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  1. Rajamoorthy Y, Taib NM, Harapan H, Wagner AL, Munusamy S
    PLoS One, 2023;18(6):e0286924.
    PMID: 37307254 DOI: 10.1371/journal.pone.0286924
    Hand foot and mouth disease (HFMD) is a notifiable viral disease in Malaysia, and is transmitted primarily among young children. Although vaccines for enteroviruses 71 (EV-71) were approved in China against HFMD, the availability and the acceptance of the vaccine in the Malaysia are unknown. This study investigated and ascertained the determinants of willingness-to-pay (WTP) for HFMD vaccination in Selangor Malaysia. This study adopted a cross-sectional, contingent valuation method involving 390 parents of young children aged six and below. The double bounded dichotomous choice (DBDC) approach was employed to assess the WTP for HFMD vaccine among respondents. A bivariate probit model was used to assess the key determinants of WTP for HFMD vaccine, while the mean WTP was measured using the Krinsky and Robb procedure. We found that 279 (71.5%) of parents were willing to pay for the HFMD vaccination. The estimated single bounded mean WTP was MYR460.23 (equivalent to US$ 102.17) for two doses of HFMD vaccination. The double bounded analysis revealed that the vaccine's price, poor education background and lower income were the key factors that significantly affected the WTP, with the estimated mean WTP being MYR394.00 (US$ 87.47). In conclusion, most Malaysian parents are willing to pay for the HFMD vaccination. The estimated WTP identifies the optimal price point for HFMD vaccination in Malaysia. Furthermore, the government should focus on an awareness programme for the HFMD vaccination among parents who have lower income or education level.
  2. Jeyagobi S, Munusamy S, Kamaluddin MR, Ahmad Badayai AR, Kumar J
    Front Public Health, 2022;10:965017.
    PMID: 36262235 DOI: 10.3389/fpubh.2022.965017
    Cyber-aggression is global epidemic affecting citizens of cyberspace, without regards to physical, geographical and time constraints. Recent research has identified the significant role of cyber-bystanders in exacerbating and de-escalating incidents on cyber-aggression they come across. Additionally, frequent exposure to cyber-aggression is found to have been associated with negative effects on participants of cyber-aggression, ranging from self-esteem problems to mental health disorders such as depression and anxiety, and in the worst cases even suicidal behaviors and ideation. Moreover, past research had also identified that negative bystanders could potentially become aggressors themselves. Therefore, the current review is aimed at uncovering the common themes and factors that drive individuals to resort to negative bystander behavior. Hence, a systematic literature review using the PRISMA framework was carried out, involving articles published between January 2012 to March 2022, on online databases such as SCOPUS, Science Direct, SAGE Journals, Web of Science, and Springer Link. Results obtained through the synthesis of 27 selected articles, were grouped into three categories, namely situational factors, personal factors and social influence. Upon further synthesis of the results, it was noted that many of the factors had interacted with each other. Thus, practical suggestion for prevention and future research would include addressing these interactions in preventative methodologies and research interests.
  3. Rajamoorthy Y, Radam A, Taib NM, Rahim KA, Wagner AL, Mudatsir M, et al.
    PLoS One, 2018;13(12):e0208402.
    PMID: 30521602 DOI: 10.1371/journal.pone.0208402
    BACKGROUND: Malaysia has a comprehensive, publicly-funded immunization program for hepatitis B (HepB) among infants, but adults must pay for the vaccine. The number of HepB carriers among adults is expected to increase in the future; therefore, we examined the impact of five constructs (cues to action, perceived barriers, perceived benefit, perceived severity, and perceived susceptibility) on adults' willingness to pay (WTP) for HepB vaccine; secondarily, we examined the association between perceived barriers and perceived benefits.

    METHODS: Adults were selected through a stratified, two-stage cluster community sample in Selangor, Malaysia. The reliability, convergent validity, and discriminant validity of the measurement model were assessed before implementing a partial least squares structural equation model (PLS-SEM) to evaluate the significance of the structural paths.

    RESULTS: A total of 728 participants were enrolled. The five constructs all showed adequate internal reliability, convergent validity, and discriminant validity. There was a significant, positive relationship to WTP from constructs (perceived barriers [Path coefficient (β) = 0.082, P = 0.036], perceived susceptibility [β = 0.214, P<0.001], and cues to action [β = 0.166, P<0.001]), and the model all together accounted for 8.8% of the variation in WTP. There was a significant, negative relationship between perceived barriers and perceived benefit [β = -0.261, P<0.001], which accounted for 6.8% of variation in perceived benefit.

    CONCLUSIONS: Policy and programs should be targeted that can modify individuals' thoughts about disease risk, their obstacles in obtaining the preventive action, and their readiness to obtain a vaccine. Such programs include educational materials about disease risk and clinic visits that can pair HepB screening and vaccination.

  4. Ahmad Badruddin N, Roseliza-Murni A, Kamaluddin MR, Ahmad Badayai AR, Munusamy S
    BMC Psychol, 2024 Mar 15;12(1):155.
    PMID: 38491550 DOI: 10.1186/s40359-024-01649-1
    BACKGROUND: Risk of violence is closely associated with aggression propensity. However, there is a lack of research to explain the mechanisms behind this association, especially among the patients of forensic secure facilities. This review aimed to identify and synthesize the available literature concerning the intervening factors (mediating or moderating factors) in the relationship between the risk of violence and aggressive behavior in forensic secure facilities.

    METHODS: Two electronic academic databases were searched: Scopus and Web of Science (WoS) using specific keywords as search terms derived from the PCC framework with no specific time limit. The search strategy was developed based on the JBI Manual for Evidence Synthesis and utilised the PRISMA-ScR guidelines. Data on the risk of violence, intervening factors, and aggressive behavior were extracted from the included studies. Further analysis was performed whereby similar data were grouped and synthesised together.

    RESULTS: The initial search produced 342 studies. However, only nine studies fulfilled the inclusion criteria. The nine studies included 1,068 adult forensic inpatients from various psychiatric hospitals. Only mediation studies reported significant mechanisms of influence between the risk of violence and aggressive behavior. It is postulated that the human agency factor may be the underlying factor that influences a person's functioning and the subsequent series of events between the risk of violence and aggression.

    CONCLUSIONS: In light of the paucity of evidence in this area, a generalised conclusion cannot be established. More studies are warranted to address the gaps before conclusive recommendations can be proposed to the relevant stakeholders.

  5. Munusamy S, Syasyila K, Shaari AAH, Pitchan MA, Kamaluddin MR, Jatnika R
    BMC Psychol, 2024 Nov 18;12(1):673.
    PMID: 39558439 DOI: 10.1186/s40359-024-02129-2
    The proliferation of fake news on social media platforms has become a significant concern, influencing public opinion, political decisions, and societal trust. While much research has focused on the technological and algorithmic factors behind the spread of misinformation, less attention has been given to the psychological drivers that contribute to the creation and dissemination of fake news. Cognitive biases, emotional appeals, and social identity motivations are believed to play a crucial role in shaping user behaviour on social media, yet there is limited systematic understanding of how these psychological factors intersect with online information sharing. Existing studies tend to focus on individual aspects of fake news consumption, such as susceptibility to misinformation or partisan biases, leaving a gap in understanding the broader psychological mechanisms behind both the creation and dissemination of fake news. This systematic review aims to fill this gap by synthesizing current research on the psychological factors that influence social media users' involvement in dissemination and creation of fake news. Twenty-three studies were identified from 2014 to 2024 following the PRISMA guidelines. We have identified five themes through critical review and synthesis of the literature which are personal factors, ignorance, social factors, biological process, and cognitive process. These themes help to explain the psychological factors contributing to the creation and dissemination of fake news among social media users. Based on the findings, it is evident that diverse psychological factors influence the dissemination and creation of fake news, which must be studied to design better strategies to minimize this issue.
  6. Rajamoorthy Y, Taib NM, Munusamy S, Anwar S, Wagner AL, Mudatsir M, et al.
    BMC Public Health, 2019 Jan 10;19(1):47.
    PMID: 30630464 DOI: 10.1186/s12889-018-6375-8
    BACKGROUND: Hepatitis B (HepB) is a major public health concern in Malaysia yet little is known about knowledge and awareness of this infection in the country. Such information is essential for designing effective intervention strategies for HepB prevention and control. The aim of this study was to characterize knowledge and awareness regarding HepB in Malaysia and to identify their associated sociodemographic determinants.

    METHODS: A community-based cross-sectional survey was conducted between January and May 2016 in Selangor state of Malaysia. A two-stage cluster random sampling design was used and one adult member of selected households was interviewed face-to-face. Logistic regression was used to estimate the differences in knowledge and awareness between groups.

    RESULTS: A total of 764 households completed the interviews and were included in the final analysis. Only 36.9 and 38.8% of the participants had good knowledge and awareness, respectively. The factors associated with good knowledge were being in the 35-44 year age group, Malay ethnicity, high educational attainment and high family income. Being Chinese, being older and having high educational attainment were determinants of having good awareness towards HepB. Participants who had good knowledge were 2.5 times more likely to also have good awareness (OR: 2.41, 95% CI: 1.78-3.26, p 

  7. Rajamoorthy Y, Radam A, Taib NM, Rahim KA, Munusamy S, Wagner AL, et al.
    PLoS One, 2019;14(4):e0215125.
    PMID: 30964934 DOI: 10.1371/journal.pone.0215125
    BACKGROUND: In Malaysia, one million individuals are estimated to be infected with the hepatitis B virus. A vaccine for infants has been compulsory since 1989, whereas those born before 1989 need to spend their own money to be vaccinated in private clinics or hospitals. The aim of this study was to investigate and ascertain the determinants of willingness to pay (WTP) for adult hepatitis B vaccine in Selangor, Malaysia.

    METHODS: In 2016, 728 households were selected through a stratified, two stage cluster sample and interviewed. Willingness to pay for hepatitis B vaccine was estimated using the Contingent Valuation Method, and factors affecting WTP were modelled with logit regression.

    RESULTS: We found that 273 (37.5%) of the households were willing to pay for hepatitis B vaccination. The mean and median of WTP was estimated at Ringgit Malaysia (RM)303 (approximately US$73) for the three dose series. The estimated WTP was significantly greater in those with higher levels of education, among Malays and Chinese (compared to others, predominantly Indians), and for those with greater perceived susceptibility to hepatitis B virus infection. Other factors-perceived severity, barriers, benefits and cues to action-were not significantly associated with WTP for adult hepatitis B vaccination.

    CONCLUSION: Additional resources are needed to cover the households that are not willing to pay for hepatitis B vaccination. More awareness (particularly in regards to hepatitis B virus susceptibility) could change the national perception towards self-paid hepatitis B virus vaccination and increase hepatitis B vaccine coverage.

  8. Rajamoorthy Y, Wagner AL, Kumaran VV, Munusamy S, Taib NM, Tin OH, et al.
    Narra J, 2023 Dec;3(3):e187.
    PMID: 38450341 DOI: 10.52225/narra.v3i3.187
    Children are susceptible and a potential source of transmission for coronavirus disease 2019 (COVID-19). However compulsory COVID-19 vaccination programs among children have not been a focus in Malaysia. The aim of this study was to measure parents' willingness to pay (WTP) for the COVID-19 vaccine and analyze the effects of socioeconomic variables on parents' WTP. An online cross-sectional study was conducted in Malaysia with two waves of surveys (i.e., different samples for each wave), March and June 2021. The study participants were Malaysian parents above 18 years old. Parents were randomized between two vaccine effectiveness profiles (95% and 50% effectiveness) and two risk levels of an adverse event (5% and 20% risk of fever). The WTP was estimated using a double-bounded dichotomous choice. Socioeconomic variables such as age of parent, gender, insurance, income, and education were examined. A total of 292 parents in March 2021 and 271 in June 2021 were included in the study. The vaccine safety and effectiveness profile did not significantly impact the WTP. In March 2021, the estimated WTP ranged from RM344.74 to RM399.64 (US$82.5 to US$95.6) across vaccine profiles and between RM377.55 and RM444.33 (US$90.3 to US$106.3) in June. Insurance status was associated with the parents' WTP, and during the June wave, the age of parents influenced the WTP. Implementing subsidies or free vaccinations is considerable to increase herd immunity and prevent transmission of COVID-19 in Malaysia.
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