute exposure to a virtual reality environment over 2 weeks. The standard stress management group received a stress management program once during the study period.

    RESULTS: The results showed a heterogeneous sample, whereby a significantly younger, less-working years, and higher anxiety baseline score were found in the virtual reality exposure therapy group compared to standard stress management and wait-list groups. Nonetheless, the virtual reality exposure therapy group showed a reduction in depression, anxiety, and stress score (P < .001). The standard stress management group showed a reduction in anxiety score only (P = .002), whereas no significant changes were observed in the wait-list group. For positive emotion, all 3 groups showed significant improvement.

    CONCLUSION: Short-term virtual reality exposure therapy is a feasible intervention for the negative and positive emotions; however, cautious interpretation is needed due to significant heterogeneous sample. Replication of study with comparable groups is recommended.

  14. Ahmed TH, Tiang JJ, Mahmud A, Gwo-Chin C, Do DT
    Sensors (Basel), 2023 Jul 29;23(15).
    PMID: 37571565 DOI: 10.3390/s23156782
    This paper develops a novel approach for reliable vehicle-to-vehicle (V2V) communication in various environments. A switched beam antenna is deployed at the transmitting and receiving points, with a beam management system that concentrates the power in each beam using a low-computation algorithm and a potential mathematical model. The algorithm is designed to be flexible for various environments faced by vehicles. Additionally, an anti-failure system is proposed in case the intelligent transportation system (ITS) system fails to retrieve real-time Packet Delivery Ratio (PDR) values related to traffic density. Performance metrics include the time to collision in seconds, the bit error rate (BER), the packet error rate (PER), the average throughput (Mbps), the beam selection probability, and computational complexity factors. The proposed system is compared with traditional systems. Extensive experiments, simulations, and comparisons show that the proposed approach is excellent and reliable for vehicular systems. The proposed study demonstrates an average throughput of 1.7 Mbps, surpassing conventional methods' typical throughput of 1.35 Mbps. Moreover, the bit error rate (BER) of the proposed study is reduced by a factor of 0.1. Additionally, the proposed framework achieves a beam power efficiency of touching to 100% at computational factor of 34. These metrics indicate that the proposed method is both efficient and sufficiently robust.
  15. Hamid TA, Salih SA, Zillah Abdullah SF, Ibrahim R, Mahmud A
    PeerJ, 2024;12:e17058.
    PMID: 38500524 DOI: 10.7717/peerj.17058
    BACKGROUND: Frailty is a significant healthcare challenge worldwide, increasing interest in developing more assessment tools covering for frailty. Recently, there has been a growing awareness of a correlation between social variables and frailty in older people. However, there is a lack of understanding of the social domains of frailty and the related adverse outcomes, particularly in the Asia-Pacific settings. This study aimed to characterize the social frailty domains and their health outcomes by overviewing the frailty screening tools in older people living in the Asia-Pacific region.

    METHODOLOGY: A systematic review, using the PRISMA guideline, was conducted on articles published between 2002 and 2023 from three electronic databases: PubMed, Scopus, and ScienceDirect. A manual search was conducted for the references of the included articles using Google Scholar. Included articles must be in English and were based on empirical evidence published in peer-reviewed journals and focus on the assessment of domains of social frailty in older people aged 60 or over in the Asia-Pacific (East Asia, Southeast Asia, and Oceania).

    RESULT: A total of 31 studies were included in the thematic analysis, from which 16 screening tools measuring six social domains were reviewed. The six domains were: social networks, followed by social activities, social support, financial difficulties, social roles, and socioeconomic, arranged in four categories: social resources, social needs, social behaviors (or social activities), and general resources. The six social domains predicted mortality, physical difficulties, and disability incidence. Other adverse health outcomes were also associated with these social domains, including cognitive disorders, mental illness, and nutritional disorders (n = 5 domains each), dementia (n = 4 domains), and oral frailty, hearing loss, obesity, and chronic pain (n = 3 domains each).

    CONCLUSION: Overall, social frailty is a complex construct with multiple dimensions, including the frailty of social and general resources, social behaviors, and social needs, leading to several health disorders. The findings contribute to understanding the conceptual framework of social frailty in older people and its related health outcomes. Therefore, it could facilitate professionals and researchers to monitor and reduce the risks of adverse health outcomes related to each domain of social frailty, contributing to a better aging process.

  16. Mohamad NF, Mansor Z, Mahmud A, Mohamed Ghazali IM, Sarimin R
    Int J Technol Assess Health Care, 2024 Feb 28;40(1):e18.
    PMID: 38415300 DOI: 10.1017/S0266462324000102
    OBJECTIVES: To determine the level of awareness of health technology assessment (HTA) and its predictors among clinical year medical students in public universities in Klang Valley, Malaysia.

    METHODS: A cross-sectional study using the stratified random sampling method was conducted among clinical year medical students in four public universities in Klang Valley, Malaysia. Data on the level of awareness of HTA and its associated factors were collected using a self-administered online questionnaire. Descriptive, bivariate, and multivariate analyses were performed using IBM SPSS version 27 to determine the level of awareness of HTA and its predictors.

    RESULTS: Majority (69 percent) of participants had a low level of awareness of HTA. The predictors of high-level awareness of HTA were attitude toward HTA (adjusted odds ratio (AOR) = 7.417, 95 percent confidence interval (CI): 3.491, 15.758), peer interaction on HTA (AOR = 0.320, 95 percent CI: 0.115, 0.888), and previous training on HTA (AOR = 4.849, 95 percent CI: 1.096, 21.444).

    CONCLUSIONS: Most future doctors in public universities exhibit a low awareness of HTA. This study highlights the interplay between attitudes toward HTA, peer interaction, and previous training as influential predictors of HTA awareness. An integrated and comprehensive educational approach is recommended to cultivate a positive attitude and harness the positive aspects of peer interaction while mitigating the potential negative impact of misconceptions. Emphasizing early exposure to HTA concepts through structured programs is crucial for empowering the upcoming generation of healthcare professionals, enabling them to navigate HTA complexities and contribute to evidence-based healthcare practices in Malaysia and beyond.

  17. Deverell L, Bhowmik J, Lau BT, Al Mahmud A, Sukunesan S, Islam FMA, et al.
    PMID: 32643468 DOI: 10.1080/17483107.2020.1785565
    PURPOSE: Orientation and Mobility (O&M) professionals teach people with low vision or blindness to use specialist assistive technologies to support confident travel, but many O&M clients now prefer a smartphone. This study aimed to investigate what technology O&M professionals in Australia and Malaysia have, use, like, and want to support their client work, to inform the development of O&M technologies and build capacity in the international O&M profession.

    MATERIALS AND METHODS: A technology survey was completed by professionals (n = 36) attending O&M workshops in Malaysia. A revised survey was completed online by O&M specialists (n = 31) primarily in Australia. Qualitative data about technology use came from conferences, workshops and interviews with O&M professionals. Descriptive statistics were analysed together with free-text data.

    RESULTS: Limited awareness of apps used by clients, unaffordability of devices, and inadequate technology training discouraged many O&M professionals from employing existing technologies in client programmes or for broader professional purposes. Professionals needed to learn smartphone accessibility features and travel-related apps, and ways to use technology during O&M client programmes, initial professional training, ongoing professional development and research.

    CONCLUSIONS: Smartphones are now integral to travel with low vision or blindness and early-adopter O&M clients are the travel tech-experts. O&M professionals need better initial training and then regular upskilling in mainstream O&M technologies to expand clients' travel choices. COVID-19 has created an imperative for technology laggards to upskill for O&M tele-practice. O&M technology could support comprehensive O&M specialist training and practice in Malaysia, to better serve O&M clients with complex needs.Implications for rehabilitationMost orientation and mobility (O&M) clients are travelling with a smartphone, so O&M specialists need to be abreast of mainstream technologies, accessibility features and apps used by clients for orientation, mobility, visual efficiency and social engagement.O&M specialists who are technology laggards need human-guided support to develop confidence in using travel technologies, and O&M clients are the experts. COVID-19 has created an imperative to learn skills for O&M tele-practice.Affordability is a significant barrier to O&M professionals and clients accessing specialist travel technologies in Malaysia, and to O&M professionals upgrading technology in Australia.Comprehensive training for O&M specialists is needed in Malaysia to meet the travel needs of clients with low vision or blindness who also have physical, cognitive, sensory or mental health complications.

  18. Siddiky NA, Sarker MS, Khan MSR, Begum R, Kabir ME, Karim MR, et al.
    Microorganisms, 2021 Apr 28;9(5).
    PMID: 33924919 DOI: 10.3390/microorganisms9050952
    Virulent and multi drug resistant (MDR) Salmonellaenterica is a foremost cause of foodborne diseases and had serious public health concern globally. The present study was undertaken to identify the pathogenicity and antimicrobial resistance (AMR) profiles of Salmonellaenterica serovars recovered from chicken at wet markets in Dhaka, Bangladesh. A total of 870 cecal contents of broiler, sonali, and native chickens were collected from 29 wet markets. The overall prevalence of S. Typhimurium, S. Enteritidis, and untyped Salmonella spp., were found to be 3.67%, 0.57%, and 1.95% respectively. All isolates were screened by polymerase chain reaction (PCR) for eight virulence genes, namely invA, agfA, IpfA, hilA, sivH, sefA, sopE, and spvC. S. Enteritidis isolates carried all virulence genes whilst S. Typhimurium isolates carried six virulence genes except sefA and spvC. A diverse phenotypic and genotypic AMR pattern was found. Harmonic descending trends of resistance patterns were observed among the broiler, sonali, and native chickens. Interestingly, virulent and MDR Salmonella enterica serovars were found in native chicken, although antimicrobials were not used in their production cycle. The research findings anticipate that virulent and MDR Salmonella enterica are roaming in the wet markets which can easily anchor to the vendor, consumers, and in the food chain.
  19. Antwi J, Arkoh AA, Choge JK, Dibo TW, Mahmud A, Vankhuu E, et al.
    Hum Resour Health, 2021 09 14;19(1):110.
    PMID: 34521441 DOI: 10.1186/s12960-021-00646-4
    BACKGROUND: Shortages and maldistribution of healthcare workers persist despite efforts to increase the number of practitioners. Evidence to support policy planning and decisions is essential. The World Health Organization has proposed National Health Workforce Accounts (NHWA) to facilitate human resource information systems for effective health workforce planning and monitoring. In this study, we report on the accreditation practices for accelerated medically trained clinicians in five countries: Ethiopia, Ghana, Kenya, Malaysia, and Mongolia.

    METHOD: Using open-ended survey responses and document review, information about accreditation practices was classified using NHWA indicators. We examined practices using this framework and further examined the extent to which the indicators were appropriate for this cadre of healthcare providers. We developed a data extraction tool and noted any indicators that were difficult to interpret in the local context.

    RESULTS: Accreditation practices in the five countries are generally aligned with the WHO indicators with some exceptions. All countries had standards for pre-service and in-service training. It was difficult to determine the extent to which social accountability and social determinants of health were explicitly part of accreditation practices as this cadre of practitioners evolved out of community health needs. Other areas of discrepancy were interprofessional education and continuing professional development.

    DISCUSSION: While it is possible to use NHWA module 3 indicators there are disadvantages as well, at least for accelerated medically trained clinicians. There are aspects of accreditation practices that are not readily coded in the standard definitions used for the indicators. While the indicators provide detailed definitions, some invite social desirability bias and others are not as easily understood by practitioners whose roles continue to evolve and adapt to their health systems.

    CONCLUSION: Regular review and revision of indicators are essential to facilitate uptake of the NHWA for planning and monitoring healthcare providers.

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