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  1. Abdul Rahim NI, Shahar HK, Mohd Nazan NIN
    MyJurnal
    ABSTRACTS FOR INTERNATIONAL FAMILY HEALTH CONFERENCE 2019 (I-FaH 2019)
    Introduction: Diabetes is a global epidemic and the public knowledge on this progressive disease is important to control the disease. This study aims to determine the diabetes knowledge of a community in Sungai Petani and the associated factors.
    Methods: A cross-sectional study using multi-stage sampling was carried out in Sungai Petani, Kedah, Malaysia between April to May 2019, by a validated and reliable questionnaire. Data was analysed using IBM SPSS version 25.0. Mann-Whitney U and Kruskal Wallis test were used.
    Results: Of 370 non-diabetic adults participated in this study with majority of them were females (61.9%), Malays (79.2%), had at least secondary education (53.5%), married (78.6%), overweight (34.6%), not-hypertensive (80.8%), had no family history of diabetes (52.2%) and not-smoking (86.8%). The mean ±SD age was 46.1 ±13. And median (IQR) monthly income was RM3037.40 ±3005.90. The diabetes knowledge median (IQR) score was 26.0 (9.0). Half of respondents did not know about items on “the different types of diabetes”, “diabetics should carry sweets when they are out” and “diabetics should not do-nate blood”. Diabetes knowledge was found to have significant association with diabetes screening uptake, income level, education level, marital status, BMI, family history of diabetes and smoking.
    Conclusion: Diabetes knowledge among Sungai Petani community was found to be adequate but there is still misconception regarding diabetes and its management. Collective efforts should be taken to improve the general population’s knowledge on diabetes.
  2. Essiet IA, Baharom A, Shahar HK, Uzochukwu B
    Pan Afr Med J, 2017;26:110.
    PMID: 28533833 DOI: 10.11604/pamj.2017.26.110.10409
    INTRODUCTION: Physical activity among university students is a catalyst for habitual physical activity in adulthood. Physical activity has many health benefits besides the improvement in academic performance. The present study assessed the predictors of physical activity among Nigerian university students using the Social Ecological Model (SEM).

    METHODS: This cross-sectional study recruited first-year undergraduate students in the University of Uyo, Nigeria by multistage sampling. The International Physical Activity Questionnaire (IPAQ) short-version was used to assess physical activity in the study. Factors were categorised according to the Socio-Ecological Model which consisted of individual, social environment, physical environment and policy level. Data was analysed using the IBM SPSS statistical software, version 22. Simple and multiple logistic regression were used to determine the predictors of sufficient physical activity.

    RESULTS: A total of 342 respondents completed the study questionnaire. Majority of the respondents (93.6%) reported sufficient physical activity at 7-day recall. Multivariate analysis revealed that respondents belonging to the Ibibio ethnic group were about four times more likely to be sufficiently active compared to those who belonged to the other ethnic groups (AOR = 3.725, 95% CI = 1.383 to 10.032). Also, participants who had a normal weight were about four times more likely to be physically active compared to those who were underweight (AOR = 4.268, 95% CI = 1.323 to 13.772).

    CONCLUSION: This study concluded that there was sufficient physical activity levels among respondents. It is suggested that emphasis be given to implementing interventions aimed at sustaining sufficient levels of physical activity among students.

  3. Noman S, Shahar HK, Abdul Rahman H, Ismail S
    PMID: 32059587 DOI: 10.3390/ijerph17041167
    Breast cancer is the most common cancer spread among women worldwide. Whereas many studies have discussed the significance of breast cancer screening among women in various countries, few have attempted to discuss this topic among female school teachers. As teachers educate and communicate with students, this may play an essential role in health education and in promoting healthy behavior, such as breast cancer screening. The primary goal of this study is to develop and implement an educational intervention of breast cancer screening and evaluate its effectiveness among Yemeni female school teachers in Malaysia. This was carried out as per the health belief model. A cluster-randomized controlled trial was conducted among 183 Yemeni female school teachers in twelve schools in Klang Valley, Malaysia. A random assignment of the target schools was made to include them within the intervention or control group. Participants in the intervention group were offered a 90-minute session for one-day educational intervention on breast cancer screening. On the other hand, participants in the control group were offered the same educational materials at the end of the study. Relevant data was collected at baseline, one month following the intervention, and then three- and six-months follow-up assessments. Analysis of such data was done via IBM SPSS software 25.0 by generalized estimating equations (GEE) to assess the differential changes over time. A primary outcome embodied in breast cancer screening practice uptake was expected. Secondary outcomes include the target group's knowledge on and beliefs of breast cancer screening. This study intends to contribute to the credibility and effectiveness of utilizing a theory-based breast cancer screening intervention in order to raise the awareness of women on conducting breast cancer screening.
  4. Saraswathy T, Nalliah S, Rosliza AM, Ramasamy S, Jalina K, Shahar HK, et al.
    BMC Med Educ, 2021 Sep 09;21(1):482.
    PMID: 34503488 DOI: 10.1186/s12909-021-02907-1
    BACKGROUND: This study aimed at determining the effectiveness of an innovative approach using interprofessional simulation scenarios (IPSS) in improving knowledge, attitude, and practice (KAP) of hospital-acquired infection control (HAIC) among health professionals.

    METHODS: The interventional study was conducted in a teaching hospital in Malaysia. Purposive sampling was used to recruit participants from surgical, intensive care, and other units. Thirty-six health professionals in the experimental and forty in the control group completed the study. All subjects participated in an interactive lecture and demonstrated four IPSS on HAIC i.e. (i) taking blood specimen (ii) bedsore dressing (iii) collecting sputum for acid-fast bacilli and (iv) intermittent bladder catheterization. Each team consisted of a doctor and a nurse. A self-administered questionnaire on KAP on HAIC was completed by respondents during the pre-, immediately and, post-intervention. An independent t-test was conducted to measure the significance between the experimental and control group.

    RESULTS: The mean scores for KAP among the experimental group increased following the intervention. Significant differences in scores were seen between the two groups post-intervention (p 

  5. Hossain M, Mani KK, Mohd Sidik S, Shahar HK, Islam R
    BMC Public Health, 2014;14:775.
    PMID: 25081860 DOI: 10.1186/1471-2458-14-775
    BACKGROUND:
    Knowledge and awareness concerning sexually transmitted diseases (STDs) has become the burning issue of the day. Although STDs pose serious risks to health security, there is very little literature quantifying the knowledge and awareness of these diseases and their principal socioeconomic determinants. The aim of this study is to determine the effect of different socio-economic and demographic factors on knowledge and awareness about STDs among women in Bangladesh.

    METHODS:
    This is a cross-sectional study using data from the Bangladesh Demographic and Health Survey (BDHS) 2011. It involves 10,996 women in six divisions of Bangladesh - Dhaka, Rajshahi, Chittagong, Barisal, Khulna and Sylhet. In this study, the percentage distribution and logistic regression model are used to identify which factors are associated with knowledge and awareness among women in Bangladesh about STDs.

    RESULTS:
    There is a significant association between geographic division (Dhaka: OR = 1.669, 95% CI = 0.89-2.10, Khulna: OR = 2.234, 95% CI = 1.2-3.2); places of residence (Rural: OR = 0.363, 95% CI = 0.20-1.08), respondent's age (20-29 years: OR = 1.331; 95% CI = 0.98-2.31); education (Primary: OR = 2.366, 95% CI = 1.98-3.1, secondary: OR = 10.089, 95% CI = 8.98-12.77, higher: OR = 20.241, 95% CI = 18.33-22.65); listening to radio (OR = 1.189, 95% CI = 1.29-3.12) and watching TV (OR = 2.498, 95% CI = 2.22-4.09) with knowledge and awareness among women in Bangladesh about STDs.

    CONCLUSION:
    There is a need to improve the education in Bangladesh about STDs particularly among those in the rural areas and older ages of women (30-49 years). Formal, informal and special educational knowledge and awareness programmes may be implemented to educate people concerning STDs in Rajshahi, Sylhet and Chittangong division. Campaigns and mass media can be used to increase the knowledge and awareness among the community, especially among women. Policies concerning the issue of STDs need to be improved and can be emphasized in collaboration with government agencies to ensure the success of these campaigns.
  6. Noman S, Shahar HK, Abdul Rahman H, Ismail S, Abdulwahid Al-Jaberi M, Azzani M
    PMID: 33396424 DOI: 10.3390/ijerph18010263
    There have been various systematic reviews on the significance of educational interventions as necessary components to encourage breast cancer screening (BCS) and reduce the burden of breast cancer (BC). However, only a few studies have attempted to examine these educational interventions comprehensively. This review paper aimed to systematically evaluate the effectiveness of various educational interventions in improving BCS uptake, knowledge, and beliefs among women in different parts of the world. Following the PRISMA guidelines, a comprehensive literature search on four electronic databases, specifically PubMed, Scopus, Web of Science, and ScienceDirect, was performed in May 2019. A total of 22 interventional studies were reviewed. Theory- and language-based multiple intervention strategies, which were mainly performed in community and healthcare settings, were the commonly shared characteristics of the educational interventions. Most of these studies on the effectiveness of interventions showed favorable outcomes in terms of the BCS uptake, knowledge, and beliefs among women. Educational interventions potentially increase BCS among women. The interpretation of the reported findings should be treated with caution due to the heterogeneity of the studies in terms of the characteristics of the participants, research designs, intervention strategies, and outcome measures.
  7. Alrubaiee GG, Baharom A, Faisal I, Shahar HK, Daud SM, Basaleem HO
    BMC Nurs, 2021 Feb 17;20(1):33.
    PMID: 33596894 DOI: 10.1186/s12912-021-00551-0
    BACKGROUND: Previous cross-sectional studies have reported limited knowledge and practices among nurses regarding controlling nosocomial infections (NIs). Even though health institutions offer many irregular in-service training courses to solve such issues, a three year-nursing educational programme at institutions is not adequate to enable nurses to handle NIs. Therefore, this study aims to evaluate the implementation of an educational module on NIs control measures among Yemeni nurses.

    METHODS: A single-blinded randomised hospital-based trial was undertaken involving 540 nurses assigned to two intervention groups and a waitlist group. Intervention group-1 received a face-to-face training course comprising 20 h spread over six weeks and a hard copy of the module, while intervention group-2 only received the hard copy of the module "without training". In contrast, the waitlist group did not receive anything during the period of collecting data. A self-administered NI control measures-evaluation questionnaire was utilised in collecting the data from the participants; before the intervention, at six weeks and 3 months after the end of the intervention. The period of data collection was between 1st May and 30th October 2016.

    RESULTS: The results from collecting and analysing the data showed a statistically significant difference in the mean knowledge scores between the intervention groups that were detectable immediately post-intervention with a mean difference (MD) of 4.31 (P 

  8. Noman S, Shahar HK, Rahman HA, Ismail S, Aljaberi MA, Abdulrahman MN
    BMC Womens Health, 2021 Dec 29;21(1):437.
    PMID: 34965865 DOI: 10.1186/s12905-021-01543-7
    BACKGROUND: The reliability and validity of the Champion's Health Belief Model Scale (CHBMS) used in assessing the belief of women regarding breast cancer (BC) and breast cancer screening (BCS) have been examined on various populations. However, the use of this tool has not been adequately assessed for its validity in ethnic minorities. This study assessed the validity and reliability of CHBMS by analyzing the factor structure and internal reliability of the factors among Yemeni women in Malaysia.

    METHODS: A survey was conducted among 103 female teachers from 10 schools. SPSS version 22.0 was utilized in analyzing the data. Descriptive statistics were computed for the socio-demographic characteristics. The Cronbach's alpha coefficients were used in assessing the internal reliability. The Exploratory Factor Analysis (EFA) was used to analyze the factor structure of the translated items. Parallel analysis was performed to determine the number of factors accurately.

    RESULTS: The alpha coefficients of the factors had acceptable values ranging between 0.76 and 0.87. The factor analysis yielded six and five factors for breast self-examination (BSE) and mammography (MMG), with a total explained variance of 47.69% and 52.63%, respectively. The Kaiser-Meyer-Olkin (KMO) index values of 0.64 and 0.72, and the Bartlett's Test of Sphericity (P = 0.0001) for BSE and MMG, respectively, verified the normality distribution and the adequacy of the sample size for EFA. All the items on each factor were from the same construct that were consistent with the number of factors obtained in the scale development study. The items achieved adequate factor loadings that ranged between 0.47 and 0.88.

    CONCLUSIONS: The translated version of the CHBMS is a validated scale used in assessing the beliefs related to BC and BCS among Yemeni women living in Malaysia. Healthcare workers could use the scales to assess women's beliefs on BC and BCS. This instrument could be used to test the effectiveness of the intervention programs.

  9. Mohd Tariq MN, Shahar HK, Baharudin MR, Ismail SNS, Manaf RA, Salmiah MS, et al.
    BMC Public Health, 2021 09 24;21(1):1735.
    PMID: 34560858 DOI: 10.1186/s12889-021-11719-3
    BACKGROUND: Flood disaster preparedness among the community seldom received attention. Necessary intervention must be taken to prevent the problem. Health Education Based Intervention (HEBI) was developed following the Health Belief Model, particularly in improving flood disaster preparedness among the community. The main objective of this study is to assess the effect of HEBI on improving flood disaster preparedness among the community in Selangor. This study aims to develop, implement, and evaluate the impact of health education-based intervention (HEBI) based on knowledge, skills, and preparedness to improve flood disaster preparedness among the community in Selangor.

    METHOD: A single-blind cluster randomized controlled trial will conduct at six districts in Selangor. Randomly selected respondents who fulfilled the inclusion criteria will be invited to participate in the study. Health education module based on Health Believed Theory will be delivered via health talks and videos coordinated by liaison officers. Data at three-time points at baseline, immediate, and 3 months post-intervention will be collected. A validated questionnaire will assess participants' background characteristics, knowledge, skill, and preparedness on disaster preparedness and perception towards disaster. Descriptive and inferential statistics will be applied for data analysis using IBM Statistical Package for Social Sciences version 25. Longitudinal correlated data on knowledge, skills, preparedness, and perception score at baseline, immediate post-intervention, and 6 months post-intervention will be analyzed using Generalized Estimating Equations (GEE).

    DISCUSSION: It is expected that knowledge, skills, preparedness, and flood disaster perception score are more significant in the intervention group than the control group, indicating the Health Education Based Intervention (HEBI).

    TRIAL REGISTRATION: Thai Clinical Trial TCTR20200202002 .

  10. Bala U, Leong MP, Lim CL, Shahar HK, Othman F, Lai MI, et al.
    PLoS One, 2018;13(5):e0197711.
    PMID: 29795634 DOI: 10.1371/journal.pone.0197711
    BACKGROUND: Down syndrome (DS) is a genetic disorder caused by presence of extra copy of human chromosome 21. It is characterised by several clinical phenotypes. Motor dysfunction due to hypotonia is commonly seen in individuals with DS and its etiology is yet unknown. Ts1Cje, which has a partial trisomy (Mmu16) homologous to Hsa21, is well reported to exhibit various typical neuropathological features seen in individuals with DS. This study investigated the role of skeletal muscles and peripheral nerve defects in contributing to muscle weakness in Ts1Cje mice.

    RESULTS: Assessment of the motor performance showed that, the forelimb grip strength was significantly (P<0.0001) greater in the WT mice compared to Ts1Cje mice regardless of gender. The average survival time of the WT mice during the hanging wire test was significantly (P<0.0001) greater compared to the Ts1Cje mice. Also, the WT mice performed significantly (P<0.05) better than the Ts1Cje mice in the latency to maintain a coordinated motor movement against the rotating rod. Adult Ts1Cje mice exhibited significantly (P<0.001) lower nerve conduction velocity compared with their aged matched WT mice. Further analysis showed a significantly (P<0.001) higher population of type I fibres in WT compared to Ts1Cje mice. Also, there was significantly (P<0.01) higher population of COX deficient fibres in Ts1Cje mice. Expression of Myf5 was significantly (P<0.05) reduced in triceps of Ts1Cje mice while MyoD expression was significantly (P<0.05) increased in quadriceps of Ts1Cje mice.

    CONCLUSION: Ts1Cje mice exhibited weaker muscle strength. The lower population of the type I fibres and higher population of COX deficient fibres in Ts1Cje mice may contribute to the muscle weakness seen in this mouse model for DS.

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