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Fulltext Norm-dist Monte-Carlo integrative method for the improvement of fuzzy analytic hierarchy process

Wicaksono FD, Arshad YB, Sihombing H

Heliyon, 2020 Apr;6(4):e03607.
PMID: 32346625 DOI: 10.1016/j.heliyon.2020.e03607

This paper presents the novel approach of the Norm-dist Monte-Carlo fuzzy analytic hierarchy process (NMCFAHP) to incorporate probabilistic and epistemic uncertainty due to human's judgment vagueness in multi-criteria decision analysis. Normal distribution is applied as the most appropriate distribution model to approximate the probability distribution function of the criteria and alternatives within Monte-Carlo simulation. To test the applicability of the proposed NMCFAHP, the case study of non-destructive test (NDT) technology selection is performed in the Petroleum Company in Borneo, Indonesia. When compared with the conventional triangular fuzzy-AHP, the proposed NMCFAHP method reduces the standard error of mean values by 90.4-99.8% at the final evaluation scores. This means that the proposed NMCFAHP significantly involves fewer errors when dealing with fuzzy uncertainty and stochastic randomness. The proposed NMCFAHP delivers reliable performance to overcome probabilistic uncertainty and epistemic vagueness in the group decision making process.

Matched MeSH terms: Decision Making
Contraceptive use in Cambodia: does household decision-making power matter?

Lai SL, Tey NP

Cult Health Sex, 2020 07;22(7):778-793.
PMID: 32037969 DOI: 10.1080/13691058.2019.1685683

In Cambodia, the growth of family planning services and socio-economic development have resulted in a spectacular rise in contraceptive prevalence rate and an equally remarkable reduction in contraceptive use differentials. With rising educational levels and increased participation in the modern labour market, Cambodian women are playing an increasingly pivotal role in household decision-making. This study used data from three rounds of Cambodia Demographic and Health Surveys to elucidate trends and patterns of contraceptive use. It then examined the determinants of contraceptive use through the use of logistic regression. The central hypothesis to be tested was whether or not women's involvement in household decision-making affected contraceptive use. Multivariate analysis showed that apart from the number of living children, women's work status and education of both men and women had a more significant impact on contraceptive use, as compared to women's power in household decision-making. More effort is needed to empower women in all aspects in order to reduce the socio-economic differentials in contraceptive use and improve their reproductive health, in line with the goal of the global agenda of the sustainable development goals (SDGs) to leave no one behind.

Matched MeSH terms: Decision Making
Malaysian researchers talk about the influence of culture on research misconduct in higher learning institutions

Olesen AP, Amin L, Mahadi Z

Account Res, 2017;24(8):469-482.
PMID: 29087734 DOI: 10.1080/08989621.2017.1399358

Based on a previous survey by the Office of Research Integrity (ORI) in the USA, a considerable number of foreign research scientists have been found guilty of research misconduct. However, it remains unclear as to whether or not cultural factors really contribute to research misconduct. This study is based on a series of interviews with Malaysian researchers from the local universities regarding their own professional experiences involving working with researchers or research students from different countries or of different nationalities. Most of the researchers interviewed agreed that cultures do shape individual character, which influences the way that such individuals conduct research, their decision-making, and their style of academic writing. Our findings also showed that working culture within the institution also influences research practices, as well as faculty mentorship of the younger generation of researchers. Given the fact such misconduct might be due to a lack of understanding of research or working cultures or practices within the institution, the impact on the scientific community and on society could be destructive. Therefore, it is suggested that the institution has an important role to play in orienting foreign researchers through training, mentoring, and discussion with regard to the "does" and "don'ts" related to research, and to provide them with an awareness of the importance of ethics when it comes to conducting research.

Matched MeSH terms: Decision Making
Fulltext Multi-Objective Optimization of Friction Stir Welding Process Parameters of AA6061-T6 and AA7075-T6 Using a Biogeography Based Optimization Algorithm

Tamjidy M, Baharudin BTHT, Paslar S, Matori KA, Sulaiman S, Fadaeifard F

Materials (Basel), 2017 May 15;10(5).
PMID: 28772893 DOI: 10.3390/ma10050533

The development of Friction Stir Welding (FSW) has provided an alternative approach for producing high-quality welds, in a fast and reliable manner. This study focuses on the mechanical properties of the dissimilar friction stir welding of AA6061-T6 and AA7075-T6 aluminum alloys. The FSW process parameters such as tool rotational speed, tool traverse speed, tilt angle, and tool offset influence the mechanical properties of the friction stir welded joints significantly. A mathematical regression model is developed to determine the empirical relationship between the FSW process parameters and mechanical properties, and the results are validated. In order to obtain the optimal values of process parameters that simultaneously optimize the ultimate tensile strength, elongation, and minimum hardness in the heat affected zone (HAZ), a metaheuristic, multi objective algorithm based on biogeography based optimization is proposed. The Pareto optimal frontiers for triple and dual objective functions are obtained and the best optimal solution is selected through using two different decision making techniques, technique for order of preference by similarity to ideal solution (TOPSIS) and Shannon's entropy.

Matched MeSH terms: Decision Making
Age-dependent FRAX-based assessment and intervention thresholds for therapeutic decision making in osteoporosis in the Malaysian population

Ratnasingam J, Niyaz M, Mariyappan S, Ong T, Chan SP, Hew FL, et al.

Arch Osteoporos, 2024 Mar 20;19(1):18.
PMID: 38503995 DOI: 10.1007/s11657-024-01371-w

Fracture risk stratification is crucial in countries with limited access to bone density measurement. 24.8% women were in the high-risk category while 30.4% were in the low-risk category. In the intermediate risk group, after recalculation of fracture risk with bone density, 38.3% required treatment. In more than half, treatment decisions can be made without bone density.
PURPOSE: We aimed to examine the role of age-dependent intervention thresholds (ITs) applied to the Fracture Risk Assessment (FRAX) tool in therapeutic decision making for osteoporosis in the Malaysian population.
METHODS: Data were collated from 1380 treatment-naïve postmenopausal women aged 40-85 years who underwent bone mineral density (BMD) measurements for clinical reasons. Age-dependent ITs, for both major osteoporotic fracture (MOF) and hip fracture (HF), were calculated considering a woman with a BMI of 25 kg/m2, aged between 40 and 85years, with a prior fragility fracture, sans other clinical risk factors. Those with fracture probabilities equal to or above upper assessment thresholds (UATs) were considered to have high fracture risk. Those below the lower assessment thresholds (LATs) were considered to have low fracture risk.
RESULTS: The ITs of MOF and HF ranged from 0.7 to 18% and 0.2 to 8%, between 40 and 85years. The LATs of MOF ranged from 0.3 to 11%, while those of HF ranged from 0.1 to 5.2%. The UATs of MOF and HF were 0.8 to 21.6% and 0.2 to 9.6%, respectively. In this study, 24.8% women were in the high-risk category while 30.4% were in the low-risk category. Of the 44.8% (n=618) in the intermediate risk group, after recalculation of fracture risk with BMD input, 38.3% (237/618) were above the ITs while the rest (n=381, 61.7%) were below the ITs. Judged by the Youden Index, 11.5% MOF probability which was associated with a sensitivity of 0.62 and specificity of 0.83 and 4.0% HF probability associated with a sensitivity of 0.63 and a specificity 0.82 were found to be the most appropriate fixed ITs in this analysis.
CONCLUSION: Less than half of the study population (44.8%) required BMD for osteoporosis management when age-specific assessment thresholds were applied. Therefore, in more than half, therapeutic decisions can be made without BMD based on these assessment thresholds.

Matched MeSH terms: Decision Making
Decoding stakeholder priorities of safety culture preferences in the oil and gas industry

Rahim H, Dapari R, Che Dom N, Mohd Noor MI

Sci Rep, 2024 Sep 05;14(1):20735.
PMID: 39237550 DOI: 10.1038/s41598-024-71294-6

Safety culture is a critical determinant of organisational performance, particularly in high-risk industries especially in oil and gas. Understanding stakeholder preferences is essential for developing effective strategies that enhance safety culture. This study utilised the Analytic Hierarchy Process (AHP) to prioritise stakeholder preferences, identifying key elements of safety culture in Malaysia's oil and gas sector. This study employed a structured methodology to evaluate safety culture within the oil and gas industry, focusing on 18 sub-elements across three key domains: psychological, behavioural, and situational factors. A diverse sample of industry experts was recruited using purposeful and snowball sampling to ensure a comprehensive representation of stakeholder views. The AHP framework was applied to analyse the data, utilizing structured questionnaires and multicriteria decision-making techniques to prioritize the identified safety culture elements. The AHP analysis identified distinct priorities among different professional groups within the oil and gas sector. Safety and Health Practitioners emphasized practical elements such as safety rules and management commitment, while academicians prioritized knowledge and training. Management personnel highlighted the importance of safety ownership and communication, whereas policymakers focused on broader, policy-oriented aspects. The findings suggest that safety culture improvement initiatives should be tailored to address the specific needs and priorities of each professional group. A nuanced understanding of stakeholder preferences is crucial for developing comprehensive strategies that integrate observable behaviours, situational conditions, and psychological factors, ultimately fostering a robust safety culture in the oil and gas industry.

Matched MeSH terms: Decision Making
Fulltext Augmented Reality Interface for Complex Anatomy Learning in the Central Nervous System: A Systematic Review

Wirza R, Nazir S, Khan HU, García-Magariño I, Amin R

J Healthc Eng, 2020;2020:8835544.
PMID: 32963749 DOI: 10.1155/2020/8835544

The medical system is facing the transformations with augmentation in the use of medical information systems, electronic records, smart, wearable devices, and handheld. The central nervous system function is to control the activities of the mind and the human body. Modern speedy development in medical and computational growth in the field of the central nervous system enables practitioners and researchers to extract and visualize insight from these systems. The function of augmented reality is to incorporate virtual and real objects, interactively running in a real-time and real environment. The role of augmented reality in the central nervous system becomes a thought-provoking task. Gesture interaction approach-based augmented reality in the central nervous system has enormous impending for reducing the care cost, quality refining of care, and waste and error reducing. To make this process smooth, it would be effective to present a comprehensive study report of the available state-of-the-art-work for enabling doctors and practitioners to easily use it in the decision making process. This comprehensive study will finally summarise the outputs of the published materials associate to gesture interaction-based augmented reality approach in the central nervous system. This research uses the protocol of systematic literature which systematically collects, analyses, and derives facts from the collected papers. The data collected range from the published materials for 10 years. 78 papers were selected and included papers based on the predefined inclusion, exclusion, and quality criteria. The study supports to identify the studies related to augmented reality in the nervous system, application of augmented reality in the nervous system, technique of augmented reality in the nervous system, and the gesture interaction approaches in the nervous system. The derivations from the studies show that there is certain amount of rise-up in yearly wise articles, and numerous studies exist, related to augmented reality and gestures interaction approaches to different systems of the human body, specifically to the nervous system. This research organises and summarises the existing associated work, which is in the form of published materials, and are related to augmented reality. This research will help the practitioners and researchers to sight most of the existing studies subjected to augmented reality-based gestures interaction approaches for the nervous system and then can eventually be followed as support in future for complex anatomy learning.

Matched MeSH terms: Decision Making
Fulltext Patient involvement in decision-making: a cross-sectional study in a Malaysian primary care clinic

Ambigapathy R, Chia YC, Ng CJ

BMJ Open, 2016 Jan 04;6(1):e010063.
PMID: 26729393 DOI: 10.1136/bmjopen-2015-010063

OBJECTIVE: Shared decision-making has been advocated as a useful model for patient management. In developing Asian countries such as Malaysia, there is a common belief that patients prefer a passive role in clinical consultation. As such, the objective of this study was to determine Malaysian patients' role preference in decision-making and the associated factors.
DESIGN: A cross-sectional study.
SETTING: Study was conducted at an urban primary care clinic in Malaysia in 2012.
PARTICIPANTS: Patients aged >21 years were chosen using systematic random sampling.
METHODS: Consenting patients answered a self-administered questionnaire, which included demographic data and their preferred and actual role before and after consultation. Doctors were asked to determine patients' role preference. The Control Preference Scale was used to assess patients' role preference.
PRIMARY OUTCOME: Prevalence of patients' preferred role in decision-making.
SECONDARY OUTCOMES: (1) Actual role played by the patient in decision-making. (2) Sociodemographic factors associated with patients' preferred role in decision-making. (3) Doctors' perception of patients' involvement in decision-making.
RESULTS: The response rate was 95.1% (470/494). Shared decision-making was preferred by 51.9% of patients, followed by passive (26.3%) and active (21.8%) roles in decision-making. Higher household income was significantly associated with autonomous role preference (p=0.018). Doctors' perception did not concur with patients' preferred role. Among patients whom doctors perceived to prefer a passive role, 73.5% preferred an autonomous role (p=0.900, κ=0.006).
CONCLUSIONS: The majority of patients attending the primary care clinic preferred and played an autonomous role in decision-making. Doctors underestimated patients' preference to play an autonomous role.
Study site: Primary care clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Decision Making*
Who decides? A qualitative study on the decisional roles of patients, their caregivers and doctors on the method of bladder drainage after spinal cord injury

Engkasan JP, Ng CJ, Low WY

Spinal Cord, 2015 Feb;53(2):130-4.
PMID: 25403504 DOI: 10.1038/sc.2014.199

STUDY DESIGN: Qualitative study using individual in-depth interviews.

OBJECTIVE: To explore the roles of patients, their caregivers and doctors when making decisions on the method of bladder drainage after spinal cord injury (SCI).

SETTING: Five public hospitals in Malaysia.

METHODS: Semistructured (one-to-one) interviews with 17 male patients with SCI, 4 caregivers and 10 rehabilitation professionals.

RESULTS: Eight themes describing the respective decisional roles of patients, their caregivers and doctors emerged from the analysis: patient's right and responsibilities, patient as an informed decision maker, forced to accept decision; surrogate decision maker, silent partner; doctor knows best, over-ride patient's decision, or reluctant decision maker. Both patients and doctors acknowledged the importance of patient autonomy but not all patients had the chance to practice it. Some felt that they were forced to accept the doctor's decision and even alleged that the doctor refused to accept their decision. Doctors considered the caregiver as the decision maker in cases that involved minors, elderly and those with tetraplegia. Some patients considered bladder problems an embarrassing subject to discuss with their caregivers and did not want their involvement. Doctors were described as knowledgeable and were trusted by patients and their caregivers to make the most appropriate option. Some doctors were happy to assume this role whereas some others saw themselves only as information providers.

CONCLUSIONS: A paternalistic model is prevalent in this decision-making process and there is a discrepancy between patients' preferred and actual decisional roles.

Matched MeSH terms: Decision Making*
Complementary and Alternative Medicine (CAM) use by Malaysian oncology patients

Farooqui M, Hassali MA, Abdul Shatar AK, Shafie AA, Seang TB, Farooqui MA

Complement Ther Clin Pract, 2012 May;18(2):114-20.
PMID: 22500849 DOI: 10.1016/j.ctcp.2011.09.003

The current study sought to evaluate Malaysian oncology patients' decision making about the use of Complementary and Alternative Medicine (CAM) for the management of their care. Patients were interviewed across three major Malaysian ethnic groups, Malay, Chinese and Indian. Thematic content analysis identified four central themes: Conceptualizing CAM, the decision making process; rationale given for selecting or rejecting CAM and barriers to CAM use. Participants generally used the term 'traditional medicine', referred to locally as 'ubat kampung', meaning medicine derived from 'local traditions'. Mixed reactions were shown concerning the effectiveness of CAM to cure cancer and the slow progression of CAM results and treatment costs were cited as major barriers to CAM use. Concerns regarding safety and efficacy of CAM in ameliorating cancer as well as potential interactions with conventional therapies highlighted the importance of patients' knowledge about cancer treatments.

Matched MeSH terms: Decision Making*
Fulltext Clinicians' knowledge, beliefs and acceptance of intravenous-to-oral antibiotic switching, Hospital Pulau Pinang

Lee SL, Azmi S, Wong PS

Med J Malaysia, 2012 Apr;67(2):190-8.
PMID: 22822642 MyJurnal

A cross-sectional study was conducted to explore clincians' baseline knowledge, practice beliefs and acceptance of intravenous (IV)-to-oral antibiotic switching practice in Hospital Pulau Pinang. The factors most highly rated for antibiotic conversion were the ability to maintain oral intake (85.6%) and microbiology etiology (85.0%). Majority of the clinicians (76%) agreed with the traditional clinical rule that "patient should be afebrile for 24 hours before IV-to-oral switch". Specialists and consultants had the highest knowledge score among the clinicians. However, they were generally less positive about a guideline being integrated into practice.

Matched MeSH terms: Decision Making*
Teaching engineering ethics using BLOCKS game

Lau SW, Tan TP, Goh SM

Sci Eng Ethics, 2013 Sep;19(3):1357-73.
PMID: 23065541 DOI: 10.1007/s11948-012-9406-3

The aim of this study was to investigate the use of a newly developed design game called BLOCKS to stimulate awareness of ethical responsibilities amongst engineering students. The design game was played by seventeen teams of chemical engineering students, with each team having to arrange pieces of colored paper to produce two letters each. Before the end of the game, additional constraints were introduced to the teams such that they faced similar ambiguity in the technical facts that the engineers involved in the Challenger disaster had faced prior to the space shuttle launch. At this stage, the teams had to decide whether to continue with their original design or to develop alternative solutions. After the teams had made their decisions, a video of the Challenger explosion was shown followed by a post-game discussion. The students' opinion on five Statements on ethics was tracked via a Five-Item Likert survey which was administered three times, before and after the ethical scenario was introduced, and after the video and post-game discussion. The results from this study indicated that the combination of the game and the real-life incident from the video had generally strengthened the students' opinions of the Statements.

Matched MeSH terms: Decision Making/ethics*
Fulltext Physician's intention to initiate health check-up discussions with men: a qualitative study

Tong SF, Low WY, Ismail SB, Trevena L, Willcock S

Fam Pract, 2011 Jun;28(3):307-16.
PMID: 21115986 DOI: 10.1093/fampra/cmq101

BACKGROUND: Although prevalent in primary care settings, men's health issues are rarely discussed. Yet, primary care doctors (PCDs) are well positioned to offer health check-ups during consultations.
OBJECTIVES: This study aims to develop a substantive theory to explain the process of decision making by which PCDs engage men in discussing health check-ups.
METHODS: Grounded theory method was adopted. Data source was from 14 in-depth interviews and 8 focus group discussions conducted with a semi-structured guide. Interviews were recorded and transcribed verbatim for analysis. Initial open coding captured the concepts of processes from the data, followed by selective and theoretical coding to saturate the core category. Constant comparative method was used throughout the process to allow emergence of the theory.
RESULTS: Fifty-two PCDs from private and public settings were interviewed. PCDs engaged male patients in health check-ups when they associated high medical importance with the relevant issues. The decision to engage men also depended on perceived chances of success in negotiations about health check-ups. A high chance of success, associated with minimal negotiation effort, is associated with men being most receptive to health check-ups. When doctors feel the importance of a particular health issue, they place less emphasis on their perceived men's receptivity to discuss that health issue in their intention to engage them in discussing it.
CONCLUSIONS: Engaging male patients in appropriate health check-up activities requires a series of actions and decisions by the PCDs. The decision to engage the patient depends on the perceived balance between the receptivity of male patients and the medical importance of the issues in mind.

Matched MeSH terms: Decision Making*
International comparison of care for very low birth weight infants: parents' perceptions of counseling and decision-making

Partridge JC, Martinez AM, Nishida H, Boo NY, Tan KW, Yeung CY, et al.

Pediatrics, 2005 Aug;116(2):e263-71.
PMID: 16061579

To characterize parent perceptions and satisfaction with physician counseling and delivery-room resuscitation of very low birth weight infants in countries with neonatal intensive care capacity.

Matched MeSH terms: Decision Making*
Perceived involvement and preferences in shared decision-making among patients with hypertension

Mah HC, Muthupalaniappen L, Chong WW

Fam Pract, 2016 06;33(3):296-301.
PMID: 26993483 DOI: 10.1093/fampra/cmw012

BACKGROUND: Shared decision-making (SDM) is an important component of patient-centred care. However, there is limited information on its implementation in Malaysia, particularly in chronic diseases such as hypertension.
OBJECTIVE: The objective of this study was to examine perceived involvement and role preferences of patients with hypertension in treatment decision-making.
METHODS: A cross-sectional survey was conducted among 210 patients with hypertension in a teaching hospital in Malaysia.
RESULTS: The majority of respondents agreed that their doctor recognized that a decision needs to be made (89.5%) and informed them that different options are available (77.1%). However, respondents' perceived level of involvement in other aspects of treatment decision-making process was low, including in the selection of treatment and in reaching an agreement with their doctor on how to proceed with treatment. In terms of preferred decision-making roles, 51.4% of respondents preferred a collaborative role with their physicians, 44.8% preferred a passive role while only 1.9% preferred an active role. Age and educational level were found to be significantly related to patient preferences for involvement in SDM. Younger patients (<60 years) and those with higher educational level preferred SDM over passive decision-making (ρ < 0.01). Encouragement from health care providers was perceived as a major motivating factor for SDM among patients with hypertension, with 91% of respondents agreeing that this would motivate their participation in SDM.
CONCLUSION: Preferences for involvement in decision-making among patients with hypertension are varied, and influenced by age and educational level. Physicians have a key role in encouraging patients to participate in SDM.

Matched MeSH terms: Decision Making*
Fulltext Individual aspiration or family survival: rural-urban female migration in Malaysia

Kusago T

Asian Pac Migr J, 1998;7(4):483-523.
PMID: 12295220 DOI: 10.1177/011719689800700404

"This paper analyzes the determinants of female migration to export processing zones (EPZs) in Malaysia. A comparison of the individual and household migration models reveals interesting and important contrasting results. First, the role played by the expected net income gains is opposite in the two models: negative in the individual model, positive in the household model. Second, family migration experience is significant in the individual model but not in the household model. Third, attitudes matter to the household decision on a daughter's migration but not in the individual model. These contrasting results suggest that explaining the daughter's migration decision may require more than separation of the individual motives and familial needs."

Matched MeSH terms: Decision Making*
International labor migration and the family: some observations from Indonesia

Hugo G

Asian Pac Migr J, 1995;4(2-3):273-301.
PMID: 12320103

This article addresses two dimensions of the complex interrelationship between the family and international labor migration in Indonesia: the role of the family in influencing labor movements out of Indonesia; and the consequences of this movement on family well-being, structure, and functioning. Research on this topic in Indonesia is highly limited due mainly to the recency of large scale international labor migration, inadequate data collection systems, a high incidence of undocumented migration, and failure of available research to be sensitive to family related issues. Against a rapidly changing economic and social situation, two major overlapping systems of migration have developed. The official system is focused strongly on the Middle East (although other Asian destinations are increasing in significance) and is dominated by female migrants. The undocumented system is much larger in volume, is focused upon Malaysia, involves more males than females, and is becoming permanent in some cases. The role, status, and experiences of women migrants in relation to their families (decision making, networks, remittances) are discussed with recommendations for other areas needing further research attention.

Matched MeSH terms: Decision Making*
A grounded explanation of why women present with advanced breast cancer

Taib NA, Yip CH, Low WY

World J Surg, 2014 Jul;38(7):1676-84.
PMID: 24280975 DOI: 10.1007/s00268-013-2339-4

Advanced breast cancer presentation remains a large obstacle in lowering mortality rates in low- and middle-resource countries. This study aims to explore the reasons why women present with breast cancer at an advanced stage.

Matched MeSH terms: Decision Making*
Cultural considerations in forgoing enteral feeding: A comparison between the Hong Kong Chinese, North American, and Malaysian Islamic patients with advanced dementia at the end-of-life

Ngan OMY, Bergstresser SM, Sanip S, Emdadul Haque ATM, Chan HYL, Au DKS

Dev World Bioeth, 2020 06;20(2):105-114.
PMID: 31241234 DOI: 10.1111/dewb.12239

Cultural competence, a clinical skill to recognise patients' cultural and religious beliefs, is an integral element in patient-centred medical practice. In the area of death and dying, physicians' understanding of patients' and families' values is essential for the delivery of culturally appropriate care. Dementia is a neurodegenerative condition marked by the decline of cognitive functions. When the condition progresses and deteriorates, patients with advanced dementia often have eating and swallowing problems and are at high risk of developing malnutrition. Enteral tube feeding is a conventional means of providing artificial nutrition and hydration to meet nutritional needs, but its benefits to the frail population are limitedly shown in the clinical evidence. Forgoing tube feeding is ethically challenging when patients are mentally incompetent and in the absence of an advance directive. Unlike some developed countries, like the United States of America, death and dying is a sensitive issue or even a taboo in some cultures in developing countries that forgoing enteral tube feeding is clinically and ethically challenging, such as China and Malaysia. This article in three parts 1) discusses the clinical and ethical issues related to forgoing tube feeding among patients with advanced dementia, 2) describes how Hong Kong Chinese, North American, and Malaysian Islamic cultures respond differently in the decision-making patterns of forgoing tube feeding for patients with advanced dementia, and 3) reiterates the clinical implications of cultural competence in end-of-life care.

Matched MeSH terms: Decision Making/ethics*
Fulltext Older women breast cancer survivors: decision making, sources of information and wellness activities in Malaysia

Mohamed NA, Muhamad M

Asian Pac J Cancer Prev, 2013;14(3):2043-8.
PMID: 23679316

The purpose of this study ??s to profile older breast cancer survivors in Malaysia. In a survey study, ? custom made questionnaire was administered to 69 breast cancer patients and survivors between 60 and 84 years of age in Peninsular Malaysia. The main ethnic group recorded was Chinese, followed by Malay and Indian. The majority of women were married (87%) and had children (84.1%). Just over half (53.6%) had primary and secondary education, whereas 24.7% had higher education. Fifty five percent of the study participants made their own decision on treatment, 60.8% exercised at least 3 times in a week, and 56.6% sought information from specialists. Our study suggests that older breast cancer survivors are aware of the importance of exercise in their daily lives and make attempts to be cancer free (e.g. doing exercise, recreational activity and have good relationships with friends and family).

Matched MeSH terms: Decision Making*

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