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Fulltext A food poisoning outbreak due to Staphylococcus aureus, Kapar, Malaysia, 1983

Rampal L

Med J Malaysia, 1983 Dec;38(4):294-8.
PMID: 6599985

An epidemiological investigation was carried out on a food borne outbreak in a National Type Primary School (Chinese). The findings of the outbreak are reported. Of the 495 Chinese students (ages between 7-12 years) interviewed, 321 were exposed to one or more of the food items sold at the school canteen. The median incubation period was one hour for the outbreak. The main symptoms were related to the upper gastro-intestinal tract (nausea and vomiting). Fried meehoon (rice vermicelli) was suspected as being the responsible vehicle. The causative organism was Staphylococcus aureus. 48 cases were treated in the Main Health Centre, Kapar.
Fulltext A study on the anti-smoking measures adopted by the local authorities in Malaysia, 1982

Rampal L

Med J Malaysia, 1983 Sep;38(3):203-5.
PMID: 6672563

Anti-smoking measures, adopted by local authorities before the guideline on the ban of cigarette advertisement and anti-smoking campaign launched by the Government, are limited in scope and area. The activity is limited mainly to a ban on cigarette advertisements in theatres. Legislative measures are instituted only in the City Council, Municipal Councils and 2 ofthe 20 district councils surveyed. There is an awareness among several local authorities on the need for an increase in anti-smoking activities but action. is lacking. A population of 7.4 million. people lioe in areas controlled by the local authorities. The local authorities are expected to play a more active role along with other Government departments following a directive in August 1982 from the Chief Secretary to the Government.
Fulltext Prevalence of job stress and its associated factors among Universiti Putra Malaysia staff

Mukosolu, Okonkwo, Faisal Ibrahim, Rampal, Lekhraj, Nomala Ibrahim

Malaysian Journal of Medicine and Health Sciences, 2015;11(1):27-38.
MyJurnal

Stress in the work place is a global major risk factor to worker’s health, which triggers the workers to be poorly motivated and less productive. Objectives: The objective of the study was to determine the prevalence of job stress and its associated factors among Universiti Putra Malaysia staff. Methods: This is a cross sectional study involving 511 academic and non-academic staff of Universiti Putra Malaysia in Serdang. Probability proportionate to size was used for calculating the required sample size. Results: The overall prevalence of stress was 21.7% (21.0% among male and 23.0% among female). The variables found to be significantly associated with stress were: Job demand, coworker support, depression, anxiety, focus and venting of emotion and self-blame (p
Fulltext Prevalence and predictors of water pipe (Shisha) use among Iranian high school children

Mohammadi, Mahtab, Rampal, Lekhraj, Hejar Abd. Rahman, Sherina Mohd Sidik, Normala Ibrahim, Ghaleiha, Ali

Malaysian Journal of Medicine and Health Sciences, 2017;13(1):45-53.
MyJurnal

Introduction: Water pipe use is becoming increasingly common among Iranian adolescents. This study examined the prevalence and predictors of water pipe use among public high schoolchildren aged 14-17 in Iran.
Methods: A cross-sectional study was conducted among 1st, 2nd and 3rd grade public high schoolchildren in Sanadaj City, capital of Kurdistan province of Iran during the academic year 2012-2013. Cluster sampling was used to select a sample from 8 public high schools. The data were collected using validated self-administrated questionnaire that included questions on water pipe use, socio-demographic characteristics, smoking-related knowledge, attitude toward smoking, normative believes regards perceived prevalence water pipe use among peer and adults, perception of harm, self-esteem and refusal skill. A multivariate logistic regression analysis was performed to assess predictors of water pipe use.
Results: A total of 1837 students participated in this study. Students’ ages ranged from 14 to 17 years (mean age±15.09; SD±0.82 years). The overall prevalence of ever water pipe use was 36.2% (43.1% in male and 29.2% in female, (p<0.001). Age, gender, living arrangement, pocket money, academic grade, parental history of smoking, attitude, and normative believes regards perceived prevalence water pipe use among peer and adults were predictors of water pipe use among study participants.
Conclusions: The overall prevalence of water pipe is high among high school children in Sanandaj. Age, gender, pocket money, academic grade, parents smoking, attitude toward smoking and normative believes were identified as the most important predictors increasing the risk of water pipe use in the studied students.
Keywords: Water pipe use, Prevalence, Predictors of Water Pipe, High school children
Fulltext Prevalence and predictors of intestinal worm infections among Semai aboriginal tribe school children in Tapah, Malaysia

Tunbosun, Olawumi Edward, Rampal, Lekhraj, Hejar Abdul Rahman, Roslaini Abdul Majid

Malaysian Journal of Medicine and Health Sciences, 2017;13(1):28-34.
MyJurnal

Introduction: Worm infection is one of the major global public health problems especially among rural communities.
Objectives: to determine the prevalence of intestinal worm infection and factors associated among Semai Aboriginal
children aged between 6 to 13 years in Tapah, Malaysia. Methods: A cross-sectional study design was used in this
study. The estimated sample size was 508. Data was collected using a validated pretested questionnaire. Faecal
samples were also examined. Data was analysed using SPSS version 22. Results: The response rate was 80.9%.
The overall mean age of the 411 respondents was 10.1 years(95% CI = 9.89, 10.22). Majority (71.5%) were poor.
Prevalence of intestinal worm infections was 60.8% and 57.2% had multiple infections. The multiple logistic
regression analysis showed that those with poor hygiene practices were 2.18 times the odds of worm infection
when compared with children with good hygiene practices (95% CI = 1.4, 3.4). Similarly, poor attitudes towards
prevention of worm infection increased the odds of having worm infection by 1.62 times among Orang Asli children.
Children living without toilets had 2.45 times higher odds as compared with those who had proper toilets. Absence
of river near by these areas where there is no safe water supply also increases the risk of worm infection among
children by 1.84 times among Orang Asli children. Conclusions: the prevalence of worm infection is still very
high among rural Aboriginal community. Current control measures should be reassessed to enable introduction of
effective measures to reduce the worm infection among Orang Asli children.
Fulltext Are Malaysians getting fatter and rounder?: an updated systematic review (2009 – 2015)

Tan, Siew-Tin, Sherina Mohd-Sidik, Rampal, Lekhraj, Normala Ibrahim, Tan, Kit-Aun

Malaysian Journal of Medicine and Health Sciences, 2019;15(1):63-77.
MyJurnal

Overweight and obesity have become a serious health issue in worldwide and Malaysia is no exception. In view that obesity is one of the leading causes of non-communicable diseases, this systematic review aimed to explore whether Malaysian are getting fatter (overweight or obesity) and rounder (abdominal obesity). Searches of the published literature were conducted using 3 databases including EMBASE, MEDLINE, and PubMed. These were limited to cross-sectional or cohort studies in Malaysia. The databases provided the prevalence of overweight, obesity, and abdominal obesity among 15 years old and above Malaysian population from 2009 to 2015. In total, 47 articles were included in this review. Findings exhibit that the prevalence rates of overweight, obesity, and abdominal obesity range from 9.5% to 43.5%, 1.77% to 26.4% and 11.4% to 57.4%, respectively. Overweight is more predominant among males. However, obesity and abdominal obesity are more predominant among females. This means that more females are getting fatter and “rounder” as compared to males in Malaysia. The findings imply a lack of intervention programmes based on proper randomized controlled trials which are needed to adequately address the problem of obesity in Malaysia.
Fulltext Quality of life among cancer patients undergoing chemotherapy in government hospitals in Peninsular Malaysia

Subramaniam, Suhasinee, Sherina Mohd Sidik, Rampal, Lekhraj, Siti Irma Fadhilah, Periasamy, Ummavathy

Malaysian Journal of Medicine and Health Sciences, 2019;15(1):5-15.
MyJurnal

To determine the quality of life (physical health, psychological, social relationships and environment domains) among cancer patients undergoing chemotherapy in government hospitals in Peninsular Malaysia. Methods: The data were collected using self-administered questionnaires. Descriptive statistics were conducted to obtain frequency and percentage of variables. Independent sample T-test and One way ANOVA were used to determine the association between variables. Multiple linear regression model was used to determine the significant predictors. The predictors of each domain was analysed separately. Results: Quality of life among cancer patients undergoing chemotherapy in this study was determined by four domains which were physical health, psychological, social relationships and environment. The overall mean score for physical health was 52.60, psychological was 52.55, social relationships was 50.79 and environment was 51.16. The significant predictors of physical effect domain were monthly income, cancer stage, social support, nausea and vomiting. The significant predictors of psychological domain were race, marital status, cancer stage, nausea and vomiting. The significant predictors of social relationships domain were race, educational level, social support, nausea and vomiting. The significant predictors of environment domain were race, marital status, hopelessness level, nausea and vomiting. Conclusion: The quality of life among chemotherapy cancer patients is important to be observed. Based on the predictors found in this study, appropriate interventions can be taken to improve the quality of life outcomes and the response towards the treatment.
Fulltext Prevalence and predictors of depression among oncology patients receiving chemotherapy in government hospitals in Peninsular Malaysia

Mamta Vesudave Remesh Kumar, Sherina Mohd Sidik, Rampal, Lekhraj, Siti Irma Fadhilah Ismail, Periasamy, Ummavathy

Malaysian Journal of Medicine and Health Sciences, 2019;15(2):22-31.
MyJurnal

Introduction: Cancer-patients undergoing chemotherapy experience a high level of depression. The objective of this
study was to determine the prevalence and predictors of depression in cancer-patients receiving chemotherapy in
government hospitals in Peninsular Malaysia. Methods: This research was started with a cross-sectional study among
1356 patients undergoing chemotherapy in 10 government state hospitals in the Peninsular Malaysia. The data were
collected using self-administered questionnaires including socio-demographic characteristics, severity of cancer,
depression through Patient Health Questionnaire (PHQ-9), social support using the Multidimensional Scale of Perceived Social Support (MSPSS) and hopelessness using the Beck Hopelessness Scale (BHS).The research also conducted the descriptive statistics to obtain variable percentages and frequencies. Inferential analysis was also conducted by using chi-square or Fisher’s exact test in determining the relations among variables at the level of significance
where p
Fulltext Prevalence of obesity and associated factors among secondary school students in Slemani City Kurdistan Region, Iraq

Muhammad Saeed Qadir, Rampal, Lekhraj, Sherina Mohd Sidik, Salmiah Md Said, Zhian Salah Ramzi

Malaysian Journal of Medicine and Health Sciences, 2014;10(2):27-38.
MyJurnal

Obesity is a well-established risk factor for cardiovascular disease. The objective of
the study was to determine the prevalence of obesity and factors associated among secondary school students aged between 13 to 17 years at Slemani City Centre, Iraq. Methodology: A cross sectional study design was used. The calculated sample size was 1656. Probability proportional to size sampling technique was used to select the sample. A validated pretested questionnaire was used to collect the data. Weight and height were also taken. Data were analyzed using SPSS version 21. Chi-square test was used to determine an association between two categorical variables. Independent t-test was used to compare two means. Multiple logistic regression was used to determine the predictors for obesity. Results: The response rate was 92.54% and the overall mean age of the 1588 respondents was 15.42 (95% CI = 15.35, 15.49) years. The prevalence of overweight and obesity was 20.6% and 11.3% respectively. Variables significantly associated with overweight and obesity (age, monthly family income, education level of parents, body part satisfaction and body size perception) were entered into the logistic regression model. Multiple logistic regression analysis showed that the predictors for overweight and obesity were age, monthly family income, body part dissatisfaction and body size perception. Conclusion: The prevalence of overweight and obesity is high (20.6% and 11.3% respectively). The predictors of obesity among secondary school students aged between 13 to 17 years old at Slemani City Centre Kurdistan Region, Iraq were age, family income and body image dissatisfaction.
Fulltext The prevalence and factors associated with obesity among adult women in Selangor, Malaysia

Sidik SM, Rampal L

Asia Pac Fam Med, 2009 Apr 09;8(1):2.
PMID: 19358728 DOI: 10.1186/1447-056X-8-2

INTRODUCTION: The prevalence of obesity in developing countries especially among women is on the rise. This matter should be taken seriously because it can burden the health care systems and lower the quality of life.
AIM: The purpose of this study was to determine the prevalence of obesity among adult women in Selangor and to determine factors associated with obesity among these women.
METHODS: This community based cross sectional study was conducted in Selangor in January 2004. Multi stage stratified proportionate to size sampling method was used. Women aged 20-59 years old were included in this study. Data was collected using a questionnaire-guided interview method. The questionnaire consisted of questions on socio-demographic (age, ethnicity, religion, education level, occupation, monthly income, marital status), Obstetric & Gynaecology history, body mass index (BMI), and the Patient Health Questionnaire (PHQ-9).
RESULTS: Out of 1032 women, 972 agreed to participate in this study, giving a response rate of 94.2%. The mean age was 37.91 +/- 10.91. The prevalence of obesity among the respondents was 16.7% (mean = 1.83 +/- 0.373). Obesity was found to be significantly associated with age (p = 0.013), ethnicity (p = 0.001), religion (p = 0.002), schooling (p = 0.020), educational level (p = 0.016), marital status (p = 0.001) and the history of suffering a miscarriage within the past 6 months (p = 0.023).
CONCLUSION: The prevalence of obesity among adult women in this study was high. This problem needs to be emphasized as the prevalence of obesity keeps increasing, and will continue to worsen unless appropriate preventive measures are taken.
Fulltext The prevalence of anxiety among medical students

Sherina MS, Rampal L, Kaneson N

Malaysian Journal of Medicine and Health Sciences, 2005;1(1):13-20.

Objective: This study was conducted to determine the prevalence of anxiety among medical students at a local university in Malaysia and to identify its associated factors.
Methods: Across-sectional study design was used. Three-hundred and ninety-six medical students at a local university in Malaysia were included in the study. A pre-tested, modified, self-administered Beck Anxiety Inventory (BAI) was used to screen for anxiety.
Results: Three-hundred-and-ninety-six out of 414 medical students participated (response rate 95.7%).38.4% of the medical students were found to have anxiety.
Conclusion: The overall prevalence of anxiety among medical students was high (38.4%). Factors found to be significantly associated with anxiety were gender, perceived level of pressure, year of study in medical school, ethnicity and depression(p<0.05).
Keywords: Anxiety, depression, medical students, prevalence
Fulltext A profile study of 1016 drug addicts in Malaysia

Rampal L, Azhar MZ, Sanjay R

Malaysian Journal of Medicine and Health Sciences, 2005;1(2):119-129.

Introduction: A cross-sectioned study was carried out on 1016 drug addicts from Johor state to better understand their profile.
Method: A structured questionnaire prepared in three languages was used to collect the data which was analyzed using the Statistical Package for Social Sciences.
Result & Discussion: The overall mean age of the respondents was 33.8 (95% CI= 33.3 - 34.4) years and ranged from 16 to 61 years. ANOVA post hoc multiple comparison tests showed that there was a significant difference in the mean age between Malays and Chinese (p<0.05). The majority of the respondents were Malay (79.6%) and had secondary education (72.1%) or primary education (21.7%). The majority (79%) was either semi-skilled or unskilled. More than 70% had mores than five siblings. About 36% of the respondents had past a history of discipline problem at school. The majority (99.6%) of the drugs addicts had smoked before and more than 90% were currently smoking. More than 80% had consumed alcoholic beverages. The majority did not use condom when they had sex. Only 24% stated that they did use a needle or syringe that had previously been used by someone else. Less than 4% had either bleached or boiled the needle or syringe that had previously been used by someone else. About 17% were tested positive for HIV. The mean age at which the respondents first started injecting drugs was 21.5 (95% CI= 20.7 - 22.2) years. ANOVA post hoc multiple comparison tests showed that there was no significant difference in the mean age of the different ethnic groups at which the respondents first started injecting drugs. The majority (84.2%) of the drug addicts started injecting drugs between 10 and 20 years of age. Friends introduced 80% of the drug addicts to drugs. The common reasons given for first taking drugs was " I was curious about the feeling of taking drugs (43.6%), "my friends asked me to try" (23.4%), "to release tension" (15.6%) and 5% stated "to try for fun", and 3% that they were "depressed". The majority (64.2%) of the drug addicts spend RM 500 or more per month on drugs and more than 10% of them spend as much as RM 1000 or more per month.
Conclusion: These results indicate an urgent need for a more comprehensive prevention program involving family, schools, commmunities and the media and aimed at reducing drug abuse. Keywords: Profile, drug addicts, Malaysia
Fulltext Salmonella in the soil of kidergarten playgrounds in the Klang District

Jegathesan M, Rampal L, Lim YS

Med J Malaysia, 1983 Dec;38(4):308-10.
PMID: 6599988

A survey on the incidence of Salmonellae in soil was conducted on 12 kindergartens in the Klang District, The organism. was isolated from five (three urban and two rural) kindergartens from one or more soil samples tested. Ten isolates comprising six serotypes, namely, Salmonella bareilly, S. haifa, S. abony, S. weltevreden, S. agona and S. stanley, were encountered. The possible role that these soil isolates may play in the transmission. of salmonellae is discussed. The need to use more than one media in the detection of salmonellae is emphasised.
Fulltext Knowledge and attitudes of adult HIV positive patients to HIV/AIDS in Selected ART Clinics in Yola, Nigeria

Martins, Olutayo Folashade, Rampal, Lekhraj, Lye, Munn-Sann, Sherina Mohd Sidik, Norlijah Othman, Iliyasu, Zubairu, et al.

Malaysian Journal of Medicine and Health Sciences, 2015;11(2):35-44.
MyJurnal

Though cases of AIDS are visible in Nigeria and awareness of HIV is high, correct knowledge on HIV transmission and prevention has remained low with significant numbers of people living with HIV/AIDS having low attitudes towards life and the disease itself. This study determined the baseline knowledge on HIV transmission and prevention, and attitudes towards HIV/AIDS of adult HIV positive patient enrolled into care at all four comprehensive antiretroviral therapy (ART) sites in Yola, Nigeria. Baseline reports on the knowledge and attitudes of adult HIV positive patients were obtained from a three arm randomized single blind clinical trial involving 386 randomly selected adult HIV patients who were enrolled into ART care at all four comprehensive ART sites in Yola. An administered, validated structured questionnaire was used for data collection. Outcome measures were sound knowledge on HIV transmission and prevention, and attitudes towards HIV/AIDS. Data was analyzed using SPSS version 22. Test of significance was at α level 0.05. Overall 237 (61.4%) had sound knowledge on HIV transmission and prevention, while 346 (89.6%) of respondents had high attitudes towards HIV/AIDS. Though majority of respondents had sound knowledge on HIV transmission and prevention as well as high attitudes towards HIV/AIDS, interventions to improve knowledge and attitudes among this group of individuals would improve positive preventive strategies.
Fulltext Prevalence of emotional disorders among medical students in a Malaysian university

Mohd Sidik S, Rampal L, Kaneson N

Asia Pac Fam Med, 2003;2(4):213-217.

Background: Emotional disorder, one of the common human emotional states is defined as feelings of sadness and tiredness in response to life events, such as disappointments. It is one of the major problems among students and although it consists of more than half of all mental disorders, it is often left untreated each year worldwide. Aim: To determine the prevalence of emotional disorders among medical students at a university in Malaysia.
Methods: A cross sectional study design was used. All medical students at a local university in Malaysia were included in the study. A questionnaire similar to the General Health Questionnaire (GHQ-12) was used as a screening instrument.
Results: A total of 41.9% of the medical students were found to have emotional disorders. Factors found to have a significant association with emotional disorders were relationship of the respondents with their parents (chi-square=6.02, d.f.=1, p<0.05), siblings (chi-square=6.94, d.f.=1, p<0.05) and lecturers (chi-square=4.80, d.f.=1, p<0.05), as well as pressure prior to exams (chi-square=10.30, d.f.=1, p<0.05).
Conclusion: The prevalence of emotional disorders among medical students was high. There was significant association between emotional disorders and respondents' relationship with their parents, siblings and lecturers, as well as level of pressure prior to exam. Early detection of this condition is important to prevent psychological morbidity and its unwanted effects on medical students and young doctors.
Fulltext Physical and mental health problems of the elderly in a rural community of Sepang, Selangor

Mohd Sidik S, Rampal L, Afifi M

Malays J Med Sci, 2004 Jan;11(1):52-9.
PMID: 22977360 MyJurnal

The prevalence of aging population is increasing not only in developed countries, but also in developing countries like Malaysia. The aim of this study was: (1) to determine the prevalence of physical and mental health problems, and (2) to determine the association of these health problems with socio demographic factors among the elderly in a rural community in Sepang, Selangor. A cross sectional study design was used. Five out of nine villages were selected via random sampling. The elderly in the selected villages were interviewed using a pre-tested structured questionnaire which included the GDS-30, ECAQ and Barthel Index. Out of 263 elderly residents (6.2% of the total population), 223 agreed to participate in the study giving a response rate of 84.8%. The mean age of the respondents was 69.7 + 6.8 years with a median of 68 years. The prevalence of physical health problems such as chronic illness and functional dependence were 60.1% and 15.7%, respectively. While the prevalence of mental health problems such as depression and cognitive impairment were 7.6% and 22.4%, respectively. Among the health problems studied, depression was found to be significantly associated with unemployment (p<0.05), where as cognitive impairment was significantly associated with age, gender, ethnicity, marital status and level of education (p<0.05).
Prevalence of Absence of Palmaris Longus and Its Association with Gender, Hand Dominance and Absence of FDS Tendon to Little Finger Among Malay Population

Yong MW, Yusof N, Rampal L, Arumugam M

J Hand Surg Asian Pac Vol, 2017 Dec;22(4):484-489.
PMID: 29117832 DOI: 10.1142/S021881041750054X

BACKGROUND: Palmaris Longus is being widely used in reconstructive, plastic and cosmetic surgeries due to its long tendon. It is the most readily available source for tendon grafting. The objective of this study was to determine the prevalence of absence of Palmaris Longus and its association with gender, hand dominance and absence of FDS (flexor digitorum superficialis) tendon to little finger among Malay population.
METHODS: An analytical cross sectional study design was used and a self-administered proforma was distributed for data collection. 1239 Malay secondary school children in Putrajaya were tested for absence of Palmaris Longus using Schaffer's test. 4 additional tests namely Thompson's test, Mishra's test I, Mishra's test II and Pushpakumar's 'two-finger sign' method were used to confirm its absence in respondents with negative Schaffer's test. Function of Flexor Digitorum Superficialis tendon to little finger was determined by flexing PIP of little finger while hyperextend the other fingers.
RESULTS: The prevalence of absence of Palmaris Longus was 11.7%. Left side absence of Palmaris Longus was much common. There was a significant association between absence of Palmaris Longus with gender in which female had higher prevalence of absence of Palmaris Longus than male.
CONCLUSIONS: In conclusion, the prevalence of absence of Palmaris Longus in Malay population was lower than Indian but higher than Chinese population. Females had higher prevalence of absence of Palmaris Longus and no association can be found with hand dominance and absence of Flexor Digitorum Superficialis tendon to little finger.
HIV Treatment Adherence - A Shared Burden for Patients, Health-Care Providers, and Other Stakeholders

Abdulrahman SA, Ganasegeran K, Rampal L, Martins OF

AIDS Rev, 2019;21(1):28-39.
PMID: 30899114 DOI: 10.24875/AIDSRev.19000037

Successful HIV treatment is contingent on sustained high levels of treatment adherence. Several barriers to optimal adherence have been documented. In this article, we first review the global burden of non-adherence among HIV/AIDS positive individuals on a public health scale. Second, we synthesized available evidence from different study designs and stratified across the European, African, and Asian literature to determine the factors influencing adherence to scheduled clinic appointments and medication non-adherence. Third, we discuss common measurement techniques that quantify the magnitude of non-adherence, their relative advantages and limitations in current practice. From January to May 2018, we reviewed guidelines, standard operating procedures, journal articles, and book chapters on treatment adherence among HIV patients receiving adherence to antiretroviral therapy (ART) globally. We searched PubMed, Medline, Google Scholar, and Cochrane Database of Systematic Reviews with the search terms "adherence," "adherence behavior," "medication adherence," and "HIV patients," or "HIV/AIDS," and "Antiretroviral Therapy" or "ART" or "ARVs" or "highly active ART " from 2000 to 2017. We also identified articles through searches of authors' files and previous research on HIV. We included only papers published in English in this review. We then generated a final list of reference on the basis of originality and the broad scope of this review. We found rich literature evidence of research findings and best practice recommendations on the importance of adherence in HIV/AIDS management, a general understanding of factors associated with non-adherence and approaches to investigating non-adherence behavior among different populations. We observed significant contextual differences exist with regard to barriers and burden of non-adherence among these populations.
Conceptual Framework for Investigating and Influencing Adherence Behavior among HIV-Positive Populations: An Applied Social Cognition Model

Abdulrahman SA, Ganasegeran K, Rampal L, Martins OF

AIDS Rev, 2019 Aug 06;21(3):157-159.
PMID: 31386650

Non-adherence remains a significant barrier to achieving successful HIV treatment outcomes. This review aimed to holistically examine the concept of adherence in the light of current research evidence and to provide a basic and adaptable conceptual framework for investigating and influencing adherence behavior among various HIV populations. We reviewed published journal articles and gray literature within the period from 2000 to 2017. A comprehensive search from major online databases and repositories such as PubMed, Scopus, Medline, Google Scholar, and Cochrane Database of Systematic Reviews was conducted using focused search terms that included "social cognition models" or "theories and models of health behavior change" or "behavior change in health psychology" or "theory-based interventions" or "behavioral frameworks" and "adherence behavior" or "medication adherence," and "HIV patients" or "HIV/AIDS." Only papers published in English were included in this study. We found varied and extensive literature evidence supporting the use of psychobehavioral models to promote conceptual understanding of adherence behavior among HIV-positive patients globally. We observed that certain approaches at investigating nonadherence worked better among certain populations and epidemics than others, largely because of contextual differences in barriers and burden of non-adherence among these populations. We synthesized the evidence and applied social cognition models in explaining and providing a basic, evidence-based and adaptable conceptual framework for investigating and influencing adherence behavior among HIV-positive populations around the world, regardless of geographical and HIV epidemiological context.
Fulltext Effectiveness of a Pelvic Floor Muscle Exercise Intervention in Improving Knowledge, Attitude, Practice, and Self-Efficacy among Pregnant Women: A Randomized Controlled Trial

Alagirisamy P, Sidik SM, Rampal L, Ismail SIF

Korean J Fam Med, 2022 Jan;43(1):42-55.
PMID: 35130639 DOI: 10.4082/kjfm.21.0011

BACKGROUND: The awareness and practice of pelvic floor muscle exercise (PFME) in the prevention and reduction of the rate of urinary incontinence among pregnant women was considerably poor, despite the increased prevalence of urinary incontinence during pregnancy across Malaysia. There healthcare providers do not give adequate attention to the potential impact of PFME on urinary incontinence and there is limited local intervention addressed urinary incontinence during pregnancy. The objective of this study was to determine the effectiveness of a newly developed PFME intervention in terms of knowledge, attitude, practice, self-efficacy, and urinary symptoms.
METHODS: A single-blinded, two-armed, randomized control trial was included pregnant women from 18 to 20 weeks of gestation and was conducted at the Maternity Hospital of Kuala Lumpur. The intervention group received PFME in addition to the usual perinatal care. The data were collected using validated questionnaires at 4 time points: baseline, post-intervention in the early third trimester, late third trimester, and early postnatal period. The intervention effects were analyzed using a generalized estimating equation.
RESULTS: The primary analysis included pregnant women who had at least one follow-up; 122 women (71.8%) in the intervention group had significant improvement in knowledge, attitude, practice, and self-efficacy, as well as in the severity of urinary incontinence over time. However, improvement was not observed in self-reported urinary incontinence.
CONCLUSION: PFME can be considered an effective initial intervention to provide information about urinary incontinence prevention to pregnant women.

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