Chronic non-communicable diseases are the new emerging epidemic, and they are thought to challenge only rich countries; cardiovascular disease, cancer, diabetes, and other non-communicable diseases (NCDs) are now the leading cause of death and disability in low-income and middle-income countries, where they killed almost 8 million people younger than 60 years in 2013. Therefore, there is a need to develop a valid and reliable tool to measure the beliefs that influence people’s general behaviour, and a used to measure beliefs about chronic disease perceived susceptibility. The purpose of this study was to develop and validate the use of perception questionnaire among the young Iraqi adults. A total of 200 young adults participated who are free from any chronic diseases under study, and are living in Baghdad. The questionnaire, validated by an expert’s panel, translated to Arabic language, and pretested. Analyses included descriptive statistics of all the study variables, reliability estimates, and construct validity using confirmatory factor analysis (CFA). Results showed that mean age of respondents was 30 years old, majority were males 71.5%, and EFA showed that factor loading was more than 0.4. CFA results show that Chi-square (df) = 1.213(2); p value (>0.05) = 0.297. Internal consistency reliability analysis on health-related behaviour; special practice, information seeking and perceived probability of diseases have good Cronbach’s α value of between 0.8 - 0.9. These findings revealed that validation is favourable and can be utilized on larger scale of sample to proceed with main study on chronic disease perceived susceptibility among healthy people.
perception ; validity ; chronic disease

Introduction: Elderly is a vulnerable population that is prone to sarcopenia which is associated with the loss of muscle mass, strength and function which are some of the diseases that affect the elderly. The association between environmental factors with sarcopenia should be explored as it has the potential to influence the health and disability of a person. At present, limited research is conducted to investigate the association that could be attributed to the complex interaction between human and environmental interactions. Hence this review is conducted to identify the environmental factors associated with sarcopenia. Methods: A systematic review was conducted using PubMed, SCOPUS, Web of Science and manual search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. We used articles that had been written in English and relevant articles were then screened, duplicates were removed, eligibility criteria were applied, and studies that met the criteria were reviewed. The keywords environmental factors, pollutants food environment, neighbourhood environment, locality and sarcopenia were included. Results: Initial search generated 934 publications and 12 articles were included after the inclusion and exclusion criteria for this review. In this review, environmental factors associated with sarcopenia are divided into 3 themes that comprises of food environment (availability and physical access, economic access and food quality and safety), neighbourhood environment and pollutants. Conclusion This systematic review revealed an association between the food environment, neighbourhood environment and pollutants with sarcopenia. The findings are salient as they could aid policymakers in formulating the necessary strategy to reduce the morbidity and mortality associated with sarcopenia, especially with the increase in the ageing population globally.

There is a large volume of published studies describing the adverse relationship between treatment non-adherence with tuberculosis treatment outcome. Non-adherence could result in increased risks of prolonged infectiousness, drug resistance, relapse cases and poor survival among tuberculosis patients. Nevertheless, few studies are to be found providing detailed on the reason of defaulting treatment among tuberculosis patients in Malaysia. Hence the goal of this paper is to find out the barriers and motivations factors that affect patients’ treatment compliance among our local tuberculosis patients. This is a qualitative study which included 12 in-depth interviews with tuberculosis non-compliance patients who were treated at Institute of Respiratory Medicine, Kuala Lumpur. All the conversations were recorded, transcribed and analysed by using thematic analysis. It was found that low knowledge, self-negative attitudes, traditional believes, negative perceptions towards health caregiver, drug side effects, stigma, financial problems, less family support and work commitments are the barriers that prevent the patients from religiously taking their anti-tuberculosis treatment. Meanwhile, factors that encourage them to continue their treatment were the believes of bad effects of the disease onto their lives and health, good relationship between patient and health caregiver and social support from people around them. In conclusion, non-adherence involved a dynamic influence of individual, socio-economic and treatment-related factors on the patients. The results presented here may facilitate improvement in the activities in promoting compliance among tuberculosis patients in the future which tailored to the patients’ specific needs.
Tuberculosis

Many of our chronic kidney disease (CKD) patients venture into complementary and alternative medicine (CAM) to seek a cure for the disease beyond conventional management. The objective of this study was to determine the prevalence and pattern of CAM usage; and its association with the progression of CKD in our population. This was a cross-sectional survey recruited CKD patients from Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Data was collected via interview using questionnaires which explore the demographics, type and pattern of CAM use. Patients’ comorbidities and serum creatinine were extracted from the medical notes to assess the association between progression of CKD and usage of CAM. Chi-square, Independent Samples t-test, Mann-Whitney U test and logistic regression were used to evaluate for an association. Three hundred and seventy two eligible patients were recruited. The prevalence of CAM use was 29% in the past year. Younger age, higher education and higher income level were associated with significantly more usage of CAM. Natural products were the commonest type of CAM used (86.1%). The belief in the effectiveness of CAM was the main reason for its uptake and about 57.8% revealed their practice to their physician. We found that the use of CAM in Malaysian CKD patients did not influence the progression of the disease.

Objective: The study aims to determine pattern of verbal memory and learning impairment and its associated factors among patients with bipolar I disorder in a psychiatric clinic of a university hospital. Methods: A case control study comparing verbal memory test performance in 40 patients with bipolar I disorder to that of 40 healthy normal subjects using Rey Auditory Verbal Learning Test (RAVLT). The association between demographic, clinical characteristics and poor verbal memory performance were examined. Results: Up to 92% of patients with bipolar I disorder have impaired short term working memory in this hospital-based study. They also recalled fewer words in all the RAVLT trials and had difficulties learning the word list in comparison to that of normal healthy individuals. Verbal memory and learning impairment are observed in bipolar illness in the absence of active mood symptoms while duration and severity of illness are not found to have any effect on verbal memory and learning. Conclusion: There is consistent verbal memory and learning problems in individuals with bipolar I disorder and their presence in the absence of mania, depression and mixed symptoms during the course of the illness suggests a trait related deficit.

The aim of this study is to determine risks factor of mortality among patient with post percutaneous coronary intervention. Estimation of post operative mortality risk factor is essential for planning prevention modalities. This is retrospective cohort study based on secondary data extracted from the National Cardiovascular Disease Database (NCVD-ACS and NCVD PCI). Both these registries were interlinked and was further matched to JPN (Jabatan Pendaftaran Negara/National registration Department) to assess mortality among the patients who underwent PCI and all death which occurred in between 2007, 2008 and 2009. There were 630 patients in this studied. Age, history of diabetes mellitus, peripheral vascular, renal failure and previous percutaneous coronary intervention were univariately associated with mortality. However based on logistics stepwise method, only age and history of renal failure had showed statistically significant and sizeable odds ratio in predicting the patient died of coronary death. Older age and renal failure are the predicting factors for mortality among patients with post percutaneous coronary intervention.

Tuberculosis (TB) is known as a disease that prone to spatial clustering. Recent development has seen a sharp rise in the number of epidemiologic studies employing Geographical Information System (GIS), particularly in identifying TB clusters and evidences of etiologic factors. The aim of this systematic review is to determine evidence of TB clustering, type of spatial analysis commonly used and the application of GIS in TB surveillance and control. A literature search of articles published in English language between 2000 and November 2015 was performed using MEDLINE and Science Direct using relevant search terms related to spatial analysis in studies of TB cluster. The search strategy was adapted and developed for each database using appropriate subject headings and keywords. The literature reviewed showed strong evidence of TB clustering occurred in high risk areas in both developed and developing countries. Spatial scan statistics were the most commonly used analysis and proved useful in TB surveillance through detection of outbreak, early warning and identifying area of increased TB transmission. Among others are targeted screening and assessment of TB program using GIS technology. However there were limitations on suitability of utilizing aggregated data such as national cencus that were pre-collected in explaining the present spatial distribution among population at risk. Spatial boundaries determined by zip code may be too large for metropolitan area or too small for country. Nevertheless, GIS is a powerful tool in aiding TB control and prevention in developing countries and should be used for real-time surveillance and decision making.
Tuberculosis cluster ; geographical information system ; spatial analysis

Violence among adolescents is a significant public health issue. The focus was on school-going adolescents because of the life-long negative impact at an individual level both for the perpetrator and victim. Besides, it increases the costs to provide health, welfare, and criminal justice as well as decreases general productivity at the community level. The study aims to determine the prevalence of violence-related behavior, characteristics of both victims and perpetrators, in addition to inter and intrapersonal factors associated with violence-related behaviors. A study was carried out in 2013, which involved all upper secondary school students (aged 16 to 17 years). It was a part of the Malaysian Adolescent Health Risk Behavior (MyAHRB) study, which was conducted in 11 states in Peninsular Malaysia. Standardized, validated questionnaires were used for data collection. The prevalence of violence-related behaviors was 22.4%, and this was higher among male students as compared to females (29.1% vs. 16.3%). Multivariable analysis revealed that the odds of violence-related behaviour increased among males, Malay race, drug use, smoking, had exposure to sex, which sometimes and always felt lonely and had attempted suicide. Agreeable to ensure that their lifestyles do not transgress religious limit and belief was significantly protective. This study provides evidence for a targeted approach to combat violence-related behaviors among adolescents.

The risk factors associated with mental health among adolescents are usually described by researchers at an individual level. Neighbourhood factors and health have opened a new insight into the field of epidemiology. The aim of this study was to assess the reliability and validity of a newly developed Neighbourhood Factors on Mental Health Questionnaire among Malaysian adolescents. A cross-sectional study was conducted in four secondary schools in Kuala Lumpur, Malaysia using a newly developed questionnaire which comprised of two main domains and seven items. Exploratory factor analysis and Cronbach’s alpha were used to measure the instrument’s construct validity and reliability. A total of 106 adolescents participated in this research. The majority of adolescents were 13 years old (40.6%), female (55.7%), Malays (68.9%), have parents who only studied until secondary school (66.0%) and lived in flats (32.1%). Bartlett’s Test of Sphericity was significant (Chi-square = 258.361, p<0.001) and Kaiser-Meyer-Olkin (KMO) value was 0.820. The final model of the instrument contained two domains, the neighbourhood physical environment and neighbourhood social environment factors. Factor loadings for all items were satisfactory ranging from 0.591 to 0.870. The overall Cronbach’s alpha was 0.810. The Neigbourhood Factors on Mental Health Questionnaire was found to be a valid and reliable instrument. It can be used to assess neighbourhood physical and social factors that can influence mental health of adolescents in Malaysia.​

As air travelling now becomes cheaper and available to almost all people of any walk of life, travelling across international borders is fast becoming a lifestyle of many. Having travel health service as part of health care services is important to address the issues of travel related illnesses among travellers. However, lacks of published guidelines pertaining to travel health service rendering many countries to overlook its importance. The aim of this paper is to review published literatures and authoritative websites on the components needed to develop guideline to establish travel health services. A systematic literature search was done using pre-specified keywords for literatures published between years 2000 – 2016. Literatures written in English and fully accessible were all included. No exclusion criteria was set before the search. Online authoritative websites pertaining to travel health were also referred. A total of six literatures ranging from expert opinion, review paper and original study, together with three authoritative websites related to travel health were reviewed. Among the important components needed to be considered for developing the guideline for establishing travel health services are to prioritise pre-travel health service, to set up specialised travel health clinic, to produce travel health/medicine specialist, to emphasize on continuous education and training of the practitioners and to apply multiagency and multidisciplinary approach with adequate fund for research in travel health. As a conclusion, policy makers should prioritise and select the most important components in developing guideline for travel health service.
Travel health service ; travel medicine ; guideline development