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  1. Fulltext Systematic review of factors associated with willingness to pay for health financing scheme
    Azimatun Noor, A., Syed Mohamed Aljunid
    Malaysian Journal of Public Health Medicine, 2017;17(2):0-0.
    MyJurnal
    Health care has emerged as one of the fastest growing industry worldwide. This induced health care costto rise tramendously. However, it is important to preserve high quality health care services that are equitable and affordable. In many countries, people are expected to contribute to the cost of the health care. Are populations ready to accept the concept and willing to pay for health financing scheme? What possible factors that may associate with their decision? This is the objective of the study, to examine the relevance evidence for this through a systematic review of literatures.We systematically searched Ovid MEDLINE and Google Schoolar databases until April 2016. We assessed the study population willingness to pay for health financing scheme and determine the significant variables that associate with WTP. 19 full-text articles were included in the review. Factors that were found significantly associated with WTP for health financing scheme by many studies were age, education, income and residential locality. Other factors that also found associated with WTP were health care services utilization and expenditure. The review findings showed that WTP for health financing scheme is beyond the households’ financial capacity and has multifactorial influences.
  2. Fulltext Perception of individuals in farming sector towards health care services in the implementation of the new national health financing scheme
    Azimatun Noor, A., Mohd Rizal, A.M., Rozital, H., Aljunid, S.M.
    Malaysian Journal of Community Health, 2009;15(1):16-20.
    MyJurnal
    Introduction : Limited access to health services, variations in quality of health care and pressure to contain escalation of health care cost are problems in health care systems that are faced by all the societies in the world especially in developing countries. There is an urgent need to conduct a study to assess perception of individual towards health care services in the new planned National Healthcare Financing Scheme.
    Objective : The study objective is to examine the perception towards health care services among the farming community and to assess the willingness to contribute to The New National Health Financing Scheme.
    Methods : A cross sectional study involving farmers in the state of Selangor in Peninsular Malaysia was conducted. A total of 400 farmers as the household head were selected using multistage random sampling method.
    Results : The respondents’ mean score of perception towards public healthcare services were higher than the respondents’ mean score of perceptions towards private healthcare services except for accessibility and convenience aspects. There was no association between willingness to contribute to The New National Healthcare Financing Scheme and perception towards public healthcare services but there was association between willingness to contribute to The New National Healthcare Financing Scheme and perception towards private healthcare services.
    Conclusion : Perception towards healthcare services is an important element in the implementation of The New National Healthcare Financing Scheme as it will determine the willingness of an individual to contribute to it.
  3. Does work-family balance mediate the relationship between work-family conflicts and job satisfaction of academicians?
    Rahman MM, Ali NA
    J Community Psychol, 2021 03;49(2):361-374.
    PMID: 33131092 DOI: 10.1002/jcop.22464
    Extreme workloads and strict work schedules make an individual cut their time and energy from their family domain, which may create a conflict, and this situation is called Work-Family Conflict (W-FC). Besides this, Work Family Balance (WFB) and Job Satisfaction (JS) issues are significant for academics because they have to play two roles (Job and Family) at the same time. This paper's fundamental objective was to investigate the indirect effect (mediation) of WFB through both forms of W-FC and JS. Following the convenience sampling technique, 250 married academicians from different private universities were considered for the sample size. Analysis of Moment Structures (AMOS) and Statistical Package for the Social Sciences (SPSS) was used to complete the data analyses. The outcomes of this study showed that out of the two forms, only W to F has significant adverse effects on JS. Also, it was found that to some extent, WFB showed a partial mediating effect only between W to FC and JS, whereas there was no mediating effect through F to WC and JS. These findings will help both academicians and higher authorities of private universities in Bangladesh. The higher authorities and decision-makers of the private universities in Bangladesh can identify the sources of W-FCs and take the necessary steps to mitigate the level of W-FCs.
  4. Fulltext Customers’ satisfaction among urban and rural public health clinics in state of Selangor, Malaysia
    Sharifa Ezat, W.P., Jamsiah, M., Malka, S.A., Azimatun Noor, A., Tuti Ningseh, Noor Izzah, A.S.
    Malaysian Journal of Public Health Medicine, 2010;10(2):52-67.
    MyJurnal
    Health services are considered to be of good quality if customers’ expectations and perceptions are well balanced. Determinants confirming customers’ expectations will lead to satisfaction, while factors disconfirming it will result in customers’ dissatisfaction, reduced compliance to physicians’ treatment and deterioration in overall disease management. A cross-sectional comparative study was carried out from September till October 2008 to determine population satisfaction with health services provided by the public health clinics in Selangor. A total of 3840 respondents from the urban Health Clinics (HCs) and 4768 respondents from rural HCs were selected applying multi-stage random sampling from 54 HCs in nine districts from Selangor. Self-administrated questionnaires formulated by adopting SERVQUAL method based on modified five dimensions plus four dimensions of Clinics Corporation were used . Results showed the proportion of satisfaction among the population towards services provided by the public HCs was high at 86.1%. From X2 bivariate analysis; satisfied respondents were significantly from Indian and Chinese ethnic community more than the Malays, more among the less educated, the older age category (more than 33 years old) and males’ were slightly more satisfied than females. Patients who visited HCs more than three times were more satisfied than one time visitors. Occupation, marital status and HCs urban-rural locality were not significantly associated with customers’ satisfaction level. All dimensions showed high satisfaction level especially on treatment outcome, except on health care workers (HCWs) caring and professionalism domains. Working as a team was slightly higher in the urban areas compared to rural area. Overall, the SERVQUAL score of all dimensions were higher among the urban respondents albeit not significant. Clients’ perceptions were generally higher than expectations reflecting the high satisfactions among clients at 86.1%. Much improvement needs to be put into training HCWs to be more caring and adapting a professional attitude towards clients. Clients’ satisfactions in the urban and rural HCs were almost equal and did not reflect a decrease of health services priority in the rural areas.
  5. Fulltext Factors affecting outpatients’ satisfactionat at University Kebangsaan Malaysia Medical Centre (UKMMC)
    Hasyimah, R., Aniza, I., Ahmad Taufik, J., Jamsiah, M., Azimatun Noor, A.
    Malaysian Journal of Public Health Medicine, 2014;14(2):77-85.
    MyJurnal
    The level of patient satisfaction is important for service quality in hospitals. This study aims to measure the level of patient satisfaction at University Kebangsaan Malaysia Medical Centre (UKMMC) and the factors affecting it. A cross-sectional study was conducted on 520 respondents at the outpatient department in four clinics in UKMMC by using self-administered questionnaires. Respondents were selected using a systematic sampling method based on the list of patient appointments. The level of patient satisfaction was measured using the PSQIII domain. Less than half of the respondents were satisfied with the overall service provided (41.0%), while the others (59.0%) were not satisfied. Based on the domain studied, the level of satisfaction varies widely: the highest satisfaction were interpersonal relationships (75.8%) followed by the registration process (73.8%), technical quality (71.3%), communication (66.7%), physical facilities (64.6%), accessibility (60.2%), and financial (47.3%). The level of patient satisfaction was low and financial domain should be given more attention to in order to ensure an increase in patient satisfaction levels.
    Study site: Surgery, Orthopaedic, Obstetric and Gynaecology, and Medical clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
  6. Fulltext Factors influencing childhood immunization defaulters in Sabah, Malaysia
    Shamsul Azhar, S., Rohaizat, H., Azimatun Noor, A., Rozita, H., Nazarudin, S., Nirmal, K.
    International Medical Journal Malaysia, 2012;11(1):17-22.
    MyJurnal
    Introduction: The purpose of this study was to determine the prevalence of defaulters of immunization, and their associated risk factors among children age 12 to 24 months. Materials and Methods: A cross-sectional study was conducted in all government's maternal child health clinics in District of Kota Kinabalu, Sabah. Data was collected using a standardised questionnaire from July to November 2006. Results: The prevalence rate for defaulting immunization was 16.8% from the 315 respondents. Bivariable analysis showed various significant factors associated with defaulters such as mother’s employment status, family mobility, transportation and cost. Nonetheless, multivariable analysis showed only mother’s age, mother employment status and family size were the significant predictors for defaulting immunization. Immunization that had the highest rate of defaulters was DPT–OPV booster dose (56.6%), followed by MMR immunization (43.4 %) and
    DPT-Hib/OPV and Hep B third dose (37.7%).Conclusion: Employed mothers with bigger family size should be more closely monitored and advised to reduce the chance of defaulting on the immunization. Health promotion activities also should focus to these groups of mothers.
  7. Fulltext Comparing cost for elective lower segment caesarean section costing using top-down and activity based costing methods
    Aniza I., Putri, N., Azimatun Noor, A., Amrizal, M.N., Saperi, S., Aljunid, S.M.
    Malaysian Journal of Public Health Medicine, 2011;11(1):36-46.
    MyJurnal
    Top-down costing and activity based costing are the most frequent costing methodologies used for analyzing cost. Top-down costing is accomplished by assigning total expenditure of hospital to patient by apportioning the expenditure of cost centers (unit of service) in hospital to give the cost per patient per visit, per day or per admission. Conversely, activity based costing is accomplished by tracking every resource used by patient individually. Since this study started in 2009, Top-down costing calculation was based on financial year in 2009 with adjusted up to 12.6% from 2008 data. This percentage was taken based on the trend of hospital expenditure during 2005 till 2008. An assumption was made that non-financial data (performance and administrative data) for 2009 was similar to 2008. Top-down costing was calculated using Clinical Cost Modeling Software developed by Unit Case-mix of UKMMC to obtain cost of elective lower segment caesarean section (LSCS) per day at ward which was RM922. Whereas activity based costing was calculated using clinical pathway of elective LSCS. Given the average length of stay in 2009 was 4 days, the cost of elective LSCS according to top-down costing was RM3, 688 and activity based costing was RM1774. As a result, cost of elective LSCS is 108% higher using top-down costing.
  8. Fulltext Occupational stress and its associated factors among academician in a research university, Malaysia
    Noor A, Ismail NH
    Malaysian Journal of Public Health Medicine, 2016;16(1):81-91.
    MyJurnal
    The prevalence of occupational stress among academician is increasing in developed and developing countries. The job is not only to teach, but also involve in doing research, publications, consultation and administrative work. This study aims to assess the prevalence of occupational stress among academic staff in a research university and to investigate the association and correlation between stress and job factors which are career development, research, teaching and interpersonal relationship. One research university in Malaysia was selected randomly. A cross-sectional study was conducted and the respondents were recruited by using a randomized stratified sampling method. A total of 380 self-administered and validated Depression, Anxiety and Stress Scale-21 (DASS-21) and Stress Sources Questionnaires (SSQ) were distributed among academic staff between March to May 2012. The statistical analyses used were χ2, independent–t test and Pearson Correlation. Response rate was 81.1%. Stress prevalence was 22.1%. All socio-demographic factors showed no association with stress except ethnic group. Teaching, research and career development had significant association with stress among academic staff (p<0.05). Overall result showed career development, that include university condition and required publications for promotion were the greatest source of stress among the academicians. Occupational stress showed positive linear relationship to career development, research and teaching. There was a fair positive relationship between occupational stress and career development, research and teaching. It is recommended to organize continuous stress assessment program to identify and evaluate the current level of stress at the university level. This data could be a foundation for implementing prevention and control measures to reduce stress in the workplace.
    Keywords: academic staff, lecturer, occupational stress, research, teaching, career development, interpersonal relationship, research university, job stress
  9. Fulltext The phosphorylation of endogenous Nedd4-2 In Na(+)-absorbing human airway epithelial cells
    Ismail NA, Baines DL, Wilson SM
    Eur J Pharmacol, 2014 Jun 05;732:32-42.
    PMID: 24657276 DOI: 10.1016/j.ejphar.2014.03.005
    Neural precursor cell expressed, developmentally down-regulated protein 4-2 (Nedd4-2) mediates the internalisation / degradation of epithelial Na(+) channel subunits (α-, β- and γ-ENaC). Serum / glucocorticoid inducible kinase 1 (SGK1) and protein kinase A (PKA) both appear to inhibit this process by phosphorylating Nedd4-2-Ser(221), -Ser(327) and -Thr(246). This Nedd4-2 inactivation process is thought to be central to the hormonal control of Na(+) absorption. The present study of H441 human airway epithelial cells therefore explores the effects of SGK1 and / or PKA upon the phosphorylation / abundance of endogenous Nedd4-2; the surface expression of ENaC subunits, and electrogenic Na(+) transport. Effects on Nedd4-2 phosphorylation/abundance and the surface expression of ENaC were monitored by western analysis, whilst Na(+) absorption was quantified electrometrically. Acutely (20min) activating PKA in glucocorticoid-deprived (24h) cells increased the abundance of Ser(221)-phosphorylated, Ser(327)-phosphorylated and total Nedd4-2 without altering the abundance of Thr(246)-phosphorylated Nedd4-2. Activating PKA under these conditions did not cause a co-ordinated increase in the surface abundance of α-, β- and γ-ENaC and had only a very small effect upon electrogenic Na(+) absorption. Activating PKA (20min) in glucocorticoid-treated (0.2µM dexamethasone, 24h) cells, on the other hand, increased the abundance of Ser(221)-, Ser(327)- and Thr(246)-phosphorylated and total Nedd4-2; increased the surface abundance of α-, β- and γ-ENaC and evoked a clear stimulation of Na(+) transport. Chronic glucocorticoid stimulation therefore appears to allow cAMP-dependent control of Na(+) absorption by facilitating the effects of PKA upon the Nedd4-2 and ENaC subunits.
  10. Acute effect of static and dynamic stretching on hip dynamic range of motion during instep kicking in professional soccer players
    Amiri-Khorasani M, Abu Osman NA, Yusof A
    J Strength Cond Res, 2011 Jun;25(6):1647-52.
    PMID: 21358428 DOI: 10.1519/JSC.0b013e3181db9f41
    The purpose of this study was to examine the effects of static and dynamic stretching within a pre-exercise warm-up on hip dynamic range of motion (DROM) during instep kicking in professional soccer players. The kicking motions of dominant legs were captured from 18 professional adult male soccer players (height: 180.38 ± 7.34 cm; mass: 69.77 ± 9.73 kg; age: 19.22 ± 1.83 years) using 4 3-dimensional digital video cameras at 50 Hz. Hip DROM at backward, forward, and follow-through phases (instep kick phases) after different warm-up protocols consisting of static, dynamic, and no-stretching on 3 nonconsecutive test days were captured for analysis. During the backswing phase, there was no difference in DROM after the dynamic stretching compared with the static stretching relative to the no-stretching method. There was a significant difference in DROM after the dynamic stretching compared with the static stretching relative to the no-stretching method during (a) the forward phase with p < 0.03, (b) the follow-through phase with p < 0.01, and (c) all phases with p < 0.01. We concluded that professional soccer players can perform a higher DROM of the hip joint during the instep kick after dynamic stretching incorporated in warm-ups, hence increasing the chances of scoring and injury prevention during soccer games.
  11. Biomechanical responses of thigh and lower leg during 10 consecutive soccer instep kicks
    Amiri-Khorasani M, Abu Osman NA, Yusof A
    J Strength Cond Res, 2011 Apr;25(4):1177-81.
    PMID: 20838249 DOI: 10.1519/JSC.0b013e3181d6508c
    This study investigated the number of trials necessary to obtain optimal biomechanical responses in 10 consecutive soccer instep kicks. The kicking motions of dominant legs were captured from 5 experienced and skilled adult male soccer players (height: 184.60 ± 4.49 cm; mass: 80 ± 4.24 kg; and age: 25.60 ± 1.14 years) using a 3D infrared high-speed camera at 200 Hz. Some of the important kinematics and kinetics parameters are maximum thigh angular velocity, maximum lower leg angular velocity, maximum of thigh moment, maximum lower leg moment at forward and impact phases, and finally maximum ball velocity after impact selected to be analyzed. There was a significant decrease of ball velocity between the first and the fifth kick and the subsequent kicks. Similarly, the lower leg angular velocity showed a significant decrease after the fifth kick and thereafter. Compared with the first kick, the thigh angular velocity has been shown to decrease after the sixth kick and thereafter, and the thigh moment result of the sixth kick was significantly lower when compared with the first kick. Moreover, the lower leg moment result of the fourth kick was significantly lower in comparison with the first kick. In conclusion, it seems that 5 consecutive kicks are adequate to achieve high kinematics and kinetics responses and selecting more than 5 kicks does not result in any high biomechanical responses for analysis.
  12. Fulltext Impact of Physical Activity on Cognitive Decline, Dementia, and Its Subtypes: Meta-Analysis of Prospective Studies
    Guure CB, Ibrahim NA, Adam MB, Said SM
    Biomed Res Int, 2017;2017:9016924.
    PMID: 28271072 DOI: 10.1155/2017/9016924
    The association of physical activity with dementia and its subtypes has remained controversial in the literature and has continued to be a subject of debate among researchers. A systematic review and meta-analysis of longitudinal studies on the relationship between physical activity and the risk of cognitive decline, all-cause dementia, Alzheimer's disease, and vascular dementia among nondemented subjects are considered. A comprehensive literature search in all available databases was conducted up until April 2016. Well-defined inclusion and exclusion criteria were developed with focus on prospective studies ≥ 12 months. The overall sample from all studies is 117410 with the highest follow-up of 28 years. The analyses are performed with both Bayesian parametric and nonparametric models. Our analysis reveals a protective effect for high physical activity on all-cause dementia, odds ratio of 0.79, 95% CI (0.69, 0.88), a higher and better protective effect for Alzheimer's disease, odds ratio of 0.62, 95% CI (0.49, 0.75), cognitive decline odds ratio of 0.67, 95% CI (0.55, 0.78), and a nonprotective effect for vascular dementia of 0.92, 95% CI (0.62, 1.30). Our findings suggest that physical activity is more protective against Alzheimer's disease than it is for all-cause dementia, vascular dementia, and cognitive decline.
  13. WITHDRAWN: Patient-specific interface pressure case study at transradial prosthetic socket: comparison trials between ICRC polypropylene socket and air splint socket
    Abd Razak NA, Abu Osman NA, Ali SA, Gholizadeh H
    Eur J Phys Rehabil Med, 2016 Jan 15.
    PMID: 26771916
    Ahead of Print article withdrawn by publisher
  14. Fulltext How good are doctors as drug prescribers?
    Rahman AR, Noor AR, Hassan Y
    Med J Malaysia, 1994 Dec;49(4):364-8.
    PMID: 7674972
    The training of doctors in therapeutics has created interesting discussions internationally. A survey of senior hospital pharmacists currently practising throughout West Malaysia was embarked on during a recent postgraduate seminar. About sixty per cent said prescribing errors were common amongst doctors. Sixteen per cent of the prescribing errors were potentially serious. Most of the time errors were due to carelessness, lack of knowledge on drug action or a combination of both. Nearly 35% of prescribing errors were not acknowledged by doctors. Most doctors did not give reasons for not acknowledging pharmacists' intervention. About half (46.5%) of the respondents thought that doctors were not adequately trained in the use of drugs.
  15. The Malaysian community's acceptance and willingness to pay for a National Health Financing Scheme
    Azimatun Noor A, Saperi S, Aljunid SM
    Public Health, 2019 Oct;175:129-137.
    PMID: 31473369 DOI: 10.1016/j.puhe.2019.07.008
    OBJECTIVES: Currently, Malaysia faces great challenges in allocating adequate resources for healthcare services using a tax-based system. Therefore, Malaysia has no choice but to reform its healthcare financing system. The objective of this study is to assess Malaysian household willingness to pay and acceptance levels to the proposed National Health Financing Scheme.

    STUDY DESIGN: This is a cross-sectional study.

    METHODS: In total, 774 households from four states in Malaysia completed face-to-face interviews. A validated structured questionnaire was used, which was composed of a combination of open-ended questions, bidding games and contingent valuation methods regarding the participants' willingness to pay.

    RESULTS: The study found that the majority of households supported the establishment of the National Health Financing Scheme, and half proposed that a government body should manage the scheme. Most (87.5%) of the households were willing to contribute 0.5-1% of their salaries to the scheme through monthly deductions. Over three-quarters (76.6%) were willing to contribute to a higher level scheme (1-2%) to gain access to both public and private healthcare basic services. Willingness to pay for the National Health Financing Scheme was significantly higher among younger persons, females, those located in rural areas, those with a higher income and those with an illness.

    CONCLUSION: There is a high level of acceptance for the National Health Financing Scheme in the Malaysian community, and they are willing to pay for a scheme organised by a government body. However, acceptance and willingness to pay are strongly linked to household socio-economic status. Policymakers should initiate plans to establish the National Health Financing Scheme to provide the necessary financing for a sustainable health system.

  16. Laryngeal paralysis in organophosphorous poisoning
    Indudharan R, Win MN, Noor AR
    J Laryngol Otol, 1998 Jan;112(1):81-2.
    PMID: 9538454
    Organophosphorous poisoning causing isolated laryngeal paralysis has only been rarely reported before. We describe a case of difficult extubation in a patient with organophosphorous poisoning, the cause of which was found to be bilateral vocal fold palsy. This is a type of intermediate paralysis that recovers with time. Such a condition should be thought of as a cause of dyspnoea or difficult extubation in patients with organophosphorous poisoning.
  17. Blood pressure regulation by the kallikrein-kinin system
    Sharma JN, Uma K, Noor AR, Rahman AR
    Gen. Pharmacol., 1996 Jan;27(1):55-63.
    PMID: 8742494
    1. The kallikrein-kinin system has a significant role in regulating arterial blood pressure. 2. Reduced formation of the kinin compontents may cause hypertensive diseases. This is because of the fact that this system is responsible for vasodilatation, reduction in total peripheral resistance, natriuresis, diuresis, increasing renal blood flow and releasing various vasodilator agents. 3. Reduced kinin-kallikrein generation in hypertensive subjects may also be associated with genetic and environmental defects. 4. The kallikrein-kinin system when administered to hypertensive patients can lower their raised blood pressure to normotensive levels. 5. The mode of action of angiotensin-converting enzyme inhibitors principally may be dependent on the kinin system protection.
  18. Haematoma testes due to traditional massage in a neonate
    Ram SP, Kyaw K, Noor AR
    Trop Doct, 1994 Apr;24(2):81-2.
    PMID: 8009626
  19. Suppression of hypotensive responses of captopril and enalapril by the kallikrein inhibitor aprotinin in spontaneously hypertensive rats
    Sharma JN, Amrah SS, Noor AR
    Pharmacology, 1995 Jun;50(6):363-9.
    PMID: 7568335
    The present investigation evaluated the effects of aprotinin, an inhibitor of kallikrein, on blood pressure responses, heart rate, and duration of hypotension induced by acute administration of captopril and enalapril (angiotensin-converting enzyme inhibitors) in anaesthetized spontaneously hypertensive rats. Captopril (20 mg/kg) and enalapril (20 mg/kg) administered intravenously caused a significant (p < 0.001) fall in systolic and diastolic blood pressures in the absence of aprotinin. In contrast, captopril (20 mg/kg) and enalapril (20 mg/kg) failed (p > 0.05) to cause a fall in systolic and diastolic blood pressures in the presence of aprotinin (2 mg/kg). Captopril and enalapril were able to significantly reduce the heart rate (p < 0.05 and p < 0.001) in the presence as well as in the absence of aprotinin. The duration of hypotension produced by captopril and enalapril was abolished significantly (p < 0.001) in the presence of aprotinin. These findings may suggest that captopril and enalapril caused hypotension via the kallikrein pathway, since the kallikrein inhibitor aprotinin can antagonize the hypotensive responses of these agents. Thus, kallikrein may be an independent mediator in the regulation of blood pressure.
  20. Simple high-performance liquid chromatographic method for determination of alpha-tocopherol in human plasma
    Julianto T, Yuen KH, Noor AM
    J Chromatogr B Biomed Sci Appl, 1999 Sep 10;732(1):227-31.
    PMID: 10517240
    A simple high-performance liquid chromatographic method using UV detection was developed for the determination of alpha-tocopherol in human plasma. The method entailed direct injection of the plasma sample after deproteinization using acetonitrile-tetrahydrofuran (3:2). The mobile phase comprised methanol-tetrahydrofuran (94:6) and analysis was run at a flow-rate of 1.5 ml/min with the detector operating at 292 nm. A Crestpak C18S (5 microm, 250 mm x 4.6 mm ID) was used for the chromatographic separation. The method had a mean recovery of 93%, while the within-day and between-day coefficients of variation and percentage errors were all less than 7%. The speed, specificity, sensitivity and reproducibility of this method make it particularly suitable for routine determination of alpha-tocopherol in human plasma. Moreover, only a small sample plasma volume (100 microl) is required for the analysis.
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