METHODS: This cross-sectional study recruited 201 patients. The Hospital Anxiety Depression Scale (HADS) was used to determine anxiety level. Subsequently, patients who had scored 8 and above on the HADS were interviewed using Mini International Neuropsychiatric Interview (M.I.N.I) to ascertain the diagnosis of GAD. Whilst the Numerical Rating Scale (NRS) assessed pain severity. Multiple logistic regression analysis was used to determine factors associated with GAD.
RESULTS: Among those patients with chronic pain, the prevalence of GAD was 18.9%. Gender (AOR:7.94; 95% CI:2.34, 26.93), duration of the pain (AOR:1.30; 95% CI:1.03,1.63) and pain severity (AOR:18.75; CI:1.23,285.13) were significant factors associated with GAD.
CONCLUSION: GAD is a prevalent condition among chronic pain patients.
Methods: A cross-sectional validation study involving 219 elderlies with cognitive impairment was conducted using universal sampling method. Participants aged 60 years old and above, scored less than 11 for the short mini mental state examination (SMMSE), have sufficient command of the Malay or English language, residing in the government nursing homes and attending memory clinics in government hospitals in Klang Valley were sampled. The GDS-15 English version underwent adaptation, translation, face validation and field testing to produce the Malay version. Psychometric analysis was performed using the exploratory factor analysis and its internal consistency was examined.
Results: Mean age of participants were 72.61 ± 7.79. Majority were male (50.7%), Malay (50.2%), studied at least until primary school (71.7%) and stayed at nursing homes (50.2%). Construct validity showed significant Bartlett's test of sphericity (Chi-square = 1,340.058, P < 0.001) and Kaiser-Meyer-Olkin (KMO) test of 0.90. Factor loadings for each item in the depression domain were satisfactory ranging from 0.42 to 0.83. Factor loadings for each item in the psychosocial activities' domain were satisfactory ranging from 0.53 to 0.76. For the questionnaire reliability analysis, the total Cronbach's alpha for the final model was satisfactory, with and overall Cronbach's alpha of 0.89. Cronbach's alpha value for the depression and psychosocial activities domain was 0.861 and 0.80, respectively.
Conclusion: The GDS (Malay version) is a valid and reliable tool to screen for depression in elderly with cognitive impairment.
MATERIALS AND METHODS: This retrospective review concerned data for patients diagnosed with colorectal cancer in the years 1995 to 2011 collected from the Wilayah Persekutuan Health Office, taken from the cancer notification form (NCR-2), and patient medical records from the Surgical Department, Universiti Kebangsaan Malaysia Medical Centre (UKMMC). A total of 146 cases were analyzed. All the data collected were analysed using ArcGIS version 10.0 and SPSS version 19.0.
RESULTS: Patients aged 60 to 69 years accounted for the highest proportion of cases (34.2%) and males slightly predominated 76 (52.1%), Chinese had the highest number of registered cases at 108 (74.0%) and staging revealed most cases in the 3rd and 4th stages. Kernel density analysis showed more cases are concentrated up in the northern area of Petaling and Kuala Lumpur subdistricts. Spatial global pattern analysis by average nearest neighbour resulted in nearest neighbour ratio of 0.75, with Z-score of -5.59, p value of <0.01 and the z-score of -5.59. Spatial autocorrelation (Moran's I) showed clustering significant with p<0.01, Z score 3.14 and Moran's Index of 0.007. When mapping clusters with hotspot analysis (Getis-Ord Gi), hot and cold spots were identified. Hot spot areas fell on the northeast side of KL.
CONCLUSIONS: This study demonstrated significant spatial patterns of cancer incidence in KL. Knowledge about these spatial patterns can provide useful information to policymakers in the planning of screening of CRC in the targeted population and improvement of healthcare facilities to provide better treatment for CRC patients.
METHODS: The development of the MUAPHQ C-19 was conducted in two stages. Stage I resulted in the generation of the instrument's items (development), and stage II resulted in the performance of the instrument's items (judgement and quantification). Six-panel experts related to the study field and ten general public participated to evaluate the validity of the MUAPHQ C-19. The content validity index (CVI), content validity ratio (CVR) and face validity index (FVI) were analysed using Microsoft Excel.
RESULTS: There were 54 items and four domains, namely the understanding, attitude, practice and health literacy towards COVID-19, identified in the MUAPHQ C-19 (Version 1.0). The scale-level CVI (S-CVI/Ave) for every domain was above 0.9, which is considered acceptable. The CVR for all items was above 0.7, except for one item in the health literacy domain. Ten items were revised to improve the item's clarity, and two items were deleted due to the low CVR value and redundancy, respectively. The I-FVI exceeded the cut-off value of 0.83 except for five items from the attitude domain and four from the practice domains. Thus, seven of these items were revised to increase the clarity of items, while another two were deleted due to low I-FVI scores. Otherwise, the S-FVI/Ave for every domain exceeded the cut-off point of 0.9, which is considered acceptable. Thus, 50-item MUAPHQ C-19 (Version 3.0) was generated following the content and face validity analysis.
CONCLUSIONS: The questionnaire development, content validity, and face validity process are lengthy and iterative. The assessment of the instruments' items by the content experts and the respondents is essential to guarantee the instrument's validity. Our content and face validity study has finalised the MUAPHQ C-19 version that is ready for the next phase of questionnaire validation, using Exploratory and Confirmatory Factor Analysis.
METHODS: Medline via PubMed platform, Science Direct, Scopus, and CINAHL databases were searched to find studies that examined CRC FT. There was no limit on the design or setting of the study.
RESULTS: Out of 819 papers identified through an online search, only 15 papers were included in this review. The majority (n = 12, 80%) were from high-income countries, and none from low-income countries. Few studies (n = 2) reported objective FT denoted by the prevalence of catastrophic health expenditure (CHE), 60% (9 out of 15) reported prevalence of subjective FT, which ranges from 7 to 80%, 40% (6 out of 15) included studies reported cost of CRC management- annual direct medical cost ranges from USD 2045 to 10,772 and indirect medical cost ranges from USD 551 to 795.
CONCLUSIONS: There is a lack of consensus in defining and quantifying financial toxicity hindered the comparability of the results to yield the mean cost of managing CRC. Over and beyond that, information from some low-income countries is missing, limiting global representativeness.
MATERIALS AND METHODS: A cross-sectional study was conducted among 508 women aged 18 to 55 years from four non-governmental organizations (NGO) in Baghdad city, Iraq. A self-administered questionnaire on breast cancer knowledge and practice was distributed to participants during weekly activity of the NGO.
RESULTS: A total of 61.2% of the respondents had poor knowledge, only 30.3% performed breast self-examination (BSE) and 41.8% said that they did not know the technique to perform BSE. Associations between knowledge and marital status and age were significant. For practice, working status, education, age and family income were significant. After controlling for cofounders, the most important contributing factors for poor knowledge among respondents were marital status and not performing BSE, with adjusted odds ratio of 1.6 and 1.8 respectively.
CONCLUSIONS: Breast cancer knowledge and practice of BSE are poor among women in Baghdad city, Iraq. More promotion regarding breast cancer signs and symptoms and also how to perform BSE should be conducted using media such as television and internet as these constituted the main sources of information for most women in our study.
MATERIALS AND METHODS: The database PubMed, Web of Science and Science Direct were searched to identify the relevant literatures concerning mortality due to snakebites mortality in Asia. All the articles chosen were critically appraised for its quality using a mixed-method assessment tool by two independent reviewers with discrepancies sorted by a third person.
RESULTS: A total of 7 studies were included in the final analysis which was 3 cross-sectional studies, 2 case reports, 1 observation prospective study and 1 randomized control trial study. Two studies were conducted in India and two studies in Sri Lanka while one study was conducted in Taiwan, Vietnam and Nepal respectively. The cases of snakebite victims were retrieved from the year of 1987 until 2017. In total, there were 762 cases of snakebite victims recorded, with 61 of those victims succumbed to death. From the final total of 7 studies, 4 of the studies showed snakebites mortality were related to delayed treatment access and 3 studies due to suboptimal care.
CONCLUSION: Mortality and morbidity can be reduced if there is a quick access for victims to emergency medical care, rapid transfer time to hospital and receiving immediate optimal medical treatment from trained medical staff once in the hospital or dispensary.
OBJECTIVE: The systematic review and meta-analysis in this study aimed to explore the effect of exercise intervention on health-related quality of life of colorectal cancer survivors.
METHODS: The current study followed guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020) to identify relevant literature. Comprehensive searches were conducted using EBSCOhost, Web of Science (WOS), Scopus, Science Direct, and PubMed. The inclusion criteria included are randomised control trials studies written in English, with no restrictions for the time of publication that reported the effects of exercise intervention on health-related quality of live among colorectal cancer survivors. Meta-analysis was conducted by pooling the mean and standard deviation of post-intervention scores across randomised control trial studies using a random effects model.
RESULT: A total of 467 articles were identified but only seven articles were randomised control trials (RCT) (n = 7) with PEDro scores ranging from 6 to 9 showing good internal validity were included in the review. The results of the meta-analysis of pooled data from six RCTs studies on HRQoL showed no significant effect of exercise intervention on HRQoL in the intervention group compared to control group [SMD = 0.25; 95% CI; -0.0, 0.51; Z = 1.88; p = 0.06; I2 = 30.8%].
CONCLUSION: This meta-analysis provides key insights into the effect of exercise on the health-related quality of life (HRQoL) of colorectal cancer (CRC) survivors. Therefore, more experimental studies should be carried out with rigorous methodology to evaluate the effectiveness of exercise interventions before it is recommended as a routine activity in post-treatment management for CRC survivors.
METHODS: This is a quasi-experimental study which was conducted at Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia (UKM), and Hospital Al-Sultan Abdullah, Universiti Teknologi MARA (UiTM), Malaysia. The intervention group performed Pilates exercises with a certified Pilates instructor for eight weeks via online streaming from the participants' homes. Meanwhile, the control group participants received the usual care as stipulated by their oncologists. The primary outcome was the quality of life. The secondary outcomes were functional capacity, cancer-related fatigue, depression and salivary cortisol. Data was collected at baseline and eight weeks after the exercise intervention. The effects of the intervention were analyzed using Repeated Measures Analysis of Covariance (ANCOVA) statistical test.
RESULT: Thirty-six (36) colorectal cancer survivors were allocated into either a Pilates exercise intervention group (N= 18) or a control group (N= 18). Over eight weeks, the Pilates exercise group revealed significant group x time interactions in terms of quality of life (p = 0.003), role functioning (p = 0.012), functional capacity (p = 0.048), and stool frequency (p = 0.021). However, only the stool frequency symptom (p = 0.008) remained significant after controlling for the confounders of age, gender and stage of cancer. No significant changes in cancer-related fatigue, depression and salivary cortisol levels between the groups were observed after the intervention.
CONCLUSION: Pilates exercise had positive impacts on role functioning, bowel function, and functional capacity among colorectal cancer survivors, ultimately contributing to an improvement in quality of life.
METHODS: This is a retrospective, international, multicenter study of trauma across participating centers in the Pan Asian Trauma Outcome Study (PATOS) registry, which included trauma cases aged ≥18 years, brought to the emergency department (ED) by emergency medical services (EMS) from October 2015 to November 2018. Data of older adults (≥65 years) and younger adults (<65 years) were analyzed and compared. The primary outcome measure was in-hospital mortality, and secondary outcomes were disability at discharge and hospital and intensive care unit (ICU) length of stays.
RESULTS: Of 39,804 trauma patients, 10,770 (27.1%) were older adults. Trauma occurred more among older adult women (54.7% vs 33.2%, p
METHODS: A cross sectional study was conducted in five health clinics under Kota Kinabalu district, Sabah, Malaysia Borneo involving 162 attendees with age of 50 years old and above. A validated self-administered questionnaire was used to collect the data. Multiple logistic regression analysis was used to determine the predictors of NS-FOBT.
RESULTS: The prevalence of NS-FOBT was 85.8% (n=139). Important predictors of NS-FOBT were age (aOR: 0.922; 95% CI: 0.855, 0.995; p=0.035), Bumiputera ethnicity (vs Non Bumiputera; aOR: 4.285; 95% CI: 1.384, 13.263; p=0.012), knowledge score (aOR: 0.921; 95% CI: 0.856, 0.99; p=0.027), and attitude score (aOR: 0.801; 95% CI: 0.702, 0.913; p=0.001).
CONCLUSION: There is high prevalence of NS-FOBT. Age, ethnicity, knowledge, and attitude were important predictors of NS-FOBT. Strategies are needed to improve FOBT screening rate among the public. Socio-culturally tailored health promotion strategies as well as strengthening the communication, collaboration, and education to enhance the role of family physician is vital in improving the CRC prevention and care.
METHODS: A cross-sectional study was conducted in a locality within Selangor, sampling a total of 1449 young adults. The Cyberbullying and Online Aggression Survey was used to measure cyberbullying victimisation. The Family APGAR scale, General Health Questionnaire, Pittsburgh Sleep Quality Index and single-item measures were used to assess family dysfunction, psychological distress and health behaviour, respectively.
RESULTS: The 1-month prevalence of cyberbullying victimisation among young adults was 2.4%. The most common cyberbullying act experienced was mean or hurtful comments about participants online (51.7%), whereas the most common online environment for cyberbullying to occur was social media (45.8%). Male participants (adjusted OR (AOR)=3.60, 95% CI=1.58 to 8.23) had at least three times the odds of being cyberbullied compared with female participants. Meanwhile, participants with higher levels of psychological distress had increased probability of being cyberbullied compared with their peers (AOR=1.13, 95% CI=1.05 to 1.21).
CONCLUSIONS: As evident from this study, cyberbullying victimisation prevails among young adults and is significantly related to gender and psychological distress. Given its devastating effects on targeted victims, a multipronged and collaborative approach is warranted to reduce incidences of cyberbullying and safeguard the health and well-being of young adults.