Displaying publications 1 - 20 of 438 in total

  1. Oo, San San, Rahmah Mohd Amin, Aniza Abd Aziz, Thwe Aung, Myat Moe, Rohayah Husain
    Floods can lead to direct economic and property losses and result not only in physical injuries and deaths but
    also in psychological trauma. Post-traumatic stress disorder (PTSD) is a commonly used indicator to evaluate
    psychological injuries after disaster. This study aimed to determine the relationship between PTSD prevalence
    and related perceived severity of post flood impact by economical, non-economical and flood status severity
    domains besides relevant socio-demographic factors according to gender specific analysis. This cross-sectional
    study was conducted among community in Kampung Hulu Takir, Kuala Terengganu, Malaysia in 2015 two
    weeks after flood. It included a total of 98 males and 110 females aged 18 years and above. Data was
    collected by interview-guided questionnaire to determine the prevalence of PTSD. SPSS version 21.0 was used
    for analysis of the relationship between socio demographic factors, perceived economic, non-economic and
    flood severity with PTSD. Finally chi square test was used to assess the predictors of PTSD according to
    gender. The prevalence of PTSD was 9.2% in males and 10.9% in females, giving a total of 10.1%. Significantly
    higher prevalence of PTSD was found in severely perceived economic and flood impact categories (33.3% and
    23.8% in males; 23.8 % and 37.5% in females) and giving in overall 44.0% and 31.3 % respectively. Effective
    PTSD management strategies targeting females post flood victims who severely perceived economically and
    nature flood impact should be implemented in order to prevent further consequences of PTSD.
  2. Sharifah Nurul Aida Syed Ghazaili, Norwati Daud
    Job satisfaction is defined as pleasurable or positive emotional state which results from the appraisal of one’s job or job experience. It is often determined by how well outcome meet or exceed expectations. There are many factors which are related to job satisfaction among family physicians. Data on satisfaction among family physicians varies from country to country. This study aimed to determine the level of job satisfaction among family physicians in Malaysia and its associated factors. A cross sectional study was performed among 117 family physicians in Malaysia between July 2012 and December 2012. A questionnaire consists of socio-demographic characteristic, professional and health clinic characteristics and Warr-Cook-Wall job satisfaction scale was used. The results showed that 85% of Malaysian family physicians are satisfied with their job. They are mostly satisfied with hours of work, colleagues and fellow workers, and freedom to choose own method of working. They are least satisfied with physical working condition, rate of pay and recognition. Female gender and less number of health clinics in-charged were associated with increased in overall job satisfaction. Most of the family physicians in Malaysia are satisfied with their job. However there are certain areas that should be looked into which are physical working condition, rate of pay and recognition. Malaysian family physicians should receive equal career opportunity, promotion and salary scale like other specialties
  3. Thwe Aung, Myat Moe, Azmi Hassan, Norizhar Kadarman, Tengku Mohammad Ariff R. Hussin, Barman, Arunodaya, Salwani Ismail, et al.
    Aedes mosquito-borne Dengue morbidity is predominantly high in the tropics and subtropics regions. Dengue is also a
    public health problem in Malaysia since the first epidemic in 1973. Reducing the vector population and personal
    protection still plays an important role in dengue prevention and control. With the information of community’s dengue
    knowledge, attitude and practices (KAP), the authorities could construct evidence-based, community- empowered vector
    control program. Upon the understanding of the value of baseline data, a cross-sectional study was carried out in dengue
    hotspot areas in Seberang Takir using universal sampling. The study results showed that 54.6% of the population had high
    level of knowledge, 18.6% had good attitude and 91.7% were performing good practices against Dengue infection. After
    adjusting confounding variables, age and educational levels of respondents, knowledge as well as attitude were found to
    be significant associated factors for having good practice against Dengue. The study findings provide the need for further
    information to undertake a holistic approach which is in need of community participation and cooperatio
  4. Norhasiza Mat Jusoh, Husbani Mohd Amen Rebuan, Thwe Aun, Myat Moe, Mohaslinda Mohamad, Rohayah Husain, Abdul Rahman Esa, et al.
    Cooperative learning is one of the active learning techniques. There are three commonly recognized types of
    cooperative learning groups, namely informal cooperative learning (ICL), formal cooperative learning and
    cooperative base groups. There is no study been done on ICL which relate to radiology teaching. The results of this
    study will provide evidence to support either traditional lecture (TL) or ICL is a more suitable teaching method for
    radiology teaching. This study was aimed to compare students’ attitude and preference towards TL versus ICL in
    radiology teaching. This interventional study had been conducted among 52 third year Bachelor of Medicine and
    Bachelor of Surgery (MBBS) students at Universiti Sultan Zainal Abidin. They underwent both TL and ICL methods
    during eleven radiology lectures in classroom setting from September 2013 until July 2014. Subsequently, multiple
    items questionnaires regarding students’ attitude and preferences towards TL and ICL were administered. These
    questionnaires had undergone validation process and revealed excellent internal consistency with Cronbach’s Alpha
    of 0.90, 0.92 and 0.88 respectively. The mean total attitude score towards informal cooperative learning was (90.90)
    (SD: 11.73) significantly higher than the score for traditional lecture 85.46 (SD: 11.82) (p= 0.012). Students showed
    preference in ICL significantly in six domains. These domains were active involvement in the class, promotion of good
    rapport among classmates, getting an opportunity to help others, facilitation of understanding difficult materials,
    improvement of communication skills, opportunity for training to be a good leader and follower, and opportunity for
    enabling to participate in sharing information, making decision and problem solving. ICL method is recommended in
    radiology teaching because students demonstrated better students’ attitude and preferences in the learning sessions
    as compared to TL.
  5. Nur Jannah Ambak, Aniza Abd Aziz, Nor Azwany Yaacob, Siti Raihan Ishak, Wan Mohd Razin Wan Hassan, Syaratul Emma Hashim, et al.
    Diabetic retinopathy (DR) may result in progressive visual impairment and blindness which affects the diabetic patients‟ morbidity and quality of life significantly. The objective of this study was to determine the proportions and prognostic factors of DR severity among Type 2 diabetes mellitus patients. A cross sectional study was conducted at the Ophthalmology Clinic in a tertiary hospital using the medical record database from 2005 to 2011. A total of 216DR patients were randomly selected. The study outcome was DR severity which was classified into four grading based on the International Clinical Diabetic Retinopathy Scale. Descriptive statistics and Ordinal Logistic Regression were applied using Stata SE/11. The mean (SD) age of DR
    in this study was 56.06 (9.98) years old with almost equal sex ratio. Proportion of mild non proliferative diabetic retinopathy (NPDR) was 48.6% (95% CI: 40.0, 60.0), moderate NPDR was 28.2% (95%CI: 22.0, 40.0), severe NPDR was 6.9% (95% CI: 4.0, 11.0) and proliferative diabetic retinopathy (PDR) was 16.2% (95%CI: 10.0, 22.0). Diabetic patients that suffered from diabetes mellitus for more than 10 years, having nephropathy, every increased of HbA1c by 1% and higher total cholesterol were at increased risk of worsening DR.
    Note: content of full text inconsistent with title and abstract. Author informed.
  6. Mohd Razif Shahril, Suhaina Sulaiman, Sharifah Wajihah Wafa, Sharifah Noor Akmal
    Vitamin A, C and E intake has been shown to play a role in the etiology of breast cancer, but the findings have been
    inconsistent and limited to developed countries with higher cancer incidence. Therefore, the aim of this study is to
    examine the association of premenopausal and postmenopausal breast cancer risk with vitamin A, C and E intake from
    dietary sources. This is a population based case-control study conducted in Malaysian population among 382 breast cancer
    patients and 382 control group. Dietary intake was assessed via an interviewer-administered food frequency
    questionnaire. Logistic regression was used to compute odds ratios (OR) with 95% confidence intervals (CI) and a broad
    range of potential confounders were included in analysis. The results of this study shows a significant decreased risk of
    breast cancer among premenopausal (ORQ4 to Q1=0.38, 95% CI, 0.12 – 0.55, p-trend=0.001) and postmenopausal (ORQ4 to
    Q1=0.26, 95% CI, 0.03 – 0.75, p-trend=0.017) women was observed in the highest quartile of beta-carotene intake.
    Meanwhile, a higher intake of vitamin C showed significantly lowered risk only for premenopausal women (ORQ4 to
    Q1=0.13, 95% CI, 0.03 – 0.32, p-trend=0.001). As a conclusion, beta-carotene intake was independently related to pre- and
    postmenopausal breast cancer risk, while vitamin C intake was associated with decreased risk among premenopausal
    women only. However, no association was observed for vitamin A especially retinol and vitamin E intake from dietary
  7. Karimah Hanim Abd Aziz, Aniza Abd. Aziz, Halim Salleh, Nurul Jannah Ambak, Nor Hakimah Ab Rahman, Oo, San San, et al.
    The aim of this study was to develop a new validated questionnaire to assess the health impact of divorce on women. A
    cross sectional study was undertaken in a district in Terengganu, using a newly developed self-administered Malay
    language questionnaire comprising of six domains and 82 items. The questionnaire was constructed based on the
    literature review and discussions with experts. Exploratory factor analysis was applied in construct validity and internal
    consistency was used for reliability analysis. A total of 51 respondents were involved in this study. All the consented
    divorcees were Malays. The mean (SD) age for the divorced women was 35.8 (10.00). Majority (82.4%) of them had
    secondary education. All the final three domains demonstrated Keiser-Meyer-Olkin (KMO) of more than 0.6, significant
    Bartlett’s test of Sphericity and Cronbach’s alpha of more than 0.80. The overall Cronbach’s alpha was excellent (0.920).
    The final questionnaire consisted of two domains. Factor loading for all items in each subdomains were satisfactory. The
    final functional somatic symptoms domain consisted of 6 subdomains and 19 items with factor loading from 0.402 to
    0.914. For emotional instability domain, the final items were 13 items with factor loading from 0.548 to 0.878. The
    questionnaire was valid and reliable to be used for functional somatic symptoms and emotional instability domains. It is
    useful to assess the health impact and related intervention of divorced women. A confirmatory factor analysis may
    further confirm the final model.
  8. Nor HakimahAbRahman, AnizaAbd. Aziz, Wan MohdZahiruddin W Mohammad, Abdul NawfarSadagatullah, Wisam Abdul Kadder Yassin, Zawawi Nordin
    Diabetic foot ulcer is a major health care problem leading to hospitalization, morbidity, amputation and mortality in diabetic patients. The aim of this study is to determine the amputation-free probability and prognostic factors of major amputation among hospitalized diabetic foot patients in a tertiary teaching hospital in Malaysia. A retrospective record review study was conducted among 231 hospitalized diabetic foot patients in Hospital Universiti Sains Malaysia from 1st January 2007 until 31st December 2011 followed by 1 year follow up. Patients’ medical records were retrieved and reviewed. Socio-demographic, clinical characteristics and amputation endpoint status were recorded. The duration of amputation-free time was measured from the date of being diagnosed as diabetic foot until the date of amputation.Simple and Multiple Cox regression were performed to determine the prognostic factors of major amputation. The patients’ age ranged from 21 to 83, with mean (SD) was 56.9 (10.4) years. Majority were male (51.5%) and Malays (95.7%). The overall proportion of amputation due to diabetic foot was 88.7% which comprised of minor (76.6%) and major amputation (13.7%). The adjusted prognostic factors that were found to be significantly influence the risk of having major amputation among hospitalized diabetic foot patients in HUSM were age at diagnosed of DFU (Adjusted HR: 1.05, 95% CI: 1.00, 1.09, P=0.033), gender (Adjusted HR: 0.21, 95% CI: 0.07,0.66, P=0.007), duration of DM (Adjusted HR: 2.76, 95% CI: 1.25, 6.12, P=0.012), smoking status(Adjusted HR: 4.19, 95% CI: 1.12, 15.65, P=0.033) and status of DFU (Adjusted HR: 2.55, 95% CI: 1.10, 6.07, P=0.029). Older diabetic patients, female, having diabetes more than 10 years, smoker and recurrent DFU were at higher risk of major amputation.
  9. Ting, Lo Chieng, Rajiah, Kingston, Shan Shan, Cheong, Ming, Leow Yeow
    Nowadays, community pharmacist plays an important role in medication counseling, patients’ side effects monitoring and
    drug information delivery. The need of patient counseling has become a vital part of the pharmacy practice and
    pharmaceutical care. Through Continuing Pharmacy Education (CPE) program, pharmacists can develop into professions in
    different areas including drug delivery, drug information, technology and patient education. This study was conducted to
    evaluate the perception of community pharmacists towards patient counseling and continuing education program in
    Sabah and Sarawak, East Malaysia. A cross-sectional study design utilizing questionnaires was prepared by an extensive
    literature review. The research was carried out in four major areas in Sarawak; Sibu, Kuching, Bintulu and Miri and in
    three major areas Sabah; Kota kinabalu, Sepilok, Tawau by convenience sampling method. Descriptive analysis was
    conducted using SPSS version 18. Perception of community pharmacists towards patients counseling and continuing
    education program was analysed using scaling method. A cut-off score of 25.8 was used to indicate the perception of
    community pharmacists. The Pharmacists scored a cut-off point of 25.8 and above were considered to have good
    perception. A sample of 174 community pharmacists from Sabah and Sarawak were participated in this study. All of the
    respondents except one had positive perception towards patient counseling and continuing education program. Overall,
    almost all the community pharmacists had positive perception towards patient counseling and continuing education
    program in Sabah and Sarawak, East Malaysia. Further research is needed to evaluate perception of community
    pharmacists in different states of Malaysia and explore more on continuing education program in Malaysia.
  10. Ang, H. L., Mohamad Adam, B., Tajuddin, A., Isnoni, I., Suzanna, A., Anwar Hau M., et al.
    The incidence of hip fractures is increasing within the aging population.We determined the risk factors of in-hospital mortality following hip fracture across major hospitals in Malaysia. This is a retrospective cohort review from 18 hospitals across Malaysia in National Orthopaedic Registry of Malaysia (NORM) . We collected demographic data, prefracture co-morbidities, previous hip fracture, pre-fracture walking ability, fracture type and stability, mechanism of injury, type of management (operative or non-operative), operation types and grade of surgeon. Between 2008 and 2009, 685 patients were admitted with a hip fracture to 18 government hospitals with orthopaedic service. The overall in-hospital mortality was 2.2%. We found more in-hospital mortality in elderly patients and patients with eye and hearing problems as pre-fracture morbidity. In conclusion, patients who were elderly with multiple comorbidities especially those with eye and hearing impairment were had higher risk for immediate mortality
  11. Aniza, I, Norhayati, M
    Globally, the health of the indigenous people is lagging behind as compared to the mainstream population in countries in which they live. Despite improved overall prosperity and population longevity, social and health inequalities seem to persist in this underprivileged community. Failure in delivering effective health promotion toward the indigenous community is determined by a range of factors. This includes the absence of culturally sensitive awareness among the healthcare workers, ineffective communication of the healthcare providers, poor access to health service, lack of culturally specific health promotional materials, lack of involvement by indigenous healthcare workers, lack of community based programs and inefficiency of indigenous health data collection. Effective interventions for indigenous health require a trans-disciplinary and holistic approach that incorporates indigenous health beliefs and engages with the social and cultural drivers of health.Such culturally congruent health promotion strategies are hoped to narrow down the existing wide gap of health outcomes that contribute to inequalities between indigenous communities and the mainstream population.
  12. Nurulhuda Mat Hasan, Norwati Daud, Juwita Shaaban
    Lifestyles such as unhealthy dietary habits, physical inactivity and smoking are considered fundamental risk factors for cardiovascular disease. Preventive activities have been shown to reduce mortality and morbidity from cardiovascular disease. This study aimed to determine the prevalence of cardiovascular lifestyle risks and cardiovascular preventive activities among healthy government servants in Kuala Terengganu, Malaysia. A cross-sectional study was done from June to September 2013 among 121 government servants working at the Federal Complex, Kuala Terengganu. A questionnaire which consists of socio-demographic data, International Physical Activity Questionnaire (IPAQ), the dietary component of WHO STEPS and cardiovascular screening activities were used as tools. Clustering of cardiovascular lifestyle risks was defined as the presence of two or more of smoking, physical inactivity and unhealthy diet. Optimal cardiovascular screening is defined as having done the required screening for hypertension, diabetes, dyslipideamia and obesity. The study response rate was 90.9% (110 of 121). Prevalence of smoking, physical inactivity and unhealthy diet were 20%, 50% and 87% respectively. The prevalence of clustering of cardiovascular lifestyle risks was 57%. The prevalence of optimal cardiovascular screening for age was 49%. The prevalence of cardiovascular lifestyle risks among government servants in Kuala Terengganu is still high. About half of them did not have the optimal screening for cardiovascular disease. Measures need to be done to promote healthy lifestyle behaviors in the community. Effort should be made at the primary care level and public health to screen those with multiple cardiovascular lifestyle risks in order to optimize cardiovascular disease prevention.
  13. Aniza Abd. Aziz, Barman, Arunodaya, Rahmah Mohd Amin, Oo, San San, Norizhar Kadarman, Ahmad Fadhlinoor Marican, et al.
    The communities settled in this traditional flood-prone area are potentially at risk of frequent inundation. This
    compelled the affected population to cope or adapt some strategy to reduce the negative impacts on their lives. The
    objective of this study was to explore the coping approach among the residents in a flood affected traditional village in
    Kuala Nerus, Terengganu and determine its associated factors. A cross sectional study which involved 210 adults who
    lived in traditional village houses was conducted from April to May 2015. Universal sampling was applied. This
    community-based study was part of the curriculum requirement for undergraduate medical students of UniSZA. The
    participants’ background, experience during the recent flood and their coping response were assessed using selfadministered
    validated Malay version Brief COPE inventory that consists of three domains (emotion-focused, problemfocused
    and less-useful), 14 subscales and 30 items. The mean (SD) age of participants were 46.7(15.54) years with
    almost equal sex ratio. Most of the participants were married (78.1%) and unemployed (54.8%). The most common coping
    approach applied by the villagers was emotion-focused followed by problem-focused and less-useful coping. There were
    four adjusted variables significantly associated with higher total coping score namely awareness on evacuation site
    (b=5.38, 95%CI:1.68,9.08, p=0.005), knowledge on health risk of flood (b=3.79, 95%CI:0.92,6.66, p=0.010), discussed on
    flood preparedness with family (b=2.50, 95%CI:0.84,4.16, p=0.003) and stored food before flood (b=4.506, 95%CI
    1.67,7.34, p=0.002). The emotion-focused coping was the most preferred coping approach among the villagers. A
    significant better coping was associated with the villagers who were aware of the gazetted evacuation site and have
    knowledge on the flood health hazard. The villagers who planned with their family and practiced storage of adequate
    food as part of household preparedness also demonstrated significant higher coping level.
  14. Noor Faradila, P., Aqbal Hafeez, A., Azhar, H., Rohayu, S., Akmalia, S., Mohd Syazwan, S., et al.
    Children are much more likely than adults to get serious injuries in car crashes due to their softer bones, weaker neck muscle and fragile bodies. Child restraint system (CRS) can help in reduce injury and prevent fatality in the event of a crash. Thus the aim of this paper is to gauge the prevalence of CRS usage among guardians of children age below 11 years old. A survey to addressed guardians knowledge on CRS usage, practice and their views on fitting child restraints system to their vehicles were carried out among parents and carers who are caring children aged 11 years old and below. Seventy-four percent (74%) out of 500 respondents cited they have used CRS, however only 40% of them is currently using CRS with their children. Respondent in Kuala Lumpur and younger guardians reported twice likely to use CRS. In addition, graduate respondents are 1.5 times more likely to use CRS for their children. In conclusion, high incorrect usage rate and understanding of the CRS could promote additional injury towards the children in a car crash. Many initiatives could be introduced before the implementation of the CRS law in Malaysia such as awareness, community-based programs and CRS clinics that aim to guide guardians on the correct and effective way of installing the CRS device in their car.
  15. Farah Elida Selamat, Rozli Zulkifli
    Acoustics issues such as noise in the workplace remains one of the most prevalence occupational hazard especially in
    the manufacturing industry with heavy machineries. Increasing mechanization in all industries and most trades has
    since proliferated the noise problem. In Malaysia, much has been studied and is known about the auditory effects of
    noise. However less attention has been given to the non-auditory effects of noise such as annoyance, stress, and work
    performance, and concern about such effects is a relatively recent phenomenon. In view of this, this study aims to
    determine the level of noise from different type of machines and tools in a manufacturing plant and also the effects
    of noise to the employees. A structured questionnaire was used to assess the effects of noise on the workers and
    sound level meter was used to measure the noise level at selected work areas. The results of this study showed that
    nearly all the identified work areas exceeded the action level of 85 dB(A) and four of these areas noise levels’ are
    more than 90 dB(A) which is the permissible exposure limit according to the Factories and Machinery (Noise
    Exposure) Regulations 1989. For the questionnaire, it was found that annoyance topped the noise effects list with
    51.4%, followed by stress with 40.0%, hearing deterioration (14.3%) and job performance deterioration (2.9%). As a
    conclusion, noise control or preventive measures are suggested in order to minimize the health risks from noise
  16. Siti Khuzaimah Ahmad Sharoni, Halimaton Duriah Yunus
    Patients with chronic heart failure suffer from undesirable effects in their daily activities. Effective self-care management in conjunction with social support gives improved the wellbeing of patients with chronic heart failure. This study determines social support and self-care management among patients with chronic heart failure. A cross-sectional study was conducted at the Cardiology Clinic in Hospital Serdang, Selangor from April 2014 to June 2014. A questionnaire consisting of demographic characteristics, MOS Social Survey and Self-Care Heart Failure Index (SCHFI) was distributed to a total of 113 respondents. The results show moderately high level of social support (3.51±0.89) and level of self-care management (160.49±44.39). For instance, social support and self-care management were not statistically significant with the demographic characteristics (p>0.05). There was a positive correlation between social support and self-care management (r=0.263, p<0.05) and the findings suggest that social support should be considered a predictor in self-care management of patients with chronic heart failure.
    Keywords: social support, self-care management, patient(s), chronic heart failure

    Study site: Cardiology Clinic in Hospital Serdang, Selango
  17. Noor A, Ismail NH
    The prevalence of occupational stress among academician is increasing in developed and developing countries. The job is not only to teach, but also involve in doing research, publications, consultation and administrative work. This study aims to assess the prevalence of occupational stress among academic staff in a research university and to investigate the association and correlation between stress and job factors which are career development, research, teaching and interpersonal relationship. One research university in Malaysia was selected randomly. A cross-sectional study was conducted and the respondents were recruited by using a randomized stratified sampling method. A total of 380 self-administered and validated Depression, Anxiety and Stress Scale-21 (DASS-21) and Stress Sources Questionnaires (SSQ) were distributed among academic staff between March to May 2012. The statistical analyses used were χ2, independent–t test and Pearson Correlation. Response rate was 81.1%. Stress prevalence was 22.1%. All socio-demographic factors showed no association with stress except ethnic group. Teaching, research and career development had significant association with stress among academic staff (p<0.05). Overall result showed career development, that include university condition and required publications for promotion were the greatest source of stress among the academicians. Occupational stress showed positive linear relationship to career development, research and teaching. There was a fair positive relationship between occupational stress and career development, research and teaching. It is recommended to organize continuous stress assessment program to identify and evaluate the current level of stress at the university level. This data could be a foundation for implementing prevention and control measures to reduce stress in the workplace.
    Keywords: academic staff, lecturer, occupational stress, research, teaching, career development, interpersonal relationship, research university, job stress
  18. Lin, Lua Pei, Noor Salihah Zakaria, Nik Mazlan
    A concern in breast cancer involves changes in weight which may adversely affect the prognosis of patients. This
    study intended to evaluate weight changed uring chemotherapy and its association with prognostic outcome
    measured as event-free survival (EFS)among breast cancer patients. A total of63 women diagnosed with breast cancer
    and have been treated by anthracycline-based chemotherapy between 2005 and 2011were included.A weight change
    (WC) was calculated based on relative percentage of weight changes from baseline to post-chemotherapy and
    categorized into either weight change (WC >5%) or stable (±5% WC).Survival probabilities were estimated using the
    Kaplan-Meier (SPSS 20). Upon treatment completion, 42.9% of the women experienced weight changes. A small
    weight reduction was observed (61.1 ± 11.6kg to 60.2 ± 11.9kg; -0.8 ± 4.0kg; p=0.106). The median EFS of women who
    experienced weight change was shorter (median 61.0 months) compared to those who maintained their weight
    (median 89.0 months) (p=0.044). In this study, weight changes during breast cancer chemotherapy were associated
    with poorer prognosis in comparison to women who maintained their weight.
  19. Saad Ahmed Ali Jadoo, Syed Mohamed Aljunid, Dastan, Ilker, Dilmac, Elife, Kahveci, Rabia, Tutuncu, Tanju, et al.
    Diagnosis-related group (DRG) system is patient classification system designed to produce limited number of classes
    which are relatively similar in terms of resource consumption and clinical characteristics. The aim of this study was to
    assess the level of knowledge, attitude and practice (KAP) of Turkish health care providers toward DRG system
    implemented in Turkey.A total of 238 healthcare providers were randomly selected from two urbanand one rural hospital
    in Turkey.A questionnaire was used for data collection; contacting 32 items (10 items about knowledge, 12 items about
    attitude and 10 items about the practice) and its validity and reliability were confirmed. Data analysis was performed
    using chi-square and multivariate logistic regression.In this study,only one third of healthcare providers showed good
    knowledge (35.7%) and good practice (37.4%) about DRG system,compared to 54.2% of them showed good attitude.There
    was significant difference between age, gender, occupation groups and whether the respondents have attended a
    workshop for DRG system in terms of KAP (p > 0.05).These results indicated the need for further actions to implement
    DRG system in terms of creation of suitable environment and increasing awareness among healthcare providers,
    especially male, medical doctors, nurses, elderly, and those who have never attended a workshop, in addition to regular
    review to ensure the program would reach its targets.
  20. Hasanain Faisal Ghaz, Al-abed Ali Ahmed Al-abed, TibaNezar Hasan, Zaleha Md. Is, Mohammed A. AbdalQader, Saif Abdul-Majeed
    The association between nutrition and cancer in general had been a controversial issue between scientists in the last
    three decades, because some argued that there is a relationship and some nutrients can help in preventing cancer
    occurrence, although this has not been a consistent finding by other studies. Studies were identified through a
    systematic review of literature available on PubMed in between 1st January 2010 to 31st December 2013. We
    included all studies that assessed nutrition or diet with occurrence or mortality of breast cancer. Out of 42 articles,
    we included 8 articles in our screening and discussion. Among these 8 studies, there were 2 case-controls, 3 cohort
    and 3 randomized control trials (RCT) studies. Although most studies reported that nutrition isassociated with
    decreased risk, some reported the contrary,whereas others reported no relation. It was demonstrated a conflict
    between the included papers in regards of the association between nutrition and breast cancer. These finding needs
    to be re-evaluated in future studies.
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