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Fulltext Non-communicable diseases in the Asia-Pacific region: Prevalence, risk factors and community-based prevention

Low WY, Lee YK, Samy AL

Int J Occup Med Environ Health, 2015;28(1):20-6.
PMID: 26159943 DOI: 10.2478/s13382-014-0326-0

Non-communicable diseases (NCDs) lead to substantial mortality and morbidity worldwide. The most common NCDs are cardiovascular diseases (CVD), diabetes, cancer and chronic respiratory diseases. With the rapid increase in NCD-related deaths in Asia Pacific countries, NCDs are now the major cause of deaths and disease burden in the region. NCDs hamper achievement of the Millennium Development Goals (MDG). People in the low socio-economic group are most affected by NCDs as they have poor access to policies, legislations, regulations and healthcare services meant to combat NCDs. This results in loss of productivity by a decreasing labor force with implications at the macroeconomic level. The 3 major NCDs in the Asia Pacific region are CVDs, cancer and diabetes due to the increasing loss of disability adjusted life years (DALYs). The 4 major behavioral risk factors for NCDs are: tobacco use, alcohol consumption, inadequate physical activity and unhealthy diet. The underlying risk factors are urbanization, globalization, sedentary lifestyle, obesity and hypertension. Strategies to combat NCDs in the Asia Pacific region are as follows: population-based dietary salt reduction, health education, psychological interventions, i.e., cognitive behavioral therapy and motivational-interviewing, taxation and bans on tobacco-related advertisements, implementing smoke-free zones and surveillance by the World Health Organization. Control measures must focus on prevention and strengthening inter-sectorial collaboration.
Fulltext Psychosocial stress, sleep deprivation, and its impact on type II diabetes mellitus: Policies, guidelines, and initiatives from Malaysia

Samy AL, Hairi NN, Low WY

FASEB Bioadv, 2021 Aug;3(8):593-600.
PMID: 34377955 DOI: 10.1096/fba.2020-00115

Type II Diabetes Mellitus (T2DM) is a serious public health issue, affecting the global population, particularly those living in low- and middle-income countries. Worldwide, the prevalence of T2DM ranges between 10.4% and 13.5%, depending on the domiciliary. T2DM negatively affects individuals' quality of life and causes high economic burden due to the increasing cost of treatment and management of the disease. Risk factors associated with T2DMs include aging, lifestyle or behavior, genetics, and important biopsychological aspects, which are psychological stress and sleep deprivation. By understanding the associations of psychological stress and sleep deprivation, which contribute to pathophysiology of T2DM, policies, programs, and guidelines were developed in Malaysia to combat the issue among population at large. This narrative review examines 19 national public health policies, programs, and guidelines from the past 20 years in Malaysia that aimed to mitigate the negative health effects of psychological stress, sleep deprivation, and T2DM, both from the government and non-governmental organizations. Both psychological stress and sleep deprivation works independently or as combined effects in the pathophysiology of T2DM. Besides, in Malaysia, the government, in collaboration with non-governmental organizations, have been developing and implementing policies, programs, and guidelines to combat mental health and T2DM issues, targeted to population at large. Integration of digital technology, such as usage of social media for health promotion and dissemination of public health messages to the community and good governance from government were deemed important in the effective implementation of health policies and guidelines, resulting in better health outcome.
Predictors of Quality of Life among Older People with Mild Cognitive Impairment Attending Urban Primary Care Clinics

Samy AL, Kamaruzzaman SB, Krishnaswamy S, Low WY

Clin Gerontol, 2019 05 20;43(4):441-454.
PMID: 31107185 DOI: 10.1080/07317115.2019.1608611

OBJECTIVES: To study the prevalence of Mild Cognitive Impairment (MCI) among older people attending primary care clinics and its predictors of QOL.
METHODS: A cross-sectional study was conducted at two primary care clinics in Kuala Lumpur, Malaysia, recruiting 271 participants by utilizing the universal sampling method. Every patient who attended both the clinics during the study period and met the inclusion and exclusion criteria were approached and briefed about the study. Patients who gave consent were recruited as study participants. Information on sociodemographic, medical condition, and lifestyle behaviors were obtained. The Montreal Cognitive Assessment (MoCA) was used to screen for MCI at a score < 23. The World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire was used to evaluate QOL.
RESULTS: Prevalence of MCI was 27.3%. Lower QOL scores were found in the physical (67.3 ± 1.4), psychological (67.3 ± 1.4), social (66.9 ± 1.6) and environmental (71.3 ± 1.3) domains among participants with MCI. Among them, predictors of QOL were depression in the physical domain, age and stroke in the psychological domain, presence of other types of disorders in the social domain and diabetes and stroke in the environmental domain.
CONCLUSIONS: MCI was prevalent among study participants and were associated with poorer QOL in all domains of QOL. A better understanding of predictors of QOL in older people with MCI is deemed important.
CLINICAL IMPLICATION: Routine cognitive screening at primary care clinics will facilitate early recognition of MCI and facilitates referral to memory clinics for further assessment and treatment.
Mental Health and COVID-19: Policies, Guidelines, and Initiatives from the Asia-Pacific Region

Samy AL, Awang Bono S, Tan SL, Low WY

Asia Pac J Public Health, 2021 11;33(8):839-846.
PMID: 34308673 DOI: 10.1177/10105395211025901

The COVID-19 outbreak was declared a pandemic by the World Health Organization in March 2020 due to rapid intercontinental spread and high morbidity and mortality. Globally, the disease has had a major impact on human lives, including health, economic, employment, psychological, and overall well-being. The COVID-19, besides causing respiratory, neurological, and cardiovascular diseases, has had significant impact on mental health. Major mental health disorders, including depression, anxiety, and stress, have risen in parallel with increasing prevalence of COVID-19. Many population groups, including children, the elderly, those with chronic illnesses, and health care workers, have been affected. This review gives an overall assessment of the prevalence of COVID-19-associated psychological morbidity. In countries in the Asia-Pacific region, prevalence of depression ranged between 4.9% and 43.1%, anxiety from 7.0% to 43.0%, and stress from 3.4% to 35.7%. As COVID-19 continues to severely affect the psychosocial well-being of the population at large, countries have developed and revised policies, guidelines, and introduced new initiatives to curb mental health issues among their citizens. In the long run, pre-disaster preparedness is important to alleviate long-term post-pandemic psychiatric morbidity and to develop psychological resilience toward disasters and pandemic, alongside investment for better mental health coverage.
Eating Disorder Among Malaysian University Students and Its Associated Factors

Chan YL, Samy AL, Tong WT, Islam MA, Low WY

Asia Pac J Public Health, 2020 08 13;32(6-7):334-339.
PMID: 32787612 DOI: 10.1177/1010539520947879

Eating disorder is highly prevalent among university students worldwide. However, in Malaysia, studies on eating disorder is scanty and were mostly conducted among medical students. A stratified cluster sampling was used to recruit participants in a university based in Kuala Lumpur. This cross-sectional study was conducted among 1017/1132 students (response rate: 89.8%). The questionnaires administered was a combination of the Eating Attitude Test-26 and items related to perceived body weight, body mass index, trying to weight loss, tobacco use, posttraumatic stress disorder, and depression. Descriptive analyses were performed to provide background information of at-risk students by gender. Multiple logistic regressions were used to identify associated factors of eating disorder. The results showed that 13.9% of the university students were at risk of eating disorder. Students who were trying to lose weight and had posttraumatic stress disorder predicted eating disorder. Hence, eating disorder among university students merits attention and requires implementations of public health policies.
Psychometric assessment of the Bahasa Malaysia version of the Older Americans Resources and Services-Instrumental Activities of Daily Living (OARS-IADL)

Samy AL, Kamaruzzaman SB, Chinna K, Shunnmugam B, Krishnaswamy S, Low WY

Australas J Ageing, 2021 Dec;40(4):423-429.
PMID: 33942961 DOI: 10.1111/ajag.12958

OBJECTIVE: This study aimed to determine the psychometric properties of the Bahasa Malaysia (BM) version of the Older Americans Resources and Services-Instrumental Activities of Daily Living (OARS-IADL) questionnaire among older persons in Malaysia.
METHODS: The English version of OARS-IADL was translated to BM. The psychometric properties of the BM version of OARS-IADL were tested among older persons attending a health-care facility.
RESULTS: Two hundred and seventy-one older persons participated in the study. The mean age of participants was 67.7 ± 6.1 years. Internal consistency of the items was good (Cronbach's alpha, >0.7). Exploratory factor analysis revealed a single dimension with item factor loadings of >0.5. Confirmatory factor analysis results confirmed a single-factor model (AVE > 50%, CR > 0.7 and CR > AVE).
CONCLUSION: The BM version of the OARS-IADL questionnaire is a valid and reliable instrument that can be used to assess the IADL among older persons in Malaysia.
Fulltext Floods Amidst COVID-19 in Malaysia: Implications on the Pandemic Responses

Ng YJ, Samy AL, Tan SL, Ramesh P, Hung WP, Ahmadi A, et al.

Disaster Med Public Health Prep, 2021 Dec 23.
PMID: 34937606 DOI: 10.1017/dmp.2021.371
Fulltext Understanding the Slow COVID-19 Trajectory of Cambodia

Nit B, Samy AL, Tan SL, Vory S, Lim Y, Nugraha RR, et al.

Public Health Pract (Oxf), 2021 Nov;2:100073.
PMID: 33521738 DOI: 10.1016/j.puhip.2020.100073

COVID-19 has resulted in large number of mortalities across the globe. However, Cambodia has recorded low number of COVID-19 cases with no death. A number of factors buttress the accuracy of this phenomenon such as significant support from international health partners, culture of wearing a face mask when sick, timely response of Cambodia's neighbouring countries, and the compliance of the general public to the restrictions. Cambodia started to take stringent measures and augmented efforts to initiate policies and plans to curb the spread of the virus, including but not limited to: closure of inbound and outbound borders, shutting down of schools, and banning religious activities, gatherings and meetings, with more than 50 people. Another source of success of Cambodia is extensive mass testing, complemented with contact tracing. A strategy called "box in" the virus was introduced. Healthcare workers were trained to help in contact tracing and detection at the community level. Measures enacted so far has helped Cambodia control the pandemic. Other countries could adopt and adapt to the policies and best practices of Cambodia. However, possibilities of new waves of the pandemic may affect the country, thus, the Cambodian government needs to be cautious when lifting restrictions to avoid explosion of new cases.
Influence of mental health on the well-being status among Malaysian adults before and during COVID-19 pandemic

Cheah WL, Law LS, Samy AL, Chua BS, Siau CS, Fitriana M, et al.

Psychol Health Med, 2023 Jan;28(1):189-199.
PMID: 35437088 DOI: 10.1080/13548506.2022.2063351

The coronavirus disease (COVID-19) pandemic has affected the well-being of individuals worldwide. Due to the scarcity of information in the Malaysian context, this study aimed at investigating the changes in well-being before and during the Movement Control Order (MCO) in Malaysia and its association with mental health status. This cross-sectional study was part of a Malaysian non-probabilistic online survey on psychosocial well-being in Malaysia, under the Personal and Family Coping with COVID-19 Global South Research Consortium. A total of 543 respondents (≥18 years old) were recruited using snowball sampling. A validated self-administered questionnaire for assessing sociodemographic characteristics, well-being, anxiety, boredom, and loneliness was circulated on social media platforms (such as Facebook, Twitter, and WhatsApp) and emails. Paired samples t-test, chi-square test, and multinomial logistic regression analyses were applied during data analysis. Results revealed significant changes in the mean scores of well-being, anxiety, boredom, and loneliness before and during MCO (p