Displaying publications 161 - 180 of 203 in total

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  1. Muniandy S, Yahya HM, Shahar S, Kamisan Atan I, Mahdy ZA, Rajab NF, et al.
    BMJ Open, 2023 Nov 01;13(11):e073323.
    PMID: 37914304 DOI: 10.1136/bmjopen-2023-073323
    INTRODUCTION: Eurycoma longifolia Jack (EL), profoundly recognised as 'Tongkat Ali', is a medicinal herb originating from Southeast Asia. It is commonly used in traditional 'antiageing' treatments to address decreased energy, mood, libido and hormonal imbalances. While the benefits of EL have been extensively studied among the male population, less attention has been given to its effects on women. Menopause can impact the overall well-being of middle-aged women and incorporation of herbal supplements can aid them in managing the menopausal symptoms.

    METHODS AND ANALYSIS: This 12-week randomised double-blind, placebo-controlled, parallel-group study aims to evaluate the efficacy of the standardised water extract of EL known as Physta in increasing the quality of life of perimenopausal and postmenopausal women. The study involves 150 women aged 40-55 years who score more than 61 on the Menopause-Specific Quality of Life (MENQOL) assessment. These participants will be randomised into three groups, receiving Physta at either 50 mg or 100 mg or a placebo. The outcomes measures include mood state, quality of life, fatigue, sleep quality, sexual function and pain score assessed using Profile of Mood State, MENQOL, Chalder Fatigue Scale, Pittsburgh Sleep Quality Index, Female Sexual Function Index and the Brief Pain Inventory questionnaires, respectively. The secondary outcome of the study includes full blood analysis, urine analysis, female reproductive hormone profiling, inflammatory and oxidative stress biomarkers analysis.

    ETHICS AND DISSEMINATION: The research protocol of the study was reviewed and approved by the Research Ethics Committee of Universiti Kebangsaan Malaysia (UKM/PPI/111/8/JEP-2021-898). The findings will be disseminated to participants, healthcare professionals and researchers via conference presentations and peer-reviewed publications.

    TRIAL REGISTRATION NUMBER: ACTRN12622001341718.

  2. Md Fadzil NH, Shahar S, Singh DKA, Rajikan R, Vanoh D, Mohamad Ali N, et al.
    Geriatr Gerontol Int, 2024 Mar;24(3):251-262.
    PMID: 38329011 DOI: 10.1111/ggi.14814
    The adoption of information and communication technology (ICT) by older adults with cognitive frailty and impairment is beneficial to support aging in place and promote healthy aging. However, data are scarce regarding the use of ICT by this demographic in comparison with other age groups. This bibliometric analysis was aimed at systematically mapping the literature on ICT-related research on older adults with cognitive frailty and cognitive impairment to provide insights into research trends, patterns and knowledge gaps. Data were extracted from the Web of Science database, which identified 324 publications between 1980 and 2023. Performance analysis and science mapping were carried out using Microsoft® Excel, VOSViewer and Harzing's Publish or Perish. The analysis showed an upsurge in the research output trend over time. Notable journals, authors, citations, nations and research areas have been documented. Four key clusters were identified, including: (i) caregiver concern, support and involvement; (ii) technology as a tool for cognitive training and cognitive rehabilitation; (iii) cognitive improvement; and (iv) the use of technology for prevention and self-management. The findings derived from this analysis provide an appropriate reference for future researchers to bridge the gap in ICT-related studies among this population, and distinguish the relevant articles that are required for further investigation. These include the need for further long-term research, the incorporation of ICT-based approaches to counter cognitive frailty and the importance of multidomain telehealth interventions. Geriatr Gerontol Int 2024; 24: 251-262.
  3. Ambak R, Mohamad Nor NS, Puteh N, Mohd Tamil A, Omar MA, Shahar S, et al.
    BMC Womens Health, 2018 07 19;18(Suppl 1):111.
    PMID: 30066637 DOI: 10.1186/s12905-018-0591-3
    BACKGROUND: Obesity is an emerging global public health concern as it is related to chronic diseases and its impact to health related quality of life. The aim of this study was to assess the effect of weight reduction on health related quality of life (HRQOL) among obese and overweight housewives.

    METHODS: Data on 123 obese and overweight housewives in the intervention group from the MyBFF@home study were utilised. A validated Malaysian Malay version of Obesity Weight Loss Quality of Life (OWLQOL) questionnaire was administered at baseline and 6 months after intervention. Descriptive analysis, univariate analysis, paired t-test and multiple logistic regression were performed using SPSS Version 22.

    RESULTS: Mean body mass index (BMI) was 31.5 kg/m2 (SD:4.13), with 51 participants classified as overweight (41.5%) while 72 were obese (58.5%). About 72% of the housewives experienced weight reduction (62% reduced weight less than 5% and 11% reduced weight more than 5% of their baseline weight). There was a significant improvement in HRQOL with a pre-intervention total mean score of 59.82 (SD: 26.60) and post-intervention of 66.13 (SD: 22.82), p-value

  4. Seow SR, Mat S, Ahmad Azam A, Rajab NF, Safinar Ismail I, Singh DKA, et al.
    Expert Rev Mol Med, 2024 Apr 12;26:e8.
    PMID: 38606593 DOI: 10.1017/erm.2024.7
    Osteoarthritis (OA) commonly affects the knee and hip joints and accounts for 19.3% of disability-adjusted life years and years lived with disability worldwide (Refs , ). Early management is important in order to avoid disability uphold quality of life (Ref. ). However, a lack of awareness of subclinical and early symptomatic stages of OA often hampers early management (Ref. ). Moreover, late diagnosis of OA among those with severe disease, at a stage when OA management becomes more complicated is common (Refs , , , ). Established risk factors for the development and progression of OA include increasing age, female, history of trauma and obesity (Ref. ). Recent studies have also drawn a link between OA and metabolic syndrome, which is characterized by insulin resistance, dyslipidaemia and hypertension (Refs , ).
  5. M Zapawi MM, You YX, Shahar S, Shahril MR, Malek Rivan NF, Nik Mohd Fakhruddin NNI, et al.
    BMC Geriatr, 2024 May 01;24(1):387.
    PMID: 38693524 DOI: 10.1186/s12877-024-04966-7
    BACKGROUND: Mild Cognitive impairment (MCI) is a pre-demented state in the elderly populace. The Mediterranean & Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet has shown promise in reducing the risk of MCI and Alzheimer's disease in older people. Notably, the existing MIND diet is not adapted to the specific needs of older adults in Malaysia, considering distinct food cultures and availability. Consequently, this study aimed to develop the Malaysian version of the MIND diet (MY-MINDD) scores and investigate their association with MCI in the older adult populace of Malaysia.

    METHODS: A comprehensive pooled data analysis was conducted on combined data from 810 participants sourced from the longitudinal Long-Term Research Grant Scheme-Towards Useful Aging (LRGS-TUA) and Fundamental Research Grant Scheme (FRGS) studies. The MY-MINDD scores were developed by incorporating existing MIND diet food groups, their corresponding scoring mechanisms, and consideration of common Malaysian foods which are proven to be beneficial and detrimental to cognitive function. To substantiate the MY-MINDD scoring system, its association with MCI was evaluated using a series of validated neuropsychological test batteries.

    RESULTS: MY-MINDD consists of seven food groups promote brain health and four food groups exert negative cognitive outcomes. The study participants had an average age of 67.9 ± 4.7 years. The collective MY-MINDD score for all participants was 6.4 ± 0.1 (out of a maximum 11 points), revealing a lower score in individuals with MCI at 6.0 ± 1.7 compared to those without MCI at 6.6 ± 1.6 (p 

  6. Liew KJ, Shahar S, Shamsir MS, Shaharuddin NB, Liang CH, Chan KG, et al.
    Environ Microbiome, 2024 May 06;19(1):29.
    PMID: 38706006 DOI: 10.1186/s40793-024-00572-7
    BACKGROUND: Hot spring biofilms provide a window into the survival strategies of microbial communities in extreme environments and offer potential for biotechnological applications. This study focused on green and brown biofilms thriving on submerged plant litter within the Sungai Klah hot spring in Malaysia, characterised by temperatures of 58-74 °C. Using Illumina shotgun metagenomics and Nanopore ligation sequencing, we investigated the microbial diversity and functional potential of metagenome-assembled genomes (MAGs) with specific focus on biofilm formation, heat stress response, and carbohydrate catabolism.

    RESULTS: Leveraging the power of both Illumina short-reads and Nanopore long-reads, we employed an Illumina-Nanopore hybrid assembly approach to construct MAGs with enhanced quality. The dereplication process, facilitated by the dRep tool, validated the efficiency of the hybrid assembly, yielding MAGs that reflected the intricate microbial diversity of these extreme ecosystems. The comprehensive analysis of these MAGs uncovered intriguing insights into the survival strategies of thermophilic taxa in the hot spring biofilms. Moreover, we examined the plant litter degradation potential within the biofilms, shedding light on the participation of diverse microbial taxa in the breakdown of starch, cellulose, and hemicellulose. We highlight that Chloroflexota and Armatimonadota MAGs exhibited a wide array of glycosyl hydrolases targeting various carbohydrate substrates, underscoring their metabolic versatility in utilisation of carbohydrates at elevated temperatures.

    CONCLUSIONS: This study advances understanding of microbial ecology on plant litter under elevated temperature by revealing the functional adaptation of MAGs from hot spring biofilms. In addition, our findings highlight potential for biotechnology application through identification of thermophilic lignocellulose-degrading enzymes. By demonstrating the efficiency of hybrid assembly utilising Illumina-Nanopore reads, we highlight the value of combining multiple sequencing methods for a more thorough exploration of complex microbial communities.

  7. Goh KM, Shahar S, Chan KG, Chong CS, Amran SI, Sani MH, et al.
    Microorganisms, 2019 Oct 18;7(10).
    PMID: 31635256 DOI: 10.3390/microorganisms7100468
    Thousands of prokaryotic genera have been published, but methodological bias in the study of prokaryotes is noted. Prokaryotes that are relatively easy to isolate have been well-studied from multiple aspects. Massive quantities of experimental findings and knowledge generated from the well-known prokaryotic strains are inundating scientific publications. However, researchers may neglect or pay little attention to the uncommon prokaryotes and hard-to-cultivate microorganisms. In this review, we provide a systematic update on the discovery of underexplored culturable and unculturable prokaryotes and discuss the insights accumulated from various research efforts. Examining these neglected prokaryotes may elucidate their novelties and functions and pave the way for their industrial applications. In addition, we hope that this review will prompt the scientific community to reconsider these untapped pragmatic resources.
  8. Shahar S, Ibrahim Z, Fatah AR, Rahman SA, Yusoff NA, Arshad F, et al.
    Asia Pac J Clin Nutr, 2007;16(2):346-53.
    PMID: 17468093
    A multidimensional assessment of nutritional and health status comprised of subjective global assessment (SGA), anthropometry function, biochemistry, dietary intake, social and health aspects was carried out on 820 older people (52.8% men and 47.2% women) from four rural areas of Peninsular Malaysia. A proportion of the subjects had been classified as either overweight (25.7%) or chronic energy deficient (20.3%). Although 49% of subjects had normal body weight, 68.4% have been classified as having mild to moderate malnutrition according to the SGA. Only 1.1% and 2.3% had low serum albumin and ferritin, respectively. Almost 80% of subjects, especially men, were at high risk of cardiovascular diseases on the basis of the assessment of total cholesterol and LDL-cholesterol. The majority of the subjects (87.2%) were fully independent in performing daily tasks, with men having a significantly higher score compared to women (p<0.001). However, men were less likely to be able to perform a flexibility test (50.7%) than were women (27.0%) (p<0.05). The mean energy intake for men (1412 +/- 461 kcal/d) and women (1201 +/- 392 kcal/d) were below the Recommended Nutrient Intake (RNI) for Malaysia, although this is a difficult assertion to make in an age-group which generally experiences declining energy expenditure. Moreover, 52.5% of men and 47.5% of women might have underreported their food intake. Dietary micronutrients most likely to be deficient were thiamin, riboflavin and calcium. It is concluded that a substantial proportion of rural elderly Malays had problems related to both undernutrition and overnutrition. An appropriate nutrition intervention program is needed to improve the nutritional status of rural elderly Malays.
  9. Ahmad NA, Mat Ludin AF, Vanoh D, Tohit NM, Manaf ZA, Mohd Noah SA, et al.
    Digit Health, 2024;10:20552076241297213.
    PMID: 39600385 DOI: 10.1177/20552076241297213
    BACKGROUND: Technology advancement along with the increase in the older adults' population leads to the creation of health applications. The combination of exercise, nutrition, and cognition should be studied carefully in improving older adults' health.

    OBJECTIVE: The purpose of this study is to develop a health application, WeFit contains these three components and to determine its content validity, acceptability, and usability.

    METHODOLOGY: This study is a design and development study involving three phases. The first phase is the need analysis involving a review on 16 mobile applications available in Google play and iTunes App store as well as a review of six articles for identifying the perception of older adults in using mobile applications. Second phase is mobile application development and content validity. The content validity was determined using the Content Validity Index for Individual Items (I-CVI). Phase 3 evaluated the acceptance of the WeFit mobile application among older adults and health practitioners.

    RESULTS: Phase 1 indicated that half of the applications reviewed (50.0%) had physical activity component and the other half (50.0%) had a cognitive component, and none on nutrition. No application is reported to have all three components. In Phase 2, WeFit health application containing the three components was developed where users can view exercise and food recommendations and play cognitive games. WeFit had an I-CVI value of 0.98. With respect to acceptability, majority of the study participants (93.3%) understood the WeFit's content and the graphics used were appropriate. The usability study found that the majority of the older adults were satisfied with the interface and content. All health practitioners (100%) agreed WeFit is easy to use and agreed that it can guide them in giving medical advices.

    CONCLUSION: WeFit mobile app has been successfully developed, validated, and tested for acceptance among the older adults and health practitioners.

  10. Cheong KC, Ghazali SM, Hock LK, Yusoff AF, Selvarajah S, Haniff J, et al.
    Obes Res Clin Pract, 2014 Mar-Apr;8(2):e154-62.
    PMID: 24743011 DOI: 10.1016/j.orcp.2013.03.004
    INTRODUCTION: Previous studies have proposed the lower waist circumference (WC) cutoffs be used for defining abdominal obesity in Asian populations.
    OBJECTIVE: To determine the optimal cut-offs of waist circumference (WC) in predicting cardiovascular (CV) risk factors in the multi-ethnic Malaysian population.
    METHODS: We analysed data from 32,703 respondents (14,980 men and 17,723 women) aged 18 years and above who participated in the Third National Health and Morbidity Survey in 2006. Gender-specific logistic regression analyses were used to examine associations between WC and three CV risk factors (diabetes mellitus, hypertension, and hypercholesterolemia). The Receiver Operating Characteristic (ROC) curves were used to determine the cut-off values of WC with optimum sensitivity and specificity for detecting these CV risk factors.
    RESULTS: The odds ratio for having diabetes mellitus, hypertension, and hypercholesterolemia, or at least one of these risks, increased significantly as the WC cut-off point increased. Optimal WC cut-off values for predicting the presence of diabetes mellitus, hypertension, hypercholesterolemia and at least one of the three CV risk factors varied from 81.4 to 85.5 cm for men and 79.8 to 80.7 cm for women.
    CONCLUSIONS: Our findings indicate that WC cut-offs of 81 cm for men and 80 cm for women are appropriate for defining abdominal obesity and for recommendation to undergo cardiovascular risk screening and weight management in the Malaysian adult population.
    Study name: National Health and Morbidity Survey (NHMS-2006)
  11. Chin KY, Soelaiman IN, Naina Mohamed I, Shahar S, Teng NI, Suhana Mohd Ramli E, et al.
    Aging Male, 2012 Dec;15(4):240-5.
    PMID: 23098182 DOI: 10.3109/13685538.2012.724740
    OBJECTIVE: Variations in testosterone levels are associated with several outcomes of aging. The present study aimed to examine the relationship between age-related decline of testosterone levels and changes in bone health status, handgrip strength, body fat percentage and fat-free mass.
    MATERIALS AND METHODS: A total of 335 Malaysian Chinese and Malay men aged 40 years and above were recruited for this study. Their body compositions, calcaneal speed of sound and handgrip strength were measured and their blood was collected. Linear regression analysis was done to examine the relationship among age, testosterone levels and outcomes of aging.
    RESULTS: The results indicated significant changes in all testosterone measurements, sex hormone binding globulin level, calcaneal speed of sound, handgrip strength, body fat percentage and fat-free mass with age (p < 0.05). Age-dependent decline in bioavailable and free testosterone levels were significantly associated with reduction in calcaneal speed of sound, fat-free mass and handgrip strength (p < 0.05). Age-dependent decline in the total testosterone level was significantly associated with an increase in body fat percentage among the elderly men (p < 0.05).
    CONCLUSION: Testosterone levels are associated with changes in outcome of aging such as bone health status, muscle strength and body composition, and the relationships are age-dependent.
  12. Noah SA, Abdullah SN, Shahar S, Abdul-Hamid H, Khairudin N, Yusoff M, et al.
    J Med Internet Res, 2004 Jan 30;6(1):e4.
    PMID: 15111270
    Attempts in current health care practice to make health care more accessible, effective, and efficient through the use of information technology could include implementation of computer-based dietary menu generation. While several of such systems already exist, their focus is mainly to assist healthy individuals calculate their calorie intake and to help monitor the selection of menus based upon a prespecified calorie value. Although these prove to be helpful in some ways, they are not suitable for monitoring, planning, and managing patients' dietary needs and requirements. This paper presents a Web-based application that simulates the process of menu suggestions according to a standard practice employed by dietitians.
  13. Michael V, You YX, Shahar S, Manaf ZA, Haron H, Shahrir SN, et al.
    PMID: 34360392 DOI: 10.3390/ijerph18158099
    In this review, we have investigated the perceptions, barriers, and enabling factors that were responsible for a dietary salt reduction in the out-of-home sectors. For this purpose, we examined different knowledge databases such as Google Scholar, Ebscohost, MEDLINE (PubMed), Ovid, and Cochrane Library for research articles from September to December 2020. The inclusion criteria for the research articles were that they had to be published in English and had to be a qualitative or quantitative study that was conducted after 2010. These studies also had to report the various enablers, barriers, and perceptions regarding salt reduction in the out-of-home sectors. After implementing the inclusion criteria, we successfully screened a total of 440 studies, out of which 65 articles fulfilled all the criteria. The perceived barriers that hindered salt reduction among the out-of-home sectors included lack of menu and food variabilities, loss of sales due to salt reduction, lack of technical skills for implementing the salt reduction processes for cooking or reformulation, and an absence of environmental and systemic support for reducing the salt concentration. Furthermore, the enablers for salt reduction included the intervention programs, easy accessibility to salt substitutes, salt intake measurement, educational availability, and a gradual reduction in the salt levels. With regards to the behavior or perceptions, the effect of organizational and individual characteristics on their salt intake were reported. The majority of the people were not aware of their salt intake or the effect of salt on their health. These people also believed that low salt food was recognized as tasteless. In conclusion, the enablers, barriers, and perceptions regarding salt reduction in the out-of-home sectors were multifaceted. Therefore, for the implementation of the strategies, policies, and initiatives for addressing the barriers, the policymakers need to encourage a multisectoral collaboration for reducing the salt intake in the population.
  14. Brown MK, Shahar S, You YX, Michael V, Majid HA, Manaf ZA, et al.
    BMJ Open, 2021 07 23;11(7):e044628.
    PMID: 34301647 DOI: 10.1136/bmjopen-2020-044628
    INTRODUCTION: Current salt intake in Malaysia is high. The existing national salt reduction policy has faced slow progress and does not yet include measures to address the out of home sector. Dishes consumed in the out of home sector are a known leading contributor to daily salt intake. This study aims to develop a salt reduction strategy, tailored to the out of home sector in Malaysia.

    METHODS AND ANALYSIS: This study is a qualitative analysis of stakeholder views towards salt reduction. Participants will be recruited from five zones of Malaysia (Western, Northern, Eastern and Southern regions and East Malaysia), including policy-makers, non-governmental organisations, food industries, school canteen operators, street food vendors and consumers, to participate in focus group discussions or in-depth interviews. Interviews will be transcribed and analysed using thematic analysis. Barriers will be identified and used to develop a tailored salt reduction strategy.

    ETHICS AND DISSEMINATION: Ethical approval has been obtained from the Universiti Kebangsaan Malaysia Medical Research Ethics Committee (UKM PPI/1118/JEP-2020-524), the Malaysian National Medical Research Ethics Committee (NMRR-20-1387-55481 (IIR)) and Queen Mary University of London Research Ethics Committee (QMERC2020/37) . Results will be presented orally and in report form and made available to the relevant ministries for example, Ministry of Health, Ministry of Education and Ministry of Trade to encourage adoption of strategy as policy. The findings of this study will be disseminated through conference presentations, peer-reviewed publications and webinars.

  15. Malek Rivan NF, Shahar S, Singh DKA, Ibrahim N, Mat Ludin AF, Yahya HM, et al.
    Aging Ment Health, 2021 Sep 06.
    PMID: 34486885 DOI: 10.1080/13607863.2021.1972281
    OBJECTIVE: In this study, we aim to assess general psychological health, associated factors, and the potential of coping strategies as a mediator for middle-aged and older Malaysian adults during the COVID-19 pandemic.

    METHODS: A total of 535 individuals aged 52 years and above from the previous cohort and interventional studies in Peninsular Malaysia were contacted during the Movement Control Order (MCO) issued during the COVID-19 pandemic. Telephonic interviews were conducted to obtain participant information concerning socio-demography, physical activity, subjective well-being (SWB) as assessed using flourishing scale, coping strategies, and general psychological health (GHQ-12). Simple linear regression (SLR) and multiple linear regression (MLR) analyses were performed to identify the factors associated with GHQ-12. The associated factors were further analysed using mediation analysis to determine the potential of coping strategies as a mediator.

    RESULTS: It was observed that participants had a low mean GHQ-12 score (M = 0.80, SD = 2.19), indicating good psychological health. Living arrangement, physical activity, and flourishing scale were associated with psychological health (R2 = 0.412, p 

  16. Mazri FH, Manaf ZA, Shahar S, Mat Ludin AF, Karim NA, Hazwari NDD, et al.
    Nutrients, 2021 Nov 17;13(11).
    PMID: 34836375 DOI: 10.3390/nu13114121
    This study examined whether the temporal patterns of energy and macronutrient intake in early and late eating windows were associated with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) among non-shift workers. A total of 299 overweight/obese non-shift workers (Age: 40.3 ± 6.9 years; 73.6% women; BMI: 31.7 ± 5.0 kg/m2) were recruited in the Klang Valley area of Malaysia. The biochemical parameters were determined from fasting blood samples, whereas information on dietary intake and timing was obtained from a 7-day diet history questionnaire. The midpoint of eating was used to determine the early and late windows. Compared to MHO non-shift workers (n = 173), MUO non-shift workers (n = 126) had lower energy intake from carbohydrates and protein during the early window. In contrast, MUO participants had greater energy intake from carbohydrates and fat during the late window. Participants with unhealthy metabolic status (regardless of their chronotypes) had similar temporal patterns of energy intake characterized by smaller energy intake during the early window and greater energy intake during the late window compared with participants with healthier metabolic status. Overall, the lowest percentile of energy intake during the early window was associated with an increased risk of MUO, after adjustment for potential confounders [odds ratio (OR) = 4.30, 95% confidence interval (CI) 1.41-13.11]. The greater the energy intake during the late window, the greater the risk of MUO (OR = 2.38, 95% CI 1.11-5.13) (OR = 2.33, 95% CI 1.03-5.32) (OR = 4.45, 95% CI 1.71-11.56). In summary, consuming less energy earlier in the day and more energy and carbohydrate later in the day was associated with a greater risk of MUO. Thus, a prospective study is needed to explore the potential role of chrono-nutrition practices in modifying risk factors to delay the transition of MHO to MUO.
  17. Wong CY, Tham JS, Foo CN, Ng FL, Shahar S, Zahary MN, et al.
    Biosaf Health, 2023 Feb;5(1):37-44.
    PMID: 36588928 DOI: 10.1016/j.bsheal.2022.12.005
    Vaccination is crucial in controlling the spread of the coronavirus disease 2019 (COVID-19) that triggered the pandemic, but herd immunity can only work with high vaccination coverage in the population. This study aims to measure the COVID-19 knowledge level and determine the factors influencing COVID-19 vaccination intention among university students in Malaysia. A cross-sectional online survey was carried out with 1,274 Malaysian university students in July 2021. Univariate and multivariate analyses were employed to examine the relationships between the study variables. Results showed that the majority of university students had an acceptable level of knowledge of COVID-19. The knowledge, risk perception of COVID-19, social norms, and perceived benefit of COVID-19 vaccination were positively associated with vaccination intention. However, perceived trust in information sources of COVID-19 vaccination and the government's response to COVID-19 did not affect the university students' desire to receive the vaccination. These findings are essential for health policymakers and healthcare providers to implement evidence-based interventions to increase COVID-19 vaccination uptake among university students.
  18. Cheong KC, Yusoff AF, Ghazali SM, Lim KH, Selvarajah S, Haniff J, et al.
    Public Health Nutr, 2013 Mar;16(3):453-9.
    PMID: 22647482 DOI: 10.1017/S1368980012002911
    OBJECTIVE: To determine the optimal cut-offs of BMI for Malaysian adults.

    DESIGN: Population-based, cross-sectional study. Receiver operating characteristic curves were used to determine the cut-off values of BMI with optimum sensitivity and specificity for the detection of three cardiovascular risk factors: diabetes mellitus, hypertension and hypercholesterolaemia. Gender-specific logistic regression analyses were used to examine the association between BMI and these cardiovascular risk factors.

    SETTING: All fourteen states in Malaysia.

    SUBJECTS: Malaysian adults aged ≥18 years (n 32 703) who participated in the Third National Health and Morbidity Survey in 2006.

    RESULTS: The optimal BMI cut-off value for predicting the presence of diabetes mellitus, hypertension, hypercholesterolaemia or at least one of these cardiovascular risk factors varied from 23.3 to 24.1 kg/m2 for men and from 24.0 to 25.4 kg/m2 for women. In men and women, the odds ratio for having diabetes mellitus, hypertension, hypercholesterolaemia or at least one cardiovascular risk factor increased significantly as BMI cut-off point increased.

    CONCLUSIONS: Our findings indicate that BMI cut-offs of 23.0 kg/m2 in men and 24.0 kg/m2 in women are appropriate for classification of overweight. We suggest that these cut-offs can be used by health professionals to identify individuals for cardiovascular risk screening and weight management programmes.

  19. Mohd Rosnu NS, Ishak WS, Abd Rahman MH, Shahar S, Musselwhite C, Mat Ludin AF, et al.
    Front Public Health, 2023;11:1153822.
    PMID: 37275505 DOI: 10.3389/fpubh.2023.1153822
    INTRODUCTION: Aging is associated with physiological changes in multiple systems in the body and may impact the transportation choices of older adults. In this study, we examine the associations between biopsychosocial factors and the transportation choices of Malaysian older adults.

    METHODS: One hundred and nineteen (119) older adults, aged 60 and above, living in Klang Valley, Malaysia were recruited for this cross-sectional study. Participants were interviewed face-to-face to obtain sociodemographic data, health status (whether there were and, if yes, the number of comorbidities), outdoor mobility and transportation patterns, Instrumental Activity Daily Living (IADL) status and cognitive function. Participants' physical performance (dominant handgrip strength, 10-m walk, and timed up and go tests), hearing threshold (pure tone audiometry), and vision function (visual acuity, contrast sensitivity) were measured. Transportation patterns of older adults were categorized into three groups, that is, flexible (using public transport and/or private vehicles), using only private vehicles and restricted (relying on others or walking).

    RESULTS: Further information is needed to enable such older adults as older women, those with comorbidities and poorer functional status to access transportation, especially to meet their health care needs.

    DISCUSSION: The majority (51%) of participants were in the 'using only private vehicles' group, followed by the 'flexibles' (25%) and the 'restricted' (24%). Factors significantly associated with the restricted transportation group were: (a) being female (AdjOR 15.39, 95% CI 0.86-23.39, p 

  20. Othman F, Ambak R, Omar MA, Shahar S, Nor NSM, Ahmad MH, et al.
    J Health Popul Nutr, 2021 05 31;40(Suppl 1):10.
    PMID: 34059149 DOI: 10.1186/s41043-021-00232-3
    BACKGROUND: Monitoring sodium intake through 24-h urine collection sample is recommended, but the implementation of this method can be difficult. The objective of this study was to develop and validate an equation using spot urine concentration to predict 24-h sodium excretion in the Malaysian population.

    METHODS: This was a Malaysian Community Salt Study (MyCoSS) sub-study, which was conducted from October 2017 to March 2018. Out of 798 participants in the MyCoSS study who completed 24-h urine collection, 768 of them have collected one-time spot urine the following morning. They were randomly assigned into two groups to form separate spot urine equations. The final spot urine equation was derived from the entire data set after confirming the stability of the equation by double cross-validation in both study groups. Newly derived spot urine equation was developed using the coefficients from the multiple linear regression test. A Bland-Altman plot was used to measure the mean bias and limits of agreement between estimated and measured 24-h urine sodium. The estimation of sodium intake using the new equation was compared with other established equations, namely Tanaka and INTERSALT.

    RESULTS: The new equation showed the least mean bias between measured and predicted sodium, - 0.35 (- 72.26, 71.56) mg/day compared to Tanaka, 629.83 (532.19, 727.47) mg/day and INTERSALT, and 360.82 (284.34, 437.29) mg/day. Predicted sodium measured from the new equation showed greater correlation with measured sodium (r = 0.50) compared to Tanaka (r =0.24) and INTERSALT (r = 0.44), P < 0.05.

    CONCLUSION: Our newly developed equation from spot urine can predict least mean bias of sodium intake among the Malaysian population when 24-h urine sodium collection is not feasible.

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