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  1. Md Nor MZ, Said AH, Che Man M, Yusof MZ
    Med J Malaysia, 2024 Jan;79(1):34-41.
    PMID: 38287755
    INTRODUCTION: Patient satisfaction is widely used to monitor the quality of health care services. A significant patient load may influence health care services and patient satisfaction. Klinik Kesihatan Bandar Kuantan, Pahang (KKBK) has the highest patient loads in Pahang state, followed by Klinik Kesihatan Beserah and Klinik Kesihatan Kurnia. There are up to 700 attendees at KKBK per day, representing a population of 209679. KKBK had receives several complaints and patient unhappiness with its health care services, despite the administration's efforts to improve the clinics healthcare delivery. Thus, this study aimed to measure patients' satisfaction towards health care services at Pahang's highest patient loads primary care clinic.

    MATERIALS AND METHODS: A cross-sectional study was conducted at Klinik Kesihatan Bandar Kuantan, Kuantan, Pahang. Patients were selected using stratified random sampling, and 201 participants were selected. The selected participants were asked to fill up the self-administered validated questionnaires consisting of background characteristics and Patient Satisfaction Questionnaire 18 (PSQ-18). Data collection period was from March 2022 to August 2022. Descriptive analysis was used to describe the background characteristics of respondents and the score of patient satisfaction. Multiple linear regression was used to determine the factors associated with patient satisfaction while adjusting for cofounders.

    RESULTS: A total of 201 eligible data points were analysed in the study. The respondent mean age was 47.1 ± 16.9. Most respondents were Malay (68.7%), having secondary education (54.2%) and predominantly from the B40 income class (88.1%). The overall mean patient satisfaction score was 3.83 ± 0.31. There were significant associations between overall satisfaction with patient education level (B = -0.144; 95% CI -0.246, -0.042; p = 0.006), waiting time (B = -0.371; 95% CI -0.534, -0.209; p = 0.001) and consultation duration (B = -0.154; 95% CI -0.253, -0.055; p = 0.0020). It was found that patients with secondary education were less satisfied compared to patients with primary education level on health care services they received. Meanwhile, those who were not happy with the waiting time and consultation duration showed less satisfaction with overall healthcare services.

    CONCLUSION: Despite serving the most significant number of patients in Pahang state, most of the patient were satisfied by the health care services at Klinik Kesihatan Bandar Kuantan. However, it is recommended to improve the waiting time and the consultation time in this clinic.

  2. Muhamad S, Kusairi S, Man M, Majid NFH, Wan Kassim WZ
    Data Brief, 2021 Aug;37:107197.
    PMID: 34150965 DOI: 10.1016/j.dib.2021.107197
    This article presents data on digital adoption by enterprises in Malaysian industrial sectors during the COVID-19 pandemic. The data were collected during the periods of Conditional Movement Control Order (CMCO) and Recovery Movement Control Order (RMCO) from October 11 to December 31, 2020. Data collection was completed through an online questionnaire survey conducted among a sample of 432 enterprises from four industrial sectors, namely services, retail, manufacturing, and tourism, in all states in Malaysia. The sample was selected using cluster and systematic random sampling. The questionnaire asked respondents to state whether they used the Internet, computers, phones, web sites, e-payment, and e-commerce to complete their activities relating to finance, production and operations, human resource management, and marketing. The data were analysed using descriptive statistics and cross-tabulation. The data show the extent of digital adoption by Malaysian enterprises during the pandemic in comparison to the situation before the pandemic. The data may be of use to other similar researchers as comparison and to policy makers as guides in devising related policies.
  3. Wan Mahari WA, Awang S, Zahariman NAZ, Peng W, Man M, Park YK, et al.
    J Hazard Mater, 2022 Feb 05;423(Pt A):127096.
    PMID: 34523477 DOI: 10.1016/j.jhazmat.2021.127096
    Microwave co-pyrolysis was examined as an approach for simultaneous reduction and treatment of environmentally hazardous hospital plastic waste (HPW), lignocellulosic (palm kernel shell, PKS) and triglycerides (waste vegetable oil, WVO) biowaste as co-feedstock. The co-pyrolysis demonstrated faster heating rate (16-43 °C/min) compared to microwave pyrolysis of single feedstock (9-17 °C/min). Microwave co-pyrolysis of HPW/WVO performed at 1:1 ratio produced a higher yield (80.5 wt%) of hydrocarbon liquid fuel compared to HPW/PKS (78.2 wt%). The liquid oil possessed a low nitrogen content (< 4 wt%) and free of sulfur that could reduce the release of hazardous pollutants during its use as fuel in combustion. In particular, the liquid oil obtained from co-pyrolysis of HPW/WVO has low oxygenated compounds (< 16%) leading to reduction in generation of potentially hazardous sludge or problematic acidic tar during oil storage. Insignificant amount of benzene derivatives (< 1%) was also found in the liquid oil, indicating the desirable feature of this pyrolysis approach to suppress the formation of toxic polycyclic aromatic hydrocarbons (PAHs). Microwave co-pyrolysis of HPW/WVO improved the yield and properties of liquid oil for potential use as a cleaner fuel, whereas the liquid oil from co-pyrolysis of HPW/PKS is applicable in the synthesis of phenolic resin.
  4. Jacob MA, Ekker MS, Allach Y, Cai M, Aarnio K, Arauz A, et al.
    Neurology, 2022 Feb 08;98(6):e573-e588.
    PMID: 34906974 DOI: 10.1212/WNL.0000000000013195
    BACKGROUND AND OBJECTIVES: There is a worldwide increase in the incidence of stroke in young adults, with major regional and ethnic differences. Advancing knowledge of ethnic and regional variation in causes and outcomes will be beneficial in implementation of regional health care services. We studied the global distribution of risk factors, causes, and 3-month mortality of young patients with ischemic stroke, by performing a patient data meta-analysis from different cohorts worldwide.

    METHODS: We performed a pooled analysis of individual patient data from cohort studies that included consecutive patients with ischemic stroke aged 18-50 years. We studied differences in prevalence of risk factors and causes of ischemic stroke between different ethnic and racial groups, geographic regions, and countries with different income levels. We investigated differences in 3-month mortality by mixed-effects multivariable logistic regression.

    RESULTS: We included 17,663 patients from 32 cohorts in 29 countries. Hypertension and diabetes were most prevalent in Black (hypertension, 52.1%; diabetes, 20.7%) and Asian patients (hypertension 46.1%, diabetes, 20.9%). Large vessel atherosclerosis and small vessel disease were more often the cause of stroke in high-income countries (HICs; both p < 0.001), whereas "other determined stroke" and "undetermined stroke" were higher in low and middle-income countries (LMICs; both p < 0.001). Patients in LMICs were younger, had less vascular risk factors, and despite this, more often died within 3 months than those from HICs (odds ratio 2.49; 95% confidence interval 1.42-4.36).

    DISCUSSION: Ethnoracial and regional differences in risk factors and causes of stroke at young age provide an understanding of ethnic and racial and regional differences in incidence of ischemic stroke. Our results also highlight the dissimilarities in outcome after stroke in young adults that exist between LMICs and HICs, which should serve as call to action to improve health care facilities in LMICs.

  5. Ekker MS, Jacob MA, van Dongen MME, Aarnio K, Annamalai AK, Arauz A, et al.
    BMJ Open, 2019 Nov 14;9(11):e031144.
    PMID: 31727655 DOI: 10.1136/bmjopen-2019-031144
    INTRODUCTION: Worldwide, 2 million patients aged 18-50 years suffer a stroke each year, and this number is increasing. Knowledge about global distribution of risk factors and aetiologies, and information about prognosis and optimal secondary prevention in young stroke patients are limited. This limits evidence-based treatment and hampers the provision of appropriate information regarding the causes of stroke, risk factors and prognosis of young stroke patients.

    METHODS AND ANALYSIS: The Global Outcome Assessment Life-long after stroke in young adults (GOAL) initiative aims to perform a global individual patient data meta-analysis with existing data from young stroke cohorts worldwide. All patients aged 18-50 years with ischaemic stroke or intracerebral haemorrhage will be included. Outcomes will be the distribution of stroke aetiology and (vascular) risk factors, functional outcome after stroke, risk of recurrent vascular events and death and finally the use of secondary prevention. Subgroup analyses will be made based on age, gender, aetiology, ethnicity and climate of residence.

    ETHICS AND DISSEMINATION: Ethical approval for the GOAL study has already been obtained from the Medical Review Ethics Committee region Arnhem-Nijmegen. Additionally and when necessary, approval will also be obtained from national or local institutional review boards in the participating centres. When needed, a standardised data transfer agreement will be provided for participating centres. We plan dissemination of our results in peer-reviewed international scientific journals and through conference presentations. We expect that the results of this unique study will lead to better understanding of worldwide differences in risk factors, causes and outcome of young stroke patients.

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