Abstract Introduction: Diabetes mellitus is a major risk factor for chronic kidney disease (CKD). Thus, making routine screening among the diabetic group is necessary in order to reduce the burden of the disease. As such, various risk prediction models including QKidney model have been developed for early detection of CKD. However, the Qkidney model has not been validated in Malaysia. This study aimed to evaluate the performance of QKidney model in predicting a 5-year risk of developing CKD in a cohort of type 2 diabetes mellitus (T2DM) patients in the primary care setting. Methods: A total of 377 T2DM patients attended the primary care clinic at the town of Rawang, aged 30-74 years old, and free of CKD outcomes at baseline were recruited and followed-up for 5 years. Their CKD risk was calculated using the QKidney model. The predictive performance of QKidney model was assessed through discrimination and calibration analyses. Results: At the end of the 5-year follow-up, a total median QKidney score was 3.9% (IQR: 5.9). The median QKidney score of male participants (7.3%) was significantly higher than that of the females (3.0%) (p < 0.001). The QKidney model has a moderate discrimination in which the area under the receiver operating characteristic curve was 0.748, with good calibration (χ2 = 13.039, p = 0.111). Conclusion: It was found that the QKidney model had a moderate discriminative ability with good calibration. When taken together, it was suggested that the QKidney model could be utilized to predict a moderate-to-severe CKD risk in Malaysians with T2DM.

INTRODUCTIONThis study aims to identify the predictors of a 6-month quitting success among employees involved in workplace smoking cessation with low-intensity smoke-free policy.

MATERIALS AND METHODSA multicentre prospective cohort study was conducted among employees from 2 different public universities in Malaysia. Interventions include at least 2 sessions of behavioural therapy combined with free nicotine replacement therapy (NRT) for 8 weeks. Participants were followed up for 6 months. Independent variables assessed were on sociodemographic and environmental tobacco smoke. Their quit status were determined at 1 week, 3 months and 6 months.

RESULTSOne hundred and eighty- five smokers volunteered to participate. Among the participants, 15% and 13% sustained quit at 3 months and 6 months respectively. Multivariate analysis revealed that at 6 months, attending all 3 behavioural sessions predicted success. None of the environmental tobacco exposure variables were predictive of sustained cessation.

CONCLUSIONIndividual predictors of success in intra-workplace smoking cessation programmes do not differ from the conventional clinic-based smoking cessation. Furthermore, environmental tobacco exposure in low intensity smoke-free workplaces has limited influence on smokers who succeeded in maintaining 6 months quitting.

Adolescent ; Adult ; Humans ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Smoke-Free Policy ; Smoking ; therapy ; Smoking Cessation ; Time Factors ; Workplace ; Young Adult

PURPOSE: Low muscle strength is central to geriatric physical disabilities and mortality. The purpose of the present study was to examine handgrip strength (HGS) and its associated factors among community-dwelling older people in Sri Lanka. METHODS: A cross-sectional study was conducted in the Kandy district using multistage sampling. A total of 999 older people were recruited, with a female preponderance. Data were collected using interviewer-administered questionnaires on demographic characteristics, depression, and physical activity. Anthropometric measurements including weight, height, mid-upper arm circumference, calf circumference, and HGS were recorded. Complex sample general linear model was used to examine the association between HGS and its associated factors. RESULTS: The mean highest HGS of the study group was 12.56 kg (95% confidence interval: 11.94–13.19). Male older people had a higher HGS (17.02, 95% confidence interval: 15.55–18.49 kg) than females (10.59, 95% confidence interval: 10.12–11.06 kg). For both men and women, older age was associated with lower HGS, while mid-upper arm circumference was associated with better HGS. Diabetes mellitus, vegetarian diet, and alcohol consumption were associated with HGS for women only. CONCLUSION: Men had a higher HGS compared with women. Age, mid-upper arm circumference, diabetes mellitus, vegetarian diet, and alcohol consumption were factors associated with HGS among community-dwelling older people in Kandy district, Sri Lanka. HGS can be used as a feasible strategy to improve health status of older people by community health nurses.
Aged* ; Alcohol Drinking ; Arm ; Cross-Sectional Studies* ; Depression ; Diabetes Mellitus ; Diet, Vegetarian ; Female ; Hand Strength ; Humans ; Independent Living ; Linear Models ; Male ; Mortality ; Motor Activity ; Muscle Strength ; Nurses, Community Health ; Sri Lanka*

Introduction: Cardiovascular diseases are the main cause of morbidity and mortality in Malaysia. There is evidence of high traditional and complementary medicine (TCM) use among population with cardiovascular risk and there have been anecdotal reports about substitution of conventional medicines with TCM. We investigated the prevalence of TCM use, treatment preference and substitution of conventional medicines in study population with cardiovascular risk factors in Pahang, Malaysia. Methods: A cross-sectional survey was conducted using an interviewer-administered questionnaire in five districts of Pahang. A total of 1250 households were chosen through proportionate and systematic sampling. Respondents aged 18 years and above were selected. Results: The study population with cardiovascular risk factors who used TCM was higher than the general population (31.7% versus 25.9%). There were no clear preferences in using TCM by gender, age groups, educational level and income even though other bumiputeras showed a slight inclination towards TCM use. Among the study population with cardiovascular risk factors who consumed TCM, 20-30% of them were using TCM as a substitute for their conventional medications. Respondents from the younger age group (18-40 years) (57.1%), highest educational level (43.2%), other bumiputeras (38.4%) and highest income group (31.4%) preferred the combination of both conventional and traditional medicine. Conclusion: TCM use among population with cardiovascular risk factors is high. The high preference for combination therapy of TCM and conventional medications among young adults and the use of TCM to substitute conventional medications show that much research is needed to provide proven TCM therapies to avoid self-mismanagement of cardiovascular risk in Malaysia.
Complementary Therapies ; Medicine, Traditional

Introduction: A sustainable diet which is healthy and environmentally friendly provides the means of climate change mitigation in addition to promoting health of the population. There is an urgent need to have an indicator to measure if one’s diet is sustainable. This paper aimed to validate a newly developed Sustainable Diet Index (SDI) among young Malaysian adults. The SDI was developed based on the dietary guidelines of a sustainable diet. Methods: Five indicators (rice, animal-based food, plant-based food, food waste, and packaging) were included in the SDI. The index was validated via content validity, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) among young Malaysian adults. The dietary assessment tool used was an Android application named Sustainable Food Record. Results: Content validity showed fair to moderate correlations (0.331 - 0.816) between the indicators in the SDI. EFA produced five final factors with eight indicators in the index as follows: 1) fruits and vegetables; 2) dairy, eggs, and meat; 3) rice, cereals, and grain products; 4) food packaging; and 5) food waste management with strong factor loadings (0.760 – 0.984). All five factors with eight indicators were retained and proceeded with CFA. The fit indices from CFA demonstrated that the model was an absolutely fit. Conclusion: The validated SDI can be used as a tool to measure the sustainability of an individual’s diet in Malaysia, incorporating both health and environment considerations.

Knee pain (KP) is commonly reported among workers, especially those in non-managerial occupations such as carpenters, miners and construction workers. However, few studies have been conducted on KP among the teacher population. Therefore, this study aimed to determine the prevalence of KP among school teachers and to explore its association with individual characteristics, lifestyle, work factors, and presence of health conditions. A cross-sectional survey was conducted among teachers at public secondary schools in Selangor, Malaysia. A self-reported questionnaire was utilised to elicit information on socio-demographic characteristics, lifestyle, body mass index, work-related factors, and health-related quality of life (HRQoL). Associations with KP were analysed by logistic regression and reported as odds ratios (ORs) at a 95% confidence interval (CI). The results revealed that the 12-month prevalence of KP was 54.4%. The multivariate analysis showed that age (OR 3.55, 95% CI: 1.92–6.54), kneeling or squatting >1 hour in total (OR 1.48, 95% CI: 1.06–2.08), and physical HRQoL (OR 0.94, 95% CI: 0.92–0.96) were significantly associated with the occurrence of KP. In conclusion, the prevalence of KP among secondary school teachers is high. Age, work-related physical practises, and physical health were found to be significantly associated with KP. Therefore, appropriate strategies should be implemented to address these factors in order to reduce the occurrence of KP, especially among the older teacher population.
Body mass index

Introduction: COVID-19 survivors with mental health issues are more likely to have a lower quality of life, reduced work productivity, social troubles, and other health issues. However, information on the mental health of COVID-19 survivors is scarce. Therefore, we aimed to determine the COVID-19 survivors’ mental health status in the form of depression and its associated factors. Methods: This cross-sectional study was conducted in Malaysia, during the nationwide lockdown. Data were collected using an online questionnaire. Socio-demographic variables, comorbidities, self-perception of health, information on the person’s acute condition during COVID-19 infection, symptoms and duration of symptoms postCOVID, and state of depression were gathered. The Patient Health Questionnaire 9 was used to assess depression. Factors associated with mild to severe depression were analysed using multivariable logistic regression analyses. Results: A total of 732 COVID-19 survivors responded to the survey. The respondents were mainly females and of younger age (in their 20s and 30s). One-third of the participants perceived themselves as having poor health. One in five participants reported having Long COVID. Slightly less than half (47.3%) of the respondents had mild to severe depression (total PHQ-9 score of 5-27). In the multivariable analysis, being female (aOR: 1.68; 95% CI: 1.08,2.62), of younger age (20s – aOR: 3.26; 95% CI: 1.47, 7.25; 30s – aOR: 2.08; 95% CI: 1.05, 4.15; and 40s – aOR: 2.43; 95% CI: 1.20, 4.90; compared to those in their 50s and above), being overweight/obese (aOR: 1.83; 95% CI: 1.18, 2.83), having Long COVID (aOR: 2.45; 95% CI: 1.45, 4.16) and perceived poorer health (aOR: 4.54; 95% CI: 2.89, 7.13) Conclusion Females, younger age groups, being overweight/obese, having Long COVID and perceiving themselves to be in poor health were factors associated with higher odds of mild to severe depression.
COVID-19

Background: Metabolic syndrome (MS) is a major public health challenge worldwide. The risks of MS and chronic diseases are further escalated with the increasing burden of psychological health. This was a cross-sectional study aimed to investigate the relationship between socio-demographic, lifestyle and psychological factors and MS, as well as the independent relationship between social support and MS among school teachers in Malaysia. Methodology: Multi-stage sampling was used to recruit participants from the state of Malacca, Malaysia. Data on socio-demographics, lifestyle factors and psychological health were obtained using self-administered questionnaires, including Short-form International Physical Activity Questionnaire (IPAQ), Depression, Anxiety and Stress Scale (DASS-21), Job content questionnaire (JCQ) and the revised 8-item Malay version of the Multidimensional Scale Perceived Social Support (MSPSS-M). Anthropometric measurements and metabolic risk assessment were conducted. Univariate analysis followed by multiple logistic regressions was conducted using complex sample logistic regression analysis. Results: Of 1511 participants, the prevalence of MS was 23.3% (95% CI: 20.7, 26.1). MS was significantly associated with increasing age, male gender, Indian ethnicity, usage of saturated fats, lesser sleeping duration, job strain, iso-strain, and lower perceived social support. After adjusting for potential confounders, higher perceived social support from family, friends or both were significantly associated with the lower likelihood of MS by 4% (OR 0.96; 95% CI: 0.93, 0.98), 10% (OR 0.90; 95% CI: 0.85, 0.96) and 4% (OR 0.96; 95% CI: 0.94, 0.98), respectively. Conclusion Metabolic syndrome was associated with increasing age, male gender, Indian ethnicity, usage of saturated fats and lesser sleeping duration in our population. Psychological health such as job strain, iso strain as well as low social support may be modifiable risk factors for MS.
Malaysia

This study aimed to assess the validity and reliability of the Bahasa Malaysia (BM) version of European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire core (QLQ-C30) (version 3.0) in Malaysian patients with colorectal cancer. A cross sectional study design was used to obtain data from patients receiving treatment at two teaching hospitals in Kuala Lumpur, Malaysia. Self-administered method was used. Statistical analysis included reliability, convergent and discriminant validity and known-groups comparisons. Statistical significance was based on p value ≤ 0.05. The internal consistency Cronbach’s alpha coefficient (α) was acceptable (> 0.70) in all scales but cognitive (α = 0.56) and pain in patients with stoma bag (α = 0.35). Test-retest coefficients were high (r = 0.93 to 1.00). All items showed adequate convergent validity (r > 0.40) except for questionnaire item 5 “needs help in eating/dressing/washing”. Similarly, criteria for discriminant validity were achieved in all but item 10 “need rest”. Patients with high Karnofsky Performance Scores (KPS) scores reported significantly less dyspnoea (p = 0.021) and appetite loss (p = 0.047) compared to patients with low KPS scores. There was no significant difference between patients with and without stomas. The psychometric properties of the BM version of the QLQ-C30 were comparable to previous studies in other settings. Therefore, the questionnaire could be used to measure quality of life in Malaysian patients with colorectal cancer.