Displaying all 17 publications

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  1. Nwagbara VC, Rasiah R
    Global Health, 2015;11:44.
    PMID: 26582159 DOI: 10.1186/s12992-015-0131-y
    Against the backdrop of systemic inefficiency in the public health care system and the theoretical claims that markets result in performance and efficiency improvement, developing countries' governments have been rapidly commercializing health care delivery. This paper seeks to determine whether commercialization through an expansion in private hospitals has led to performance improvements in public hospitals.
  2. Nwagbara VC, Rasiah R, Aslam MM
    Medicine (Baltimore), 2016 Sep;95(36):e4688.
    PMID: 27603363 DOI: 10.1097/MD.0000000000004688
    Public hospitals have come under heavy scrutiny across the world owing to rising expenditures. However, much of the focus has been on cutting down costs to raise efficiency levels. Although not denying the importance of efficiency measures, this article targets a performance issue that is relevant to address the quality of services rendered in public hospitals. Thus, it is important to focus on the effectiveness of resource utilization in these hospitals. Consequently, this article seeks to examine the impact of average length of stay (ALOS) and bed turnover rates (BTR) on bed occupancy rates (BOR).
  3. Ahmed A, Al-Amin AQ, Rasiah R
    Environ Sci Pollut Res Int, 2019 Oct;26(29):30003-30015.
    PMID: 31414393 DOI: 10.1007/s11356-019-06141-7
    This study critically evaluates two COP proposals on Malaysia that have been under consideration to reduce climate damage. A top-down disaggregation framework deploying an "Empirical Regional Downscaling Dynamic Integrated Model of Climate and the Economy" is used to evaluate the local government climate roadmap and Malaysia's emissions reduction agendas under COP21 and subsequently COP22 proposals. The findings show that the costs from climate damage over the period 2010-2110 under the Malaysian Optimal Climate Action scenario will amount to MYR5,483 (US$1589) billion. The commensurate climate damage costs under the COP21 and COP22 scenario would be MYR5, 264 (US$1526) billion. Thus, the effective proposal for reducing climate damage in Malaysia over the period 2010-2110 is the COP22 time-adjusted COP21 proposal but there are a number of macroeconomic cost implications for savings and consumption that policy makers must address before acting.
  4. Cao X, Rasiah R, Furuoka F
    J Environ Public Health, 2022;2022:8914898.
    PMID: 36120149 DOI: 10.1155/2022/8914898
    Following decades of reducing greenhouse gas emissions in the transportation industry, most car companies will stop producing petrol cars and promote the development of new energy vehicles in the near future, even in China. This study is based on energy vehicle exports using China's 31 provinces' panel data from 2010 to 2020. Considering that China mainly engages in processing trade, this study analyzes the domestic energy vehicle's export sophistication after deleting intermediate goods, measuring the relationship between export sophistication and industrial upgrading with static and dynamic panel models. Then, heterogeneity tests were deployed to examine the domestic export sophistication of three major economic belts partition. The results revealed that improving export sophistication is conducive to realizing China's industrial upgrading. China's new energy vehicles industry is positively affected by export sophistication, R&D, foreign direct investment, average GDP growth rate, market factors, and human resources over the long run. Regarding regional stratification, domestic export sophistication in the eastern and western regions has more significant effects on promoting industrial upgrading than in the central region. In particular, in western regions, every increase in export sophistication by one unit will bring a significant industrial upgrading effect. Given this, China's new energy vehicles should increase export sophistication to help the country's industrial upgrading.
  5. Naghavi N, Mubarik MS, Rasiah R, Sharif Nia H
    Int J Gen Med, 2020;13:641-651.
    PMID: 32982381 DOI: 10.2147/IJGM.S253372
    Purpose: The gap between the demand and the supply of human organs for transplantation is on the rise in Malaysia, despite the efforts of governments to promote donor registration. Factors affecting willingness to donate are contextual and vary from country to country. This research mainly focuses on the selection of most suitable organ donation system through factors affecting willingness to donate in Malaysia. The objectives of this study are to prioritize those factors acting as the pillars of the organ donation system and further to select the most suitable organ donation system for Malaysia.

    Patients and Methods: The data were collected from 35 experts by using a bipolar questionnaire. The study applied an analytical hierarchal process (AHP) for prioritization factors contributing to willingness to donate and then selection of a suitable organ donation system based on prioritized factors.

    Results: Based on the AHP results, it is evident that donation perception (0.36) has the highest priority in influencing organ donation rates, followed by socioeconomic status (0.32), demographic factors (0.23), and financial incentives (0.09). Further, our results challenge the existing opt-in donation system in Malaysia and present a presumptive approach as a suitable system for increasing deceased donation rate in Malaysia. Presumptive approach promotes the role of health-care professionals in securing the family consent.

    Conclusion: This approach is a person-oriented rather than process-oriented strategy and it relies on designated requesters' skills to evoke altruism among bereaved families. Based on results, the authors recommended that relevant government agencies focus on training nurses to discuss donation with bereaved families and raising public awareness.

  6. Rasiah R, Manikam R, Chandrasekaran SK, Naghavi N, Mubarik S, Mustafa R, et al.
    Am J Transplant, 2016 05;16(5):1540-7.
    PMID: 26602367 DOI: 10.1111/ajt.13603
    Organ donation rates have continued to fall seriously short of needs worldwide, with the lowest rates recorded among developing economies. This study seeks to analyze evidence from a developing economy to explore the usefulness of social psychological theory to solve the problem. The study deployed a large survey (n = 10 412) using a convenience sampling procedure targeted at increasing the number of Malaysians registered with the Ministry of Health, Malaysia who are willing to donate organs upon death. Structural equation modeling was deployed to estimate simultaneously the relative influence of cognitive and noncognitive variables on willingness to donate deceased organs. The cognitive factors of donation perception, socioeconomic status and financial incentives, and the noncognitive factors of demography and fear showed a high statistically significant (1%) relationship with willingness to donate organs after death. While financial incentives were significant, cash rewards showed the least impact. Donation perception showed the highest impact, which shows that the development of effective pedagogic programs with simultaneous improvements to the quality of services provided by medical personnel engaged in retrieving and transplanting deceased donor organs can help raise organ donation rates.
  7. Adekunjo FO, Rasiah R, Dahlui M, Ng CW
    Afr J AIDS Res, 2020 Dec;19(4):287-295.
    PMID: 33337980 DOI: 10.2989/16085906.2020.1834417
    HIV/AIDS is a major health issue faced by the world, generally, but particularly sub-Saharan Africa. Nigeria ranked third in the world by number of people living with HIV/AIDS in 2019. Despite prominent HIV counselling and testing (HCT) intervention programmes, Nigeria faces serious challenges, such as inadequate funding and low utilisation rates. Paucity of research into such a critical topic has restricted the capacity of policy makers to address the problem adequately. Consequently, a cross-sectional study was carried out using the contingent valuation method to assess the economic quantum of payment and determining factors associated with people's willingness to pay for HCT services. Data were collected from 768 people selected by convenience sampling of three local government areas - Alimosho, Ikorodu and Surulere in Lagos State, Nigeria. Data were analysed using descriptive statistics, chi-square, Mann-Whitney, and general linear regression model analysis. Findings show that 75% of respondents were willing to pay an average fee of N1 291 ($4.22) for HCT services. Significant determinants of willingness to pay were: income; knowledge of someone living with HIV or died of AIDS; worry about HIV infection; and fear of HIV-related stigma. The findings offer vital information germane to co-payment schemes aimed at financial sustainability of HCT and HIV/AIDS programmes in Nigeria.
  8. Rasiah R, Naghavi N, Mubarik MS, Nia HS
    Nurs Ethics, 2020 Sep;27(6):1436-1449.
    PMID: 32410486 DOI: 10.1177/0969733020918927
    BACKGROUND: Organ supply-demand in developing countries worldwide has continued to widen. Hence, using a large survey (n ¼ 10,412), this study seeks to investigate whether human psychology could be used to inculcate philanthropy to raise deceased organ donation rates.

    METHODS: Three models were constructed to examine multidimensional relationships among the variables. Structural equation modeling was applied to estimate the direct and indirect influence of altruism, financial incentives, donation perception, and socioeconomic status simultaneously on willingness to donate deceased organs.

    ETHICAL CONSIDERATIONS: The study was approved by the University of Malaya ethics committee.

    RESULTS: The results show that altruism amplifies the impact of socioeconomic status and donation perception on willingness to donate. Also, the results show that financial incentives cannot complement altruism to raise organ donation rates. Hence, investing in education and public awareness enhances altruism in people, which then increases the propensity to donate.

    CONCLUSION: Evidence suggests that governments should allocate resources to increase public awareness about organ donation. Awareness programs about the importance of philanthropic donations and the participation of medical consultants at hospitals in the processes form the foundation of such a presumptive approach.

  9. Rasiah R, Ahmed A, Al-Amin AQ, Chenayah S
    Environ Sci Pollut Res Int, 2017 Jan;24(3):2632-2642.
    PMID: 27830414 DOI: 10.1007/s11356-016-7985-2
    This paper analyses empirically the optimal climate change mitigation policy of Malaysia with the business as usual scenario of ASEAN to compare their environmental and economic consequences over the period 2010-2110. A downscaling empirical dynamic model is constructed using a dual multidisciplinary framework combining economic, earth science, and ecological variables to analyse the long-run consequences. The model takes account of climatic variables, including carbon cycle, carbon emission, climatic damage, carbon control, carbon concentration, and temperature. The results indicate that without optimal climate policy and action, the cumulative cost of climate damage for Malaysia and ASEAN as a whole over the period 2010-2110 would be MYR40.1 trillion and MYR151.0 trillion, respectively. Under the optimal policy, the cumulative cost of climatic damage for Malaysia would fall to MYR5.3 trillion over the 100 years. Also, the additional economic output of Malaysia will rise from MYR2.1 billion in 2010 to MYR3.6 billion in 2050 and MYR5.5 billion in 2110 under the optimal climate change mitigation scenario. The additional economic output for ASEAN would fall from MYR8.1 billion in 2010 to MYR3.2 billion in 2050 before rising again slightly to MYR4.7 billion in 2110 in the business as usual ASEAN scenario.
  10. Rasiah R, Thangiah G, Yusoff K, Manikam R, Chandrasekaran SK, Mustafa R, et al.
    BMC Public Health, 2015;15:1242.
    PMID: 26673166 DOI: 10.1186/s12889-015-2577-5
    Numerous studies have shown the importance of physical activity in reducing the morbidity and mortality rates caused by cardiovascular disease (CVD). However, most of these studies emphasise little on the cumulative effect of CVD risk factors. Hence, this study investigates the association between physical exercise and cumulative CVD risk factors among adults in three different age groups.
  11. Rasiah R, Yusoff K, Mohammadreza A, Manikam R, Tumin M, Chandrasekaran SK, et al.
    BMC Public Health, 2013;13:886.
    PMID: 24066906 DOI: 10.1186/1471-2458-13-886
    Cardiovascular disease (CVD) related deaths is not only the prime cause of mortality in the world, it has also continued to increase in the low and middle income countries. Hence, this study examines the relationship between CVD risk factors and socioeconomic variables in Malaysia, which is a rapidly growing middle income nation undergoing epidemiologic transition.
  12. Rasiah R, Manikam R, Chandarsekaran SK, Thangiah G, Puspharajan S, Swaminathan D
    Medicine (Baltimore), 2014 Nov;93(23):e126.
    PMID: 25415665 DOI: 10.1097/MD.0000000000000126
    The growing shortage in human organs has raised serious concerns. To address this problem, we examine in this article the association between demographic and socioeconomic factors, and respondents' willingness to donate cadaveric organs using a large survey of Malaysian adults aged 18 years and above.A convenience sampling method was used to extract information from a total of 10,350 participants from Metropolitan Kuala Lumpur over the period of April 2, 2013 to February 29, 2014. In addition to analyzing the data using incidence of willingness to donate by demographic and socioeconomic factors, we carried out logistic regression analysis to estimate the odds ratio of respondents' willingness to become cadaveric organ donors controlling for age.About less than a third of the participants pledged to donate their organs upon death with women (35.6%) showing a higher incidence compared with men (33.2%). The Chinese (35.7%) and Malays (35.0%) pledged to contribute more than the Indians (31.6%) and the logistic regressions show that Malays (adjusted odds ration [OR] = 1.18) and Chinese (adjusted OR = 1.21) are more likely to donate than Indians (reference group). The results by religion were significant among Muslims and Hindus but not Buddhists. The likelihood of Muslims donating was the lowest (adjusted OR = 0.26). Income was also highly significant but the relationship with willingness to donate was negative. Against tertiary education, all other occupations were significant. However, the respondents with primary education enjoyed the highest adjusted OR (5.46) whereas that of secondary (0.48) and higher secondary (0.83) education was low. Among occupations (against supervisory, clerical, and direct workers), it was significant only among the unemployed and managers with adjusted OR of 1.50 and 1.58, respectively.Sex, education, ethnicity, religion, and income are important demographic and socioeconomic influences on the likelihood of Malaysians willing to become cadaveric organ donors. The Malaysian evidence suggests that awareness programs should be targeted at men, Muslims, Hindus, Malays, and the rich more than the others.
  13. Tumin M, Rasiah R, Noh A, Satar NM, Chong CS, Lim SK, et al.
    Clin Transplant, 2014 Apr;28(4):423-7.
    PMID: 24617562 DOI: 10.1111/ctr.12334
    A sample of Malaysians in the Klang Valley indicating their decision on becoming unrelated living kidney donors was surveyed regarding huge amounts of financial incentives to be rewarded to them. From the 1310 respondents, 72.1% said "no" on becoming a living donor. The reason "I don't think humans can live with only one kidney" scored the highest (35.6%), and from the 27.9% of the respondents who are willing to donate their organ with the right financial incentive, most of the respondents picked the reasons "I want to do something noble in life" (50%), and monetary reason scored the lowest (6.2%), indicating that financial incentive is not a major reason guiding individuals' decision on becoming living donors. We suggest that the government should put priority at targeting public education to raise the understanding on the risk, safety and the quality of life of donation and transplantation, and improving the public trust on the donation and the surgical methods to carry out transplantation.
  14. Chaw SH, Chan L, Lee PK, Bakar JA, Rasiah R, Foo LL
    J Anesth, 2016 12;30(6):1063-1066.
    PMID: 27510560 DOI: 10.1007/s00540-016-2228-8
    We report a case of drug-induced myoclonus possibly related to palonosetron, a second-generation 5-hydroxytryptamine-3 receptor antagonist which was administered as a prophylaxis for postoperative nausea and vomiting in a 28-year-old female. The recurrent episodes of myoclonus jerk involving the head, neck and shoulder persisted for a period of 4 days. The patient also exhibited an episode of severe bradycardia leading to hypotension 7 h after surgery. To our knowledge, this is the first report presenting these adverse events potentially associated with the use of palonosetron.
  15. Sharif Nia H, She L, Rasiah R, Khoshnavay Fomani F, Kaveh O, Pahlevan Sharif S, et al.
    Front Public Health, 2021;9:683291.
    PMID: 34869136 DOI: 10.3389/fpubh.2021.683291
    Background: Studies have revealed an increase in discrimination, neglect, and abuse among the older adult population during this period. This study assessed the validity and reliability of the Persian version of the ageism survey instrument tested on a sample of the Iranian older adult population during coronavirus disease (COVID-19) pandemic. An important move in counteracting ageism is to classify the ageism scale comprehensively by employing adequate psychometrics. Methods: The Persian version of the ageism scale was developed using a two-step procedure. The first step involved translating and revising the original scale to develop a Persian version of the ageism scale. The second step involved assessing the psychometric features of the newly adapted scale using construct validity through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) and thereafter assessing the reliability through the average inter-item correlation (AIC), Cronbach's alpha. The sample consisted of 400 older adults (age 65 and older), who were recruited through online data collection, with samples for EFA and CFA randomly selected from the total samples. Results: The Persian version of the ageism survey has three factors: age-related deprivation with five items, dignity with three items, and employment with three items; all of which explained 57.02% of the total variance. The outcome of the EFA was verified by the CFA, with internal consistency reliability being excellent (Cronbach's alpha was 0.725, 0.698, and 0.708 for the three factors). Conclusion: This study specifically offers a restructured three factors Persian version of the ageism survey for Iranian older adults with acceptable construct validity and reliability.
  16. Henson S, Kambhampati U, Mogues T, Olsen W, Prowse M, Ramos R, et al.
    Eur J Dev Res, 2020 Nov 19.
    PMID: 33230373 DOI: 10.1057/s41287-020-00334-4
    What is COVID-19's impact on development? What lessons can be drawn from development studies regarding the effects of and recovery from COVID-19? The unprecedented scale and scope of government interventions carry implications at all levels: global, national, and local. In this introduction, our team of Editors underline the importance of systematic substantive study to further knowledge acquisition, and rigorous global-, national-, or context-specific evaluation to inform evidence-based policymaking. The 12 articles summarised here capture these values and sense of "high quality". In particular, despite early considerations in the first year of the pandemic, they illuminate the need for diverse responses beyond business-as-usual, attention to the multiplicity of impact of policies formulated, and progressive strategies to counteract the impacts of this disaster around the world. The path of future research is clear: studies need to consider and give voice to marginalised groups to counteract the short- and long-term impacts of the pandemic.
  17. Koh W, Chakravarthy M, Simon E, Rasiah R, Charuluxananan S, Kim TY, et al.
    BMC Anesthesiol, 2021 08 16;21(1):205.
    PMID: 34399681 DOI: 10.1186/s12871-021-01414-6
    BACKGROUND: Anesthesia leads to impairments in central and peripheral thermoregulatory responses. Inadvertent perioperative hypothermia is hence a common perioperative complication, and is associated with coagulopathy, increased surgical site infection, delayed drug metabolism, prolonged recovery, and shivering. However, surveys across the world have shown poor compliance to perioperative temperature management guidelines. Therefore, we evaluated the prevalent practices and attitudes to perioperative temperature management in the Asia-Pacific region, and determined the individual and institutional factors that lead to noncompliance.

    METHODS: A 40-question anonymous online questionnaire was distributed to anesthesiologists and anesthesia trainees in six countries in the Asia-Pacific (Singapore, Malaysia, Philippines, Thailand, India and South Korea). Participants were polled about their current practices in patient warming and temperature measurement across the preoperative, intraoperative and postoperative periods. Questions were also asked regarding various individual and environmental barriers to compliance.

    RESULTS: In total, 1154 valid survey responses were obtained and analyzed. 279 (24.2%) of respondents prewarm, 508 (44.0%) perform intraoperative active warming, and 486 (42.1%) perform postoperative active warming in the majority of patients. Additionally, 531 (46.0%) measure temperature preoperatively, 767 (67.5%) measure temperature intraoperatively during general anesthesia, and 953 (82.6%) measure temperature postoperatively in the majority of patients. The availability of active warming devices in the operating room (p 

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