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Fulltext Promoting physical activity in sedentary elderly Malays with type 2 diabetes: a protocol for randomised controlled trial

Sazlina SG, Browning CJ, Yasin S

BMJ Open, 2012;2(6).
PMID: 23161092 DOI: 10.1136/bmjopen-2012-002119

INTRODUCTION: Like many countries Malaysia is facing an increase in the number of people with type 2 diabetes mellitus diabetes (T2DM) and modifiable lifestyle factors such as sedentary behaviour are important drivers of this increase. The level of physical activity is low among elderly Malay people. In Malaysia, strategies to promote physical activity in elderly Malay people with T2DM are not well documented in the research literature. This paper discusses an intervention to increase physical activity in elderly Malay people with T2DM. The aim of our study was to evaluate the effectiveness of personalised feedback alone and in combination with peer support in promoting and maintaining physical activity in comparison with usual care.
METHODS AND ANALYSIS: A three-arm randomised controlled trial will be conducted among sedentary Malay adults aged 60 years and above with T2DM attending an urban primary healthcare clinic in Malaysia. The participants will be randomised into three groups for a 12-week intervention with a follow-up at 24 and 36 weeks to assess adherence. The primary outcome of this study is pedometer-determined physical activity. Glycaemic and blood pressure control, body composition, cardiorespiratory fitness, balance, lipid profile, health-related quality of life, psychological well-being, social support and self-efficacy for exercise are the secondary measures. Linear mixed models will be used to determine the effect of the intervention over time and between groups. ETHICAL AND DISSEMINATION: The Monash University Human Research Ethics Committee and the Malaysian Ministry of Health's Medical Research Ethics Committee approved this protocol. The findings of this study will be presented at international conferences and published in peer-reviewed journals.
TRIAL REGISTRATION: This study protocol has been registered with the Malaysian National Medical Research Registry and with the Current Controlled Trial Ltd (http://www.controlled-trials.com/ISRCTN71447000/).
Physician-patient interaction satisfaction and its influence on medication adherence and type-2 diabetic control in a primary care setting

Nasir NM, Ariffin F, Yasin SM

Med J Malaysia, 2018 06;73(3):163-169.
PMID: 29962500 MyJurnal

INTRODUCTION: Medication adherence has been found to be an important determinant in achieving glycaemic control in Type 2 Diabetes (T2DM) patients. In other patient populations, physician-patient interaction satisfaction was found to influence medication adherence. It is then important to identify if this is also a factor amongst T2DM patients on insulin as poor adherence was associated with increased all-cause mortality.
METHODS: This was a cross sectional study involving 197 T2DM patients on insulin from two government primary health clinics in Gombak. Physician-patient interaction satisfaction was assessed using Skala Kepuasan Interaksi Perubatan (SKIP-11) consisting of 3 subdomains (Distress Relief, Rapport and Interaction Outcome). Medication adherence level was measured using a single item selfreport question. Data analysis for descriptive, inferential and multivariate analysis statistics were performed.
RESULTS: The mean age of the study participants was 57.12 (SD: 9.27). Majority were Malay, female, unemployed with mean BMI of 27.5. Majority reported full adherence (62.9%). High scores in the Interaction Outcome subdomain was associated with better adherence. Factors associated with high scores in this subdomain included patient education level, number of oral hypoglycaemic agent and type of insulin regime taken. This study also found that high scores in the Interaction Outcome domain is associated with lower HbA1c (p<0.05).
CONCLUSION: Physician-patient interaction satisfaction is an important factor in achieving better medication adherence which also leads to better glycaemic control in this group of patients. There is a need to identify strategies to improve satisfaction in this domain to improve patient adherence.
Fulltext Continuity of care of diabetic patients in a family practice clinic: How important is it?

Hanafi NS, Teng CL, Yasin S

Asia Pac Fam Med, 2003;2(1):10-15.

Aim: To assess the importance of continuity of care among diabetic patients attending a primary care clinic and to correlate degree of continuity of care with diabetic control. Methods: A cross sectional survey was carried out among diabetic patients (n = 166) attending follow-up consultations in a family practice clinic of a teaching hospital. Face-to-face interviews were carried out on patients' perception of continuity of care and various aspects related to diabetes. Diabetic control was assessed by glycosylated hemoglobin. Retrospective chart audits of each patient over the previous 28 months were done to assess the degree of continuity of care, measured with the Usual Provider Continuity Index (UPCI). Results: The UPCI ranged from 0.18 to 1.00 with a mean value of 0.60. The average number of visits per patient over the 28-month period was 11.7 visits. The majority of patients saw five different doctors for all their visits. There were no statistically significant associations between the degree of provider continuity with diabetic control (r = 0.054) and diabetic self-care behavior (r = 0.065). The majority of patients (89%) felt that it was important to have a regular doctor. The main reason given was that a regular doctor would know the patient's problems. Conclusions: Continuity of care was highly valued by diabetic patients attending a hospital-based family practice clinic. Even though the degree of continuity was not associated with the degree of diabetic control, patients felt that it was important to have doctors who are aware of their problems.
Fulltext Interventions to promote physical activity in older people with type 2 diabetes mellitus: a systematic review

Sazlina SG, Browning C, Yasin S

Front Public Health, 2013;1:71.
PMID: 24392445 DOI: 10.3389/fpubh.2013.00071

Type 2 diabetes mellitus (T2DM) among people aged 60 years and above is a growing public health problem. Regular physical activity is one of the key elements in the management of T2DM. Recommendations suggest that older people with T2DM will benefit from regular physical activity for better disease control and delaying complications. Despite the known benefits, many remain sedentary. Hence, this review assessed interventions for promoting physical activity in persons aged 65 years and older with T2DM.
Fulltext Effectiveness of personalized feedback alone or combined with peer support to improve physical activity in sedentary older malays with type 2 diabetes: a randomized controlled trial

Sazlina SG, Browning CJ, Yasin S

Front Public Health, 2015;3:178.
PMID: 26217658 DOI: 10.3389/fpubh.2015.00178

INTRODUCTION: Regular physical activity is an important aspect of self-management among older people with type 2 diabetes but many remain inactive. Interventions to improve physical activity levels have been studied but few studies have evaluated the effects of personalized feedback (PF) or peer support (PS); and there was no study on older people of Asian heritage. Hence, this trial evaluated whether PF only or combined with PS improves physical activity among older Malays with type 2 diabetes (T2DM) compared to usual care only.
MATERIALS AND METHODS: A three-arm randomized controlled trial was conducted in a primary healthcare clinic in Malaysia. Sixty-nine sedentary Malays aged 60 years and older with T2DM who received usual diabetes care were randomized to PF or PS interventions or as controls for 12 weeks with follow-ups at weeks 24 and 36. Intervention groups performed unsupervised walking activity and received written feedback on physical activity. The PS group also received group and telephone contacts from trained peer mentors. The primary outcome was pedometer steps. Secondary outcomes were self-reported physical activity, cardiovascular risk factors, cardiorespiratory fitness, balance, quality of life, and psychosocial wellbeing.
RESULTS: Fifty-two (75.4%) completed the 36-week study. The PS group showed greater daily pedometer readings than the PF and controls (p = 0.001). The PS group also had greater improvement in weekly duration (p
Fulltext Community-based blood pressure measurement by non-health workers using electronic devices: a validation study

Reidpath DD, Ling ML, Yasin S, Rajagobal K, Allotey P

Glob Health Action, 2012;5:14876.
PMID: 22761601 DOI: 10.3402/gha.v5i0.14876

INTRODUCTION: Population monitoring and screening of blood pressure is an important part of any population health strategy. Qualified health workers are expensive and often unavailable for screening. Non-health workers with electronic blood pressure monitors are increasingly used in community-based research. This approach is unvalidated. In a poor, urban community we compared blood pressure measurements taken by non-health workers using electronic devices against qualified health workers using mercury sphygmomanometers.
METHOD: Fifty-six adult volunteers participated in the research. Data were collected by five qualified health workers, and six non-health workers. Participants were randomly allocated to have their blood pressure measured on four consecutive occasions by alternating a qualified health worker with a non-health worker. Descriptive statistics and graphs, and mixed effects linear models to account for the repeated measurement were used in the analysis.
RESULTS: Blood pressure readings by non-health workers were more reliable than those taken by qualified health workers. There was no significant difference between the readings taken by qualified health workers and those taken by non-health workers for systolic blood pressure. Non-health workers were, on average, 5-7 mmHg lower in their measures of blood pressure than the qualified health workers (95%HPD: -2.9 to -10.0) for diastolic blood pressure.
CONCLUSION: The results provide empirical evidence that supports the practice of non-health workers using electronic devices for BP measurement in community-based research and screening. Non-health workers recorded blood pressures that differed from qualified health workers by no more than 10 mmHg. The approach is promising, but more research is needed to establish the generalisability of the results.
KEYWORDS: Malaysia; blood pressure; community workers; hypertension; measurement; screening
Study site: urban, low-income community, of the Klang Valley near Kuala Lumpur, Malaysia
Device: Mercury sphygmomanometers (Spirit brand, model number CK-101C), electronic, automatic blood pressure monitors (Omron brand model HEM-7203)
Fulltext Job stressors and smoking cessation among Malaysian male employees

Yasin SM, Retneswari M, Moy FM, Darus A, Koh D

Occup Med (Lond), 2012 Apr;62(3):174-81.
PMID: 22362839 DOI: 10.1093/occmed/kqs005

Job stressors may reduce the likelihood of quitting smoking.
Timing and risk factors associated with relapse among smokers attempting to quit in Malaysia

Yasin SM, Moy FM, Retneswari M, Isahak M, Koh D

Int J Tuberc Lung Dis, 2012 Jul;16(7):980-5.
PMID: 22507850 DOI: 10.5588/ijtld.11.0748

Many smokers attempt to quit smoking, but very few succeed.
At the limits of "capability": The sexual and reproductive health of women migrant workers in Malaysia

Freeman T, Miles L, Ying K, Mat Yasin S, Lai WT

Sociol Health Illn, 2023 Jun;45(5):947-970.
PMID: 34227694 DOI: 10.1111/1467-9566.13323

Despite the centrality of sexual and reproductive health (SRH) to UN Sustainable Development Goals (SDGs), women migrant workers in Malaysia face an environment inimical to their SRH needs. Drawing on qualitative case study material, we present the first empirical application of the capability approach (CA) to explore the reproductive health needs of women migrant workers in a developing country, offering an original analysis of the capability for SRH of these women. Specifically, we explore the resources available to them; their opportunities and freedoms ("capabilities"); and factors that mediate transformation of resources into capability sets ("conversion factors"). While SRH information and health care are notionally available, women migrant workers face multiple challenges in converting resources into functionings, constraining the achievement of capability for SRH. Challenges include language barriers, personal beliefs, power relations between workers and employers and the consequences of current migration policy. We consider the scale of the challenges facing these women in securing SRH rights, the difficulties of operationalising the CA within such a setting, and the implications of our findings for the adequacy of the CA in supporting marginalised populations.
Fulltext Contextualizing chronicity: a perspective from Malaysia

Yasin S, Chan CK, Reidpath DD, Allotey P

Global Health, 2012 Mar 08;8:4.
PMID: 22397462 DOI: 10.1186/1744-8603-8-4
Fulltext The rural bite in population pyramids: what are the implications for responsiveness of health systems in middle income countries?

Jahan N, Allotey P, Arunachalam D, Yasin S, Soyiri IN, Davey TM, et al.

BMC Public Health, 2014;14 Suppl 2:S8.
PMID: 25081203 DOI: 10.1186/1471-2458-14-S2-S8

Health services can only be responsive if they are designed to service the needs of the population at hand. In many low and middle income countries, the rate of urbanisation can leave the profile of the rural population quite different from the urban population. As a consequence, the kinds of services required for an urban population may be quite different from that required for a rural population. This is examined using data from the South East Asia Community Observatory in rural Malaysia and contrasting it with the national Malaysia population profile.
Fulltext Validity of self-measured waist and hip circumferences: results from a community study in Malaysia

Reidpath DD, Cheah JC, Lam FC, Yasin S, Soyiri I, Allotey P

Nutr J, 2013;12:135.
PMID: 24093886 DOI: 10.1186/1475-2891-12-135

BACKGROUND: Measures of central adiposity are better predictors of adverse health events than BMI. Nonetheless, BMI is more widely used in health research. One reason for this may be the limited research supporting the self-measurement of waist and hip circumference. The lack of validity studies is particularly acute in Asia. The main objective was to establish the validity of self-measurement of waist and hip circumference in a community setting and the correlation of those measures with BMI, blood pressure, and blood glucose levels.
METHODS: A community based, cross-sectional survey. A "healthy living expo" at a shopping mall in a rural town on peninsular Malaysia One hundred and thirty six (136) individuals volunteered to participate in the study, 125 of whom met the inclusion criteria. The ethnic distribution of the participants was 80% Chinese, 17% Malay and 3% Indian. Most participants were female (60%), with participants' ages ranging from 18 to 78 years (mean, 47.2). Self and assisted measurements of waist and hip were taken. Blood pressure, non-fasting blood glucose, height, and weight were also measured. Bland Altman plots and Lin's concordance coefficient were used to measure agreement between self and assisted measures. Pearson's correlation was used to examine the association of self and assisted measures with blood pressure, blood glucose, and BMI.
RESULTS: There was a downwards bias in self measured waist (-0.81 cm) and hip (-1 cm) circumferences compared with assisted measures. The concordance for the self and assisted measures of waist, hip and the ratio of the two were, respectively, .96, .93 , and .84. The correlation between measures of central adiposity and BMI, blood pressure and blood glucose were similar for self and assisted measures.
CONCLUSION: The results provide additional support for the use of self-measurement of waist and hip circumference studies of central adiposity, but is limited by the specificity of the setting.
Fulltext Universal coverage in an era of privatisation: can we guarantee health for all?

Allotey P, Yasin S, Tang S, Chong SL, Cheah JC, Reidpath DD

BMC Public Health, 2012;12 Suppl 1:S1.
PMID: 22992275
Rethinking health-care systems: a focus on chronicity

Allotey P, Reidpath DD, Yasin S, Chan CK, de-Graft Aikins A

Lancet, 2011 Feb 5;377(9764):450-1.
PMID: 21074257 DOI: 10.1016/S0140-6736(10)61856-9
Micro-bending based optical band-pass filter and its application in S-band Thulium-doped fiber amplifier

Emami SD, Rashid HA, Zarifi A, Zarei A, Soltanian MR, Yasin SZ, et al.

Opt Express, 2012 Dec 31;20(28):29784-97.
PMID: 23388806 DOI: 10.1364/OE.20.029784

A new approach for filtering an optical band-pass in optical amplifier is proposed using a macro bending. The proposed filter leverages the bending loss of higher order modes at shorter wavelengths. At longer wavelengths, the filter increases fiber's bending loss as the fundamental mode 'tail' is leak out from the cladding. The combination of wavelength dependent loss at longer and shorter wavelength gives rise to the optical band-pass filter characteristic inside the fiber. The simulated spectral response of the filter is found to be in good agreement with the experimental results. Subsequently, the proposed optical band-pass filter is applied in Thulium-doped fiber amplifiers (TDFA) system for gain and noise figure enhancements. The filter functions to suppress both the amplified spontaneous emission (ASE) at 800 nm and 1800 nm wavelength regions and thus improves both gain and noise figure performances in S-band region. By bending of the gain medium, gain and noise figure of the TDFA are improved by about 2 dB and 0.5 dB respectively, within a wavelength region from 1440 and 1500 nm when the 1050 nm pump power is fixed at 250 mW.
A Systematic Review for Enabling of Develop a Blockchain Technology in Healthcare Application: Taxonomy, Substantially Analysis, Motivations, Challenges, Recommendations and Future Direction

Hussien HM, Yasin SM, Udzir SNI, Zaidan AA, Zaidan BB

J Med Syst, 2019 Sep 14;43(10):320.
PMID: 31522262 DOI: 10.1007/s10916-019-1445-8

Blockchain in healthcare applications requires robust security and privacy mechanism for high-level authentication, interoperability and medical records sharing to comply with the strict legal requirements of the Health Insurance Portability and Accountability Act of 1996. Blockchain technology in the healthcare industry has received considerable research attention in recent years. This study conducts a review to substantially analyse and map the research landscape of current technologies, mainly the use of blockchain in healthcare applications, into a coherent taxonomy. The present study systematically searches all relevant research articles on blockchain in healthcare applications in three accessible databases, namely, ScienceDirect, IEEE and Web of Science, by using the defined keywords 'blockchain', 'healthcare' and 'electronic health records' and their variations. The final set of collected articles related to the use of blockchain in healthcare application is divided into three categories. The first category includes articles (i.e. 43/58 scientific articles) that attempted to develop and design healthcare applications integrating blockchain, particularly those on new architecture, system designs, framework, scheme, model, platform, approach, protocol and algorithm. The second category includes studies (i.e., 6/58 scientific articles) that attempted to evaluate and analyse the adoption of blockchain in the healthcare system. Finally, the third category comprises review and survey articles (i.e., 6/58 scientific articles) related to the integration of blockchain into healthcare applications. The final articles for review are discussed on the basis of five aspects: (1) year of publication, (2) nationality of authors, (3) publishing house or journal, (4) purpose of using blockchain in health applications and the corresponding contributions and (5) problem types and proposed solutions. Additionally, this study provides identified motivations, open challenges and recommendations on the use of blockchain in healthcare applications. The current research contributes to the literature by providing a detailed review of feasible alternatives and identifying the research gaps. Accordingly, researchers and developers are provided with appealing opportunities to further develop decentralised healthcare applications through a comprehensive discussion of about the importance of blockchain and its integration into various healthcare applications.
The cultural, family and community factors for resilience in southeast asian indigenous communities: A systematic review

Chua RY, Kadirvelu A, Yasin S, Choudhry FR, Park MS

J Community Psychol, 2019 09;47(7):1750-1771.
PMID: 31374592 DOI: 10.1002/jcop.22224

Although faced with historical and ongoing hardships, many indigenous communities in Southeast Asia have managed to survive and thrive. The identification of factors that assist these communities in coping with the challenges experienced would help enhance their overall psychological well-being and resilience. The current review outlines types of protective factors for the indigenous communities in Southeast Asia focusing on the cultural, family and community elements linked to their psychological well-being. Four themes of protective factors were identified strong connection to the land and the environment, embracing cultural norms and traditions, passing down and keeping indigenous knowledge across generations, and emphasis on community and social cohesion. Findings suggest that the value of interconnectedness serves as an overarching theme that forms the worldview of the indigenous communities in Southeast Asia. Interconnectedness was important to the indigenous peoples as they considered themselves to be extensions of their family, community, ancestors, future descendants, the land and to all living things and creations that reside on their lands. Future intervention attempts to promote resilience among these communities should take these factors into account, and pay closer attention to community-level factors that seem to have a profound impact on the indigenous construction of resilience.
Fulltext Protocol for a systematic review assessing the measurement of dietary sodium intake among adults with elevated blood pressure

Soh YC, Yap KH, McGrattan A, Yasin S, Reidpath D, Siervo M, et al.

BMJ Open, 2022 Jan 03;12(1):e052175.
PMID: 34980615 DOI: 10.1136/bmjopen-2021-052175

INTRODUCTION: Accurate sodium intake estimates in adults with elevated blood pressure are essential for monitoring salt reduction progress and preventing cardiovascular diseases. However, sodium assessments are challenging in this high-risk population because many commonly used antihypertensive drugs alter urinary sodium excretion. Despite the high cost and substantial participant burden of gold-standard 24-hour urine collection, the relative performance of existing spot-urine based equations and dietary self-report instruments have not been well studied in this population, who will benefit from salt restriction. This systematic review aims to describe the current methods of assessing dietary sodium intake in adults with elevated blood pressure and determine what method can provide a valid and accurate estimate of sodium intake compared with the gold standard 24-hour urine collection.
METHODS AND ANALYSIS: Studies assessing sodium intake in adults aged 18 years and above with reported elevated blood pressure will be included. Five electronic databases (MEDLINE, Embase, Global Health, WoS and Cochrane CENTRAL) will be systematically searched from inception to March 2021. Also, a manual search of bibliographies and grey literature will be conducted. Two reviewers will screen the records independently for eligibility. One reviewer will extract all data, and two others will review the extracted data for accuracy. The methodological quality of included studies will be evaluated based on three scoring systems: (1) National Heart, Lung and Blood Institute for interventional studies; (2) Biomarker-based Cross-sectional Studies for biomarker-based observational studies and (3) European Micronutrient Recommendation Aligned Network of Excellence for validation studies of dietary self-report instruments.
ETHICS AND DISSEMINATION: As the proposed systematic review will collect and analyse secondary data associated with individuals, there will be no ethical approval requirement. Findings will be disseminated in a peer-reviewed journal or presented at a conference.
PROSPERO REGISTRATION NUMBER: CRD42020176137.
The relationship between age of smoking initiation and current smoking: an analysis of school surveys in three European countries

Reidpath DD, Ling ML, Wellington E, Al-Sadat N, Yasin S

Nicotine Tob Res, 2013 Mar;15(3):729-33.
PMID: 22990215 DOI: 10.1093/ntr/nts177

INTRODUCTION: It is held that younger smoking initiates are more likely to become regular smokers. The definitions of smoking initiation (a puff, part of a cigarette, a whole cigarette) are inconsistent and raise questions about the robustness of the view. We sought to re-examine the relationship using adolescent smoking data from 3 European countries.
METHODS: A stratified secondary, logistic regression analysis of Global Youth Tobacco Survey data was conducted using a design-based analysis. Subgroup analyses were conducted of 13- to 15-year olds from Latvia (high smoking prevalence), Slovenia (moderate prevalence), and Montenegro (low prevalence) who had initiated smoking. The outcome was current smoking--smoking everyday for the past 30 days, or smoking 10 or more days in the past 30 days. Smoking initiation was operationalized as a single puff of a cigarette, and age of smoking initiation was a derived continuous measure.
RESULTS: In Latvia, there was a significant association between age of smoking initiation and current smoking for males (p < .05) and females (p < .001) when smoking was operationalized as smoking every day. It was only significant in female adolescents (p < .001) for smoking 10 or more days. In Slovenia and Montenegro, there was no significant relationship between age of smoking initiation and current smoking for either males or females.
CONCLUSIONS: The evidence about the relationship between age of smoking initiation and current smoking is not clear. Explanations for the findings may relate to a lack of power, the specificity of the measure, or problems with the theory.
Cohorts and community: a case study of community engagement in the establishment of a health and demographic surveillance site in Malaysia

Allotey P, Reidpath DD, Devarajan N, Rajagobal K, Yasin S, Arunachalam D, et al.

Glob Health Action, 2014 Dec;7(1):23176.
PMID: 28672450 DOI: 10.3402/gha.v7.23176

Background Community engagement is an increasingly important requirement of public health research and plays an important role in the informed consent and recruitment process. However, there is very little guidance about how it should be done, the indicators for assessing effectiveness of the community engagement process and the impact it has on recruitment, retention, and ultimately on the quality of the data collected as part of longitudinal cohort studies. Methods An instrumental case study approach, with data from field notes, policy documents, unstructured interviews, and focus group discussions with key community stakeholders and informants, was used to explore systematically the implementation and outcomes of the community engagement strategy for recruitment of an entire community into a demographic and health surveillance site in Malaysia. Results For a dynamic cohort, community engagement needs to be an ongoing process. The community engagement process has likely helped to facilitate the current response rate of 85% in the research communities. The case study highlights the importance of systematic documentation of the community engagement process to ensure an understanding of the effects of the research on recruitment and the community. Conclusions A critical lesson from the case study data is the importance of relationships in the recruitment process for large population-based studies, and the need for ongoing documentation and analysis of the impact of cumulative interactions between research and community engagement.

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