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Determining efficient delivery routes in specific time-frames using Geographic Information System

Abousaeidi M, Fauzi R, Muhamad R

J Environ Biol, 2016 09;37(5 Spec No):1167-1176.
PMID: 29989749

Perishable products must be transported quickly from its production area to the markets due to the climatic conditions of Malaysia. Deterioration of fresh produce is affected by temperature and delivery time. The cost to achieve such timely delivery of perishable food can affect the revenue of suppliers and retailers. Choosing an efficient delivery route at right time can reduce the total transportation cost. However, insufficient attention has been given to transportation issues with regards to fresh food delivery of greater Kuala Lumpur. The present study involves adoption of the Geographic Information System (GIS) modelling approach to determine the fastest delivery routes for fresh products to several hypermarkets. For this purpose, ArcGIS software was adopted for solving the problem of a complex road networks. With a goal of realizing the shortest time for delivery route planning, impedance function would be integrated by taking into account the time emphasized in the study. The main findings of this study include determination of efficient routes for delivery of fresh vegetables based on minimal drive time. It has been proposed that the fastest route model for delivery of fresh products is based on comparing two time frames within a day. The final output of this research was a map of quickest routes with best delivery time based on two time frames.
Fulltext Effects of sugar sources and fermentation time on the properties of tea fungus (kombucha) beverage

Muhialdin, B.J., Osman, F.A., Muhamad, R., Che Wan Sapawi, C.W.N.S., Anzian, A., Voon, W.W.Y., et al.

International Food Research Journal, 2019;26(2):481-487.
MyJurnal

Recently, fermented foods have been developing huge demand among modern consumers due to their health benefits and pleasant flavour. The objective of the present work was to evaluate the effects of fermentation time and different sugar sources on the physicochemical and antioxidant activities of kombucha tea. The sugar sources selected were white refined sugar (WRS), coconut palm sugar (CPS) and molasses sugar (MS). The fermentation substrate was boiled black tea, 10% (w/v) of each sugar, 3% (w/v) of tea fungus (SCOBY) and 10% (v/v) of previously fermented kombucha tea (back slope fermentation). The mixture was incubated in the dark at 24±3°C for 14 days. The sugar and organic acid contents were determined by HPLC, while the antioxidant active was determined by the DPPH and FRAP methods. Results demonstrated significantly higher biomass formation, glucose and sucrose content for kombucha tea fermented with WRS, while kombucha tea fermented with MS showed higher organic acid contents. Moreover, kombucha tea fermented with CPS exhibited the highest antioxidant activity and total phenolic content, followed by those fermented with MS and WRS. The present work demonstrated that kombucha tea fermented with CPS is recommended to be consumed as functional beverage for health benefits and prevention of oxidation related diseases. In addition, CPS and MS are good sugar alternatives to sucrose and other sugars frequently used in kombucha fermentation.
Fulltext Geographic Information System (GIS) modeling approach to determine the fastest delivery routes

Abousaeidi M, Fauzi R, Muhamad R

Saudi J Biol Sci, 2016 Sep;23(5):555-64.
PMID: 27579003 DOI: 10.1016/j.sjbs.2015.06.004

This study involves the adoption of the Geographic Information System (GIS) modeling approach to determine the quickest routes for fresh vegetable delivery. During transport, fresh vegetables mainly deteriorate on account of temperature and delivery time. Nonetheless, little attention has been directed to transportation issues in most areas within Kuala Lumpur. In addition, perishable food normally has a short shelf life, thus timely delivery significantly affects delivery costs. Therefore, selecting efficient routes would consequently reduce the total transportation costs. The regression model is applied in this study to determine the parameters that affect route selection with respect to the fastest delivery of fresh vegetables. For the purpose of this research, ArcGIS software with network analyst extension is adopted to solve the problem of complex networks. The final output of this research is a map of quickest routes with the best delivery times based on all variables. The variables tested from regression analysis are the most effective parameters to make the flow of road networks slower. The objective is to improve the delivery services by achieving the least drive time. The main findings of this research are that Land use such as residential area and population as variables are the effective parameters on drive time.
Genetic Diversity of Bemisia tabaci (Hemiptera: Aleyrodidae) Species Complex Across Malaysia

Shadmany M, Boykin LM, Muhamad R, Omar D

J Econ Entomol, 2019 02 12;112(1):75-84.
PMID: 30272175 DOI: 10.1093/jee/toy273

The tobacco whitefly Bemisia tabaci (Gennadius) (Hemiptera: Aleyrodidae) is a cryptic species complex with members capable of inducing huge economic losses. Precise identification of members of this complex proves essential in managing existing populations and preventing new incursions. Despite records of serious outbreaks of this pest in Malaysia little is known about species status of B. tabaci in this region. To address this, a comprehensive sampling of B. tabaci from different host plants was conducted in 10 states of Malaysia from 2010 to 2012. Members of the complex were identified by sequencing partial mitochondrial cytochrome oxidase subunit I (mtCOI) gene and constructing a Bayesian phylogenetic tree. Seven putative species were identified including Asia I, Mediterranean (MED), China 1, China 2, Asia II 6, Asia II 7, and Asia II 10. The most important finding of the study is the identification of the invasive MED species from locations without previous records of this species. All putative species except Asia I and MED are recorded from Malaysia for the first time. This study provided the first introductory map of B. tabaci species composition in Malaysia and emphasizes the urgent need for further studies to assess the status of MED invasion in this country.
Development of single locus DNA microsatellite markers in Oryctes rhinoceros (Linnaeus) using 5' anchored RAMs-PCR method

Manjeri G, Muhamad R, Faridah QZ, Tan SG

J Genet, 2012 Nov 22;91(3):e92-6.
PMID: 23257301
Fulltext Sexual dysfunction among six months postpartum women in north-eastern Malaysia

Ng YY, Muhamad R, Ahmad I

PLoS One, 2023;18(4):e0284014.
PMID: 37018316 DOI: 10.1371/journal.pone.0284014

Female sexual dysfunction (FSD) is a common problem among postpartum women. However, little is known about this topic in Malaysia. This study aimed to determine the prevalence of sexual dysfunction and its associated factors in postpartum women in Kelantan, Malaysia. In this cross-sectional study, we recruited 452 sexually active women at six months postpartum from four primary care clinics in Kota Bharu, Kelantan, Malaysia. The participants were asked to fill in questionnaires consisting of sociodemographic information and the Malay Version of the Female Sexual Function Index-6. The data were analyzed using bivariate and multivariate logistic regression analyses. With a 95% response rate, the prevalence of sexual dysfunction among sexually active, six months postpartum women was 52.4% (n = 225). FSD was significantly associated with the older husband's age (p = 0.034) and lower frequency of sexual intercourse (p<0.001). Therefore, the prevalence of postpartum sexual dysfunction in women is relatively high in Kota Bharu, Kelantan, Malaysia. Efforts should be made to raise awareness among healthcare providers about screening for FSD in postpartum women and for their counseling and early treatment.
Managing Women with Sexual Dysfunction: Difficulties Experienced by Malaysian Family Physicians

Muhamad R, Horey D, Liamputtong P, Low WY

Arch Sex Behav, 2019 04;48(3):949-960.
PMID: 30238183 DOI: 10.1007/s10508-018-1236-1

Recognizing barriers to managing sexual issues makes it more likely that effective ways to overcome them will be found. In Malaysia, where discussion of sexual issues is taboo, sociocultural factors may influence how physicians manage patients with these types of problems. This article focuses on the challenges encountered by 21 Malay family physicians when women experiencing sexual problems and female sexual dysfunction (FSD) attended their clinics, an uncommon occurrence in Malaysia, despite their high prevalence. This qualitative study employed a phenomenological framework and conducted face-to-face in-depth interviews. Three main barriers to managing women with sexual problems were identified that can hinder assessment and treatment: insufficient knowledge and training; unfavorable clinic environments; and personal embarrassment. Some barriers were associated with physician characteristics but many were systemic. These were further evaluated using social cognitive theory. Professional attitudes appear important as those physicians with an interest in managing women's health seemed to make greater effort to explore issues further and work to gain trust. Physicians who appeared indifferent to the impact of FSD showed greater reluctance to find solutions. Systemic issues included unfavorable clinical settings, lack of training, and lack of local evidence. Any strategy to address FSD needs to be underpinned by appropriate policies and resources.
Meanings of Sexuality: Views from Malay Women with Sexual Dysfunction

Muhamad R, Horey D, Liamputtong P, Low WY, Sidi H

Arch Sex Behav, 2019 04;48(3):935-947.
PMID: 30066036 DOI: 10.1007/s10508-018-1228-1

In Malaysia, female sexual dysfunction (FSD) among Malays is common, so understanding the meanings of sexuality becomes crucial, as they can vary with identity, and this may influence each woman's subsequent reaction to sexual experience. In this article, we explore the meanings of sexuality that Malay women had developed throughout their lived experience. This qualitative study, situated within a social cognitive theory and a phenomenological framework, was conducted through in-depth and photograph elicitation interviews with 26 Malay women who had self-reported experiencing FSD. The findings suggest that the meanings of sexuality for these women linked closely with fundamental factors of Malay identity, which is comprised of tradition (Adat), religion (Islam), and language, that all influence gendered roles. Malay women understood sexuality to be sexual intimacy within marriage, privileging their marital role as a "good wife" over their personal rights within a sexual relationship. This understanding of sexuality was reinforced by meanings attributed to procreation, which Malay women linked closely to the purpose of marriage and their role as a "good mother." The findings should provide useful evidence that could be used in sexual health promotions to help reduce FSD and in clinical practice to generate appropriate therapy in Malaysia and elsewhere.
Fulltext Pelvic Floor Muscle Exercise Education and Factors Associated with Implementation among Antenatal Women in Hospital Universiti Sains Malaysia

Muhammad J, Muhamad R, Husain NRN, Daud N

Korean J Fam Med, 2019 Jan;40(1):45-52.
PMID: 30613064 DOI: 10.4082/kjfm.17.0136

BACKGROUND: Pelvic floor muscle exercise is effective for pelvic floor muscle dysfunction. Despite the high prevalence of pelvic floor muscle dysfunction in women in the community, pelvic floor muscle exercise recognition is low in Malaysian society; thus, this intervention is not frequently used . This study assessed the knowledge of, attitudes towards, and use of pelvic floor muscle exercise among antenatal women before and after educational classes. The study also determined factors associated with exercise practice.
METHODS: An interventional study was conducted in 121 antenatal women selected through systematic random sampling between June and December 2010. Baseline knowledge of, attitude towards, and practice of pelvic floor muscle exercise were assessed using self-administered validated questionnaires at first visit and at 2 months postpartum. All participants attended two exercise education classes on their next two visits before delivery. A paired ttest and multivariate analysis were used for data evaluation.
RESULTS: The mean pre-intervention scores for knowledge, attitudes, and practice were 24.98, 24.25, and 3.51, respectively, with statistically significant mean score increments after intervention (P<0.001). The mean differences were 4.67 (95% confidence interval [CI], 3.86-5.49), 3.77 (95% CI, 3.05-4.50) and 3.45 (95% CI, 2.90-4.00) for knowledge, attitudes, and practice, respectively. Lack of baseline information on pelvic floor muscle exercise was significantly associated with practice change following an educational class.
CONCLUSION: Education is effective in improving knowledge of, attitude towards, and practice of pelvic floor muscle exercise. There is a need for greater effort to increase exercise awareness in our community, especially during antenatal class.
Depression and potential risk factors among the elderly with Type 2 Diabetes Mellitus in Kedah, Malaysia

Azniza MR, Draman N, Siti Suhaila MY, Muhamad R

Med J Malaysia, 2019 04;74(2):103-108.
PMID: 31079119

OBJECTIVE: Elderly with diabetes has been found to have a higher chance of depression. Therefore, the aim of this study is to determine the prevalence of depression and its associated factors among elderly with Type 2 Diabetes Mellitus in Kedah.
METHODS: A cross-sectional study was conducted at the Klinik Kesihatan Bandar, Sungai Petani, Kedah. The inclusion criteria were patients aged ≥60 years with Type 2 Diabetes Mellitus. Those with cognitive impairment, presence of organic brain syndrome, presence of severe mental disorder and patients who are either deaf or mute were excluded. The Malay version of Geriatric Depression Scale (M-GDS-14) was used to assess the depressive symptoms. The data was analysed using descriptive statistic and multiple logistic regression.
RESULTS: A total of 511 patients participated in the study. The mean age of the respondents is 64.5 (Standard Deviation 7.0) years old. There were slightly more males (53.8%). Majority were Malay (63.0%), married (76.9%) and has a household income of less than RM1000 (67.5%). The prevalence of depression was 32.1%. The number of elderly people living with their children (Adjusted Odds Ratio, aOR0.20, 95%CI: 0.07, 0.55), elderly living with spouse, children, in law and grandchildren (aOR2.95, 95%CI: 1.18, 7.37), diabetic complication (aOR4.68, 95%CI: 2.63, 8.35) and HbA1c (aOR1.23, 95%CI: 1.09, 1.39) are significantly associated with depression.
CONCLUSION: The level of depression was found to be high. Factors contributing to the significantly high level of depression are found to be associated with living arrangements, diabetic complication and HbA1c were significantly associated with depression.
The decision of breastfeeding practices among parents attending primary health care facilities in suburban Malaysia

Draman N, Mohamad N, Yusoff HM, Muhamad R

J Taibah Univ Med Sci, 2017 Oct;12(5):412-417.
PMID: 31435272 DOI: 10.1016/j.jtumed.2017.05.005

Objectives: This study aimed to determine the association between decision making for breastfeeding practices and associated factors for exclusive breastfeeding practices among parents attending primary health care facilities.
Methods: This cross-sectional study involved 196 parents who attended primary health care facilities in suburban Malaysia. A self-administered questionnaire was given to assess decision-making styles and factors associated with exclusive breastfeeding practices. Systematic random sampling was used for the non-exclusive breastfeeding group, and convenience sampling was used for the exclusive breastfeeding group. Multiple logistic regression analysis was conducted to determine the associated factors for exclusive breastfeeding practices.
Results: We found an association between the mutual decision of parents on exclusive breastfeeding and exclusive breastfeeding practices. Previous exclusive breastfeeding experience, fathers' ages, mothers' occupations and mutual decisions had significant impact on exclusive breastfeeding practices.
Conclusion: The important determinant for practising exclusive breastfeeding is parents' mutual decisions. Therefore, practitioners need to continuously educate and emphasize the fathers' role in the breastfeeding process.
Fulltext Prevalence of prehypertension and its associated factors among adults visiting outpatient clinic in Northeast Malaysia

Rafan SN, Zakaria R, Ismail SB, Muhamad R

J Taibah Univ Med Sci, 2018 Oct;13(5):459-464.
PMID: 31435362 DOI: 10.1016/j.jtumed.2018.06.005

Objectives: Prehypertension refers to a systolic blood pressure of 120-139 mmHg systolic or a diastolic blood pressure of 80-89 mmHg. Estimation of the prevalence of prehypertension in the population and identification of cardiovascular associated factors are important to reduce progression to hypertension. This study aimed to determine the prevalence of prehypertension and its associated factors among Malaysian adults.
Methods: In 2015, a cross-sectional study was conducted among adults visiting an outpatient clinic in Northeast Malaysia. Face-to-face interviews were conducted using Malay and English versions of the Malaysia Non-Communicable Disease surveillance questionnaire. This instrument captured information about sociodemographic, lifestyle status, and anthropometric data. Blood pressure was measured three times with a sphygmomanometer, the first measurement value was discarded, and an average of blood pressure from the second two readings was recorded for further data analysis. Logistic regression was performed to analyse factors associated with prehypertension.
Result: A total 151 adults participated in the study, and the prevalence of prehypertension was 37.1% (95% confidence interval [CI]: 29.29, 44.69). Factors associated with prehypertension in this study were age (adjusted odds ratio [aOR] = 1.06 95% CI: 1.02, 1.11; p = 0.007), male sex (aOR = 4.44 95% CI: 1.58, 12.44; p = 0.005), and abnormal waist circumference (aOR = 31.65 95% CI: 11.25, 89.02; p
Fulltext Coronavirus Disease 2019 Presenting as Conjunctivitis

Ying NY, Idris NS, Muhamad R, Ahmad I

Korean J Fam Med, 2021 Nov;42(6):487-490.
PMID: 32475104 DOI: 10.4082/kjfm.20.0090

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The world is currently challenged to handle this pandemic. The common symptoms of COVID-19 are fever, cough, fatigue, and shortness of breath. There are few reports on the association of SARS-CoV-2 with ocular abnormalities including conjunctivitis. We report a case of a 54-year-old woman who presented solely with conjunctivitis subsequently diagnosed with COVID-19. A lack of full history of her travel abroad was another issue leading to a delay in evaluating her COVID-19 status that increased the infection risk to her managing team. Thus, primary care practitioners should be suspicious of this atypical feature of COVID-19, thus enabling us to identify such patients at entry points. Maintaining safety measures while managing patients is also crucial.
Fulltext Knowledge, attitudes and practice of preconception care among women attending maternal health clinic in Kelantan

Kasim R, Draman N, Abdul Kadir A, Muhamad R

Education in Medicine Journal, 2016;8(4):57-68.
MyJurnal

Introduction: Pregnancy is common among women in the reproductive age and is associated with several risks. Preconception care has thus been introduced to promote health before conception and to improve pregnancy-related outcomes. The aim of this study was to determine the level of knowledge, attitudes and practices regarding preconception care among women attending antenatal care appointments. Methodology: This was a cross-sectional study conducted from April to December 2012 at Klinik Kesihatan Bachok. A self-administered questionnaire was administered to 135 respondents from 18 to 45 years of age. The questionnaire consisted of four domains, assessing socio-demographic data and knowledge, attitudes and practice of preconception care. Results: The mean (SD) knowledge, attitude and practice scores were 11.37 (3.94), 15.39 (2.12) and 10.13 (2.30), respectively. In total, 98.5% of the respondents had good attitudes, 45.2% had good practices, and 51.9% had good knowledge of preconception care. Conclusion: Women in Bachok have fair knowledge of and good attitude towards preconception care. However, they have poor preconception care practices.
Fulltext Behind the Scenes of Parents Nurturing a Child with Autism: A Qualitative Study in Malaysia

Yaacob WNW, Yaacob LH, Muhamad R, Zulkifli MM

Int J Environ Res Public Health, 2021 08 12;18(16).
PMID: 34444280 DOI: 10.3390/ijerph18168532

Many parents have experienced difficulties in parenting children with autism. We, therefore, consider a more in-depth understanding that is necessary to explore the challenges facing parents and families to provide a better outcome for both. We interviewed 21 parents of 24 children with autism spectrum disorder (ASD) to qualitatively explore the challenges they experienced through a phenomenological framework. Four main aspects emerged as challenges to the parents: inadequate knowledge, psychological distress and stigma, lack of support, and barriers to services. These four themes reflect a lack of balance between the needs of caregivers and the services and resources or support available in the community to meet those needs. Our study contributes to an understanding of how parents perceive challenges, making it easier to take necessary action to meet their needs and ease their burden of stress. A concerted effort is needed to coordinate services across all disciplines to address these challenges.
Fulltext Yaws: The forgotten tropical skin disease

Md Alwi N, Muhamad R, Ishak A, Wan Abdullah WNH

Malays Fam Physician, 2021 Nov 30;16(3):104-107.
PMID: 34938399 DOI: 10.51866/cr1275

Yaws is a rare skin disease endemic to tropical countries caused by Treponema pertenue. It is highly infectious and spreads through physical contact. In Malaysia, it was presumably eradicated during the 1960s, with the last reported case published in 1985. Due to its rarity, the disease often goes unrecognised and misdiagnosed. Here, we report the case of a 5-year-old aboriginal boy diagnosed with secondary yaws who presented with fever and an incidental finding of chronic painless ulcerated nodules and plaques on his lower limbs and gluteal region. His diagnosis was confirmed serologically with a venereal disease research laboratory lab test and he was successfully treated with a single dose of intramuscular benzathine penicillin G. Primary care physicians should not ignore this disease since its early recognition and appropriate treatment is vital to its eradication, especially in high-risk communities.
The transcript level of interleukin-6 in the cartilage of idiopathic osteoarthritis of knee

Moktar NM, Yusof HM, Yahaya NH, Muhamad R, Das S

Clin Ter, 2010;161(1):25-8.
PMID: 20393674

AIMS: The mRNA level for interleukin-6 (IL-6) is an important marker of osteoarthritis (OA). The present study aimed to investigate the level of IL-6 mRNA in the cartilage of OA knee while comparing it to the normal cartilage obtained from the same patient.
MATERIALS AND METHODS: A total of 21 patients who underwent total knee replacement were recruited for this study. Sectioning of the destructive cartilage was performed in the medial part of the proximal tibiofemoral cartilage. The unaffected lateral part of the knee in the same patient, served as a control. The mRNA level for IL-6 was assessed using LightCycler 2.0 quantitative real-time polymerase chain reaction (qRT-PCR). actin mRNA was used as an endogenous control.
RESULTS: Twelve out of 21 patients (57.1%) exhibited up regulation of IL-6 mRNA in the OA cartilage as compared to the normal cartilage. The rest of the patients (42.9%) showed down regulation of IL-6 mRNA. The statistical analysis showed there was insignificant level of IL-6 mRNA in the OA (1.91 +/- 0.45) as compared to the normal cartilage (1.13 +/- 0.44) (p > 0.05). The inter-individual variation in the level of IL-6 mRNA in the cartilage of idiopathic knee was in accordance with previous findings.
CONCLUSIONS: These observations suggest IL-6 could also act as a catabolic agent in some patients or its expression might be influenced by other cytokines.
Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Fulltext Life Table and Population Parameters of Nilaparvata lugens Stal. (Homoptera: Delphacidae) on Rice

Win SS, Muhamad R, Ahmad ZA, Adam NA

Trop Life Sci Res, 2011 May;22(1):25-35.
PMID: 24575207 MyJurnal

Survival and fertility characteristics of the brown planthopper (BPH), Nilaparvata lugens were assessed in the laboratory and field. Life tables and population parameters of the BPH were constructed in an environment with unlimited food supply and that was free of natural enemies. The highest mortality occurred in the immature stage, especially in the first and second instars. The life table analysis showed that the population density of BPH decreased gradually. The survival ratio of male to female was 0.512:0.488. The females lived for a maximum of 20 days. The trend of oviposition showed a peak at around the tenth day of the female life. The highest number of eggs produced per female per day was 9.63. The intrinsic rate of increase (rm) in egg production per female per day was 0.0677 and the daily finite of increase (λ) was 1.0688 females per female per day, with a mean generation time (T) of 34.05 days. The net reproductive rate (Ro) of the population was 10.02. The population doubling time (DT) was 10.42 days.
Fulltext Patients' experience of accessing healthcare for obesity in Peninsular Malaysia: a qualitative descriptive study

Yunus NA, Russell G, Muhamad R, Sturgiss EA

BMJ Open, 2023 Nov 21;13(11):e071087.
PMID: 37989390 DOI: 10.1136/bmjopen-2022-071087

OBJECTIVE: To explore patients' experiences accessing healthcare for obesity and their perceived behaviour changes following the care.
DESIGN: Using a descriptive qualitative research approach informed by Levesque's framework of access to healthcare, we conducted phone interviews in the Malaysian language, which were audio-recorded and transcribed verbatim. Data were analysed inductively using a reflexive thematic analysis approach.
SETTING: Primary care clinics in five states in Peninsular Malaysia.
PARTICIPANTS: Adult patients with obesity receiving face-to-face care for obesity from healthcare providers in Peninsular Malaysia.
RESULTS: We interviewed 22 participants aged 24-62, with the majority being female (77%), Malay (95%), married (73%) and with tertiary education (82%). Most participants attended obesity management services at public primary care clinics. We identified five themes: (1) moving from perceiving the need to seeking obesity care is a non-linear process for patients, (2) providers' words can inspire patients to change, (3) patients' needs and preferences are not adequately addressed in current obesity care, (4) over-focusing on weight by patients and healthcare providers can lead to self-blame and loss of hope for patients and (5) obesity healthcare can have consequences beyond weight loss.
CONCLUSION: Patients lack the self-regulatory skills to continue their lifestyle changes and struggle with self-blame and hopelessness. Over-focusing on weight by patients and obesity healthcare increase patients' self-stigmatisation. While provider-initiated weight discussions and engaging and personalised consultation provide the initial step towards weight management, obesity healthcare could be enhanced by behavioural support and patient education on the complexity of obesity. Further considerations could be given to shifting from a weight-centric to a more holistic health-centred approach in obesity healthcare.
The perceptions of healthcare practitioners on obesity management in Peninsular Malaysia: a cross-sectional survey

Yunus NA, Russell G, Muhamad R, Soh SE, Sturgiss E

BMC Health Serv Res, 2023 Jul 10;23(1):744.
PMID: 37430243 DOI: 10.1186/s12913-023-09759-z

BACKGROUND: Practitioners' perceptions of patients with obesity and obesity management shape their engagement in obesity care delivery. This study aims to describe practitioners' perceptions, experiences and needs in managing patients with obesity, determine the extent of weight stigma among health practitioners, and identify the factors associated with negative judgment towards patients with obesity.
METHODS: A cross-sectional online survey was conducted from May to August 2022 with health practitioners commonly involved in obesity management in Peninsular Malaysia, including doctors in primary care, internal medicine and bariatric surgery, and allied health practitioners. The survey explored practitioners' perceptions, barriers and needs in managing obesity, and evaluated weight stigma using the Universal Measures of Bias - Fat (UMB Fat) questionnaire. Multiple linear regression analysis was used to identify demographic and clinical-related factors associated with higher negative judgment towards patients with obesity.
RESULTS: A total of 209 participants completed the survey (completion rate of 55.4%). The majority (n = 196, 94.3%) agreed that obesity is a chronic disease, perceived a responsibility to provide care (n = 176, 84.2%) and were motivated to help patients to lose weight (n = 160, 76.6%). However, only 22% (n = 46) thought their patients were motivated to lose weight. The most frequently reported barriers to obesity discussions were short consultation time, patients' lack of motivation, and having other, more important, concerns to discuss. Practitioners needed support with access to multi-disciplinary care, advanced obesity training, financing, comprehensive obesity management guidelines and access to obesity medications. The mean (SD) of the UMB Fat summary score was 2.99 (0.87), with the mean (SD) domain scores ranging between 2.21 and 4.36 (1.06 to 1.45). No demographic and clinical-related factors were significantly associated with negative judgment from the multiple linear regression analyses.
CONCLUSION: Practitioners in this study considered obesity a chronic disease. While they had the motivation and capacity to engage in obesity management, physical and social opportunities were the reasons for not discussing obesity with their patients. Practitioners needed more support to enhance their capability and opportunity to engage with obesity management. Weight stigma in healthcare settings in Malaysia should be addressed, given the possibility of hindering weight discussions with patients.

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