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@#Aim: Depression symptoms in older persons are overlooked and untreated because they coincide with other conditions that older persons face. This review aimed to determine the prevalence and factors associated with depression among community dwelling older persons in Thailand according to the Social Cognitive Theory constructs. Design: Systematic review. Data sources: Four electronic databases: PubMed, PsychINFO, ScienceDirect and Scopus, with only articles published between January 2000 and December 2021 were included. Methods: The Preferred Reporting Systems for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to conduct this systematic review. All included articles were appraised using the Crowe Critical Appraisal Tool (CCAT), with all 13 studies were assessed to be of high quality, with score of more than 75. Results: A total of 13 full-texts articles were included in this review, of which 12 were cross-sectional study design, and only one was a cohort study. The prevalence of depression among older persons in Thailand were between 5.7% to 68%, with the most commonly reported factors that significantly associated with depression were gender, social support, marital status, employment status or income, and education level. Conclusion: Depression among older persons is a mental Health challenging issue in Thailand. Studying the factors that contribute to depression in older persons is more important in order to have a better understanding of the underlying causes as well as for early detection and effective management of depression among older persons in Thailand.
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@#Introduction: Diabetes health literacy and numeracy are health indicators of increasing attention to empower diabetic self-management. This study aimed to explore the predictors of diabetes health literacy and numeracy among urbanized older adults. Methods: A total of 408 older adults with type 2 diabetes mellitus, aged 50 years and older were recruited using stratified random sampling from eight health clinics in Petaling district. A pre-tested questionnaire was used to measure knowledge, attitude, self-efficacy, self-care behavioral skills, diabetes health literacy and numeracy related to diabetes mellitus, as well as the sociodemographic background. Multivariable linear regression was used to understand and rank the predictors of diabetes health literacy and numeracy among the respondents. Results: The total mean score for diabetes health literacy was 53.74 ± 0.60, which was significantly predicted by age (β = -0.21, p=0.01), secondary (β =12.21, p<0.001) and tertiary (β = 16.37, p<0.001) education levels, non-Malays (β = -5.83, p<0.001), being employed (β = -2.77,p=0.02), have other comorbidities (β = -3.02, p=0.003), diabetes related self-efficacy (β = -0.37, p=0.02) and self-care behavioral skills (β =0.36, p<0.001). Meanwhile, the total mean score for diabetes health numeracy was 1.50 ± 0.13 and was significantly predicted by age (β=-0.15, p<0.001), secondary (β=1.09, p=0.002) and tertiary (β=2.24, p<0.001) education levels, and attitude towards diabetes (β=0.16, p<0.001). Conclusion: Very low diabetic numeracy was observed, which was predicted by increased age, low education and low attitude score towards managing diabetes. Hence promoting diabetic numeracy should be targeted among older adults with identified risks.
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@#Introduction: Premarital sexual behaviour remains an important sexual and reproductive health issue among adolescents in Malaysia. It is also a prohibited act and considered sinful among the Muslims community. This study aimed to identify the determinants of premarital sexual behaviour among the late adolescents age group in Pahang, Malaysia. Methods: An observational study was conducted among eligible late adolescents, which were recruited using probability sampling method. Only those aged 18 to19 years old, and previously attended the public secondary schools in Malaysia were included, with non-Malaysian, married and those who were absent during the data collection day were excluded. Data was collected using a valid and reliable set of questionnaires measuring the personal (demographic profile, knowledge and attitude), behavioural (premarital sexual behaviour and high-risk activities) and environmental (subjective norms and perceived parental communication) factors. Multiple logistic regression analysis was conducted to identify the determinants of premarital sexual behaviour. Results: A total of 390 adolescents aged 18 and 19 years old participated in this study, with 82.3% of respondents reported never had premarital sexual behaviour. Multiple logistic regression showed that the male and engagement in high-risk activities had higher odds in premarital sexual behaviour respectively (AOR =11.649, 95% CI: 3.615,37.536, p <0.001; AOR=19.224, 95% CI: 7.820,47.262, p <0.001). Conclusion: Male gender and engagement in high-risk activities remained important risk factors towards the ongoing concern related to premarital sexual behaviour among adolescents in Malaysia. Failure to address this issue should be explored and improve accordingly.
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@#Introduction: Population ageing brings along various crucial implications, with working beyond retirement age is one of the economics implications of ageing. Realizing the increasing demand and concern to accommodate older adults into the workforce, this review was conducted to develop better understanding on the factors associated with post-retirement employment among older adults aged 50 years and older. Methods: Using Scopus, ScienceDirect and PubMed databases, related articles between January 2017 and June 2021 were thoroughly searched using combination of keywords and screened according to the predetermined eligibility criteria. Post-retirement employment was defined as employment of older adults aged 50 years old and above beyond retirement age or re-employment of retired older adults, either from compulsory or voluntary retirement. All observational, qualitative, mixed methods and experimental studies were included in the screening process. The Crowe Critical Appraisal Tool (CCAT) was used to assess the quality of included articles. Results: A total of 12 articles included for review, with seven articles rated as high-quality. The review had successfully identified 10 factors associated with working beyond retirement age among older adults. Having good health status and being male gender were the commonest factors influencing the decision to work beyond retirement age, followed by level of education, financial commitment/ reasons, and work characteristics. Conclusion: The findings of this review provide a crucial insight and foundation towards addressing the unique needs of older workers in the employment policy.
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@#Introduction: The unprecedented COVID-19 pandemic has led to unavoidable new norms, including increasing demands for online learning. In view of the potential constraints to virtually learn anatomy among medical students, this study was conducted to identify the level of exposure towards online anatomy learning as well as the perceived constraints among medical students in a public university in Malaysia. Methods: A cross sectional study utilizing online survey was conducted during the movement control order (MCO) enforcement in Malaysia between March and October 2020 among all consented medical students at a public university in the Klang Valley area. The data was collected using a validated self-administered questionnaire which was distributed using Google Form application. Results: A total of 281 medical students consented and completed the online survey, with 94.3% students had low level of exposure towards online anatomy learning. Year of study and accessibility towards computing facilities and internet connection were significantly associated with online anatomy learning, with the non-clinical students are 19.9 (aOR= 19.888, B=2.990, 95%CI: 2.484-159.220) times more likely to have higher exposure towards online anatomy learning respectively. Conclusion: A very high proportion of medical students having low exposure towards online anatomy learning was observed in this study, which was predicted among the clinical students. Strengthening the utilization of online learning should be seriously considered in parallel with the new norms and the many uncertainties with COVID-19 pandemic, to ensure continuity of effective and quality learning.
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@#Introduction: Musical-based education has been linked with improved students’ academic performance and mental wellbeing. This study aimed to evaluate a musical-based anatomy learning module using the combination of music, choreographed movements and 3D anatomy illustrations on muscles of the hand. Methods: A 5-minute duration video on muscles of the hand was developed through series of discussions with expert panels to incorporate the three stated components, emphasizing on the use of catchy music and simple terms to assist memorization skills. A single arm quasi-experimental pilot study was conducted with pre- and post-intervention measurement of knowledge, perception, stress and happy index related to learning anatomy. A total of 157 medical students were recruited and exposed to a total of 20 minutes video duration over three days. The effectiveness of the intervention was investigated using paired t-test and was interpreted based on the pre- and post-measured exposure mean differences. Results: The newly developed musical-based anatomy learning module had effectively improved knowledge and happy index related to learning anatomy, with significant mean differences were observed on the total mean scores for knowledge (MD= 2.707, p< 0.001) and happy index (MD=3.256, p< 0.001), as well as significant reduction of the mean scores for the negative items for perceptions and stress. Conclusion: The improved knowledge and happy index related to learning anatomy reflecting the positive impact of music used in combination choreographed movements and 3D illustrations to strengthen memorizing skills of medical students as well as instilling positive mood.
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@#Introduction: Increasing prevalence of dementia and the associated caregiving burden are expected due to longer life expectancy. This review aimed to critically assess dementia-driven caregiving burden and the associated factors in Malaysia. Methods: A systematic search using several combinations of keywords was conducted in Ovid Medline, PubMed, Science Direct, ProQuest, and Ebscohost databases. The primary outcome was the score or level of caregiver burden, while the secondary outcome was the factors associated with such burden. The quality of the individual articles was assessed using the Newcastle–Ottawa Scale and the Joanna Briggs Institute checklist. Results: The systematic search resulted in seven studies being reviewed, consisting of six cross-sectional studies and one quasi-experimental study. Using the Zarit Burden Interview, two studies reported moderate caregiver burden with mean scores of 35.4 (15.08) and 46.0 (17.0). High levels of burden or strain were reported using the Caregiver Strain Index in other studies. The three main associated factors with burden identified in these studies were the presence of behavioural and psychological symptoms of dementia (BPSD), higher education level, and lack of social support. Conclusion: Moderate to severe caregiving burden level were found to be experienced by dementia caregivers in this country. High education, lack of support, as well as taking care of patient with BPSD being the most prominent factors associated with burden. Therefore, burden should be regularly assessed among the dementia caregivers especially among those with lack of social support and manage family members with BPSD, as to prevent adverse outcome from dementia caregiving.
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@#Introduction: Despite remarkable improvement in maternal health, anaemia during pregnancy remains a significant public health threat to Malaysian women. This study aimed to determine the prevalence, severity, and associated factors of anaemia in pregnancy among pregnant mothers in Seremban, Negeri Sembilan. Methods: A total of 482 pregnant mothers were recruited using cluster sampling. Data were collected using a validated and pre-tested self-administered questionnaire consisting of four sections, namely socio-demographic and socioeconomic details, obstetric history, nutritional factors, and iron supplementation status. In this study, anaemia in pregnancy was defined as haemoglobin (Hb) <11.0 g/dL, which was based on blood test taken during the first trimester. The data were analysed using IBM SPSS version 23.0. Multiple logistic regression analysis was conducted to determine the predictive model for anaemia during pregnancy among the respondents. Results: The prevalence of anaemia in pregnancy among the respondents was 22.0%, with 95.3% respondents mildly anaemic. Respondents with an intake of iron supplementation of once daily (AOR=0.191, 95% CI: 0.074- 0.914), more than once daily (AOR=0.149, 95%CI: 0.091-0.248), and low intake of seafood (AOR=0.320, 95% CI: 0.187-0.526) were less likely to develop anaemia during pregnancy. Conclusion: The findings revealed moderate level of anaemia in pregnancy, which was dominated by those in the mild category, with increased risk predicted among young mothers. Iron supplementation (once daily or more) and low intake of seafood protected mothers from developing anaemia during pregnancy.
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@#Aims: Children below five years have been the target of screen time guidelines. The adverse health outcomes associated with it require focusing on prime strategies for reducing screen time. The current study reviews parental intervention strategies to reduce screen time among preschool-aged children. Design: Systematic review. Data sources: A total of five databases of the Cochrane register of controlled trials, CINAHL, Medline PubMed, and Scopus databases were searched from May 1 to 31, 2020. Review Methods: The keywords of “screen time”, “television”, “video”, “computer”, “mobile device”, “hand phone”, “media use”, “preschool-aged children”, “interventions”, and “strategies” used for search. The inclusion criteria are limited to specific study populations, intervention, comparison and outcomes (PICOs), language, and published study types. The quality of articles was assessed using the Cochrane Risk of Bias (RoB) tool. Results: A total of six studies that met the inclusion criteria were further analysed. It showed that besides providing knowledge and awareness regarding screen time, restrictive practices, offering alternative activities to parents and removing the screen from the child’s bedroom were the most common strategies used by successful studies. The duration of intervention between 6-8weeks was sufficient to observe screen time reduction, while faceto-face methods dominated the mode of delivery. Increasing parental self-efficacy, listing outcome expectations, and reinforcement strategies targeting both the parents and their home environment were beneficial in reducing screen time. Conclusion: Future screen time reduction studies could benefit from incorporating the above approaches for screen time reduction intervention among preschool children.
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@#Introduction: Music has been widely used in teaching and learning due to its observed positive effects. This review aimed to identify the beneficial impacts of music utilization in medical education. Methods: Using four established databases; Scopus, ScienceDirect, JSTOR and PubMed, exhaustive searched of related articles were performed for articles published between January 2010 and January 2020 using combination of keywords. Screening of titles and abstracts were conducted, with removal of duplicates. Results: Five full text articles were finally reviewed, of which one cross-sectional, three intervention and a qualitative studies. Consensus between authors had successfully identified three themes, which were positive effect of music on the well-being and performance of the medical students, as well as improved patient-doctor communication skills. Conclusion: The findings of the review confirmed the positive effects of music utilization on the well-being and performance of medical students, as well as on patient-doctor communication skills.
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@#Introduction: The universal truth surrounding the benefits of exclusive breastfeeding has seldom been disputed. However, the success of exclusive breastfeeding has not been guaranteed despite the availability of numerous interventions. The objective of this study is to review the effectiveness of various breastfeeding promotion education delivery methods in promoting exclusive breastfeeding. Design: A systematic search of leading databases was conducted for scholarly peer-reviewed randomized trials published between January 2014 and May 2019. Data sources: Eight articles were identified as relevant, all were published in English and assessed exclusive breastfeeding. Review Methods: Articles were analyzed for overall quality of evidence using the PEDro Scale. Results: A significant increase in the duration of exclusive breastfeeding was found in seven of the eight studies, with three interventions using combination verbal and written delivery methods and four interventions delivered verbally. Conclusion: Verbal delivery method was the most effective method and many studies use combination method of verbal and written to achieve the objective of their studies.
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@#Introduction: The study aims to determine the correlation of the Hearing Handicap Inventory for Elderly Screening (HHIE-S) questionnaire with the pure tone audiometry (PTA) in the Malaysian older adult population. Methods: This cross-sectional study took a random sample of adults ≥60 years in a tertiary hospital. A total of 202 participants completed both the HHIE-S questionnaire and the PTA test. The total HHIE-S score and the PTA result were explored for the correlation using a Kruskal–Wallis and the validity using the receiver operating characteristic curve. Results: A Kruskal–Wallis analysis indicated a significant correlation for the level of hearing impairment (r =.704, p < 0.001) between the HHIE-S score and the PTA result. Comparison between HHIE-S score of 8 and the PTA >25db results gave sensitivity: 87.9%, specificity: 78.4%, positive predictive value: 80.3%, and negative predictive value: 86.6%. Conclusion: This study suggests that the HHIE-S questionnaire is a good and valid screening instrument for hearing impairment detection in the Malaysian older adult population.
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@#Introduction: Measuring students’ perception of anatomy education environment provides important information for quality assurance and improvement in anatomy education. This study evaluated medical students’ perception of anatomy education environment in Universiti Putra Malaysia by using a validated tool, the Anatomy Education Environment Measurement Inventory (AEEMI). Methods: A cross-sectional study was conducted in the Faculty of Medicine and Health Sciences, Universiti Putra Malaysia between August and September 2020. Stratified random sampling was used to ensure balance sampling of two sociodemographic parameters: gender and study phase. The AEEMI was distributed online to 384 consenting students who rate their perceptions on the six factors of AEEMI: anatomy teachers and instructor, importance of anatomy knowledge, intrinsic interest in learning anatomy, anatomy learning resources, students’ effort to learn anatomy and quality of histology learning facilities, using a five-point Likert scale. The average score of each factor was calculated and compared between male and female respondents, and between preclinical and clinical ones, using SPSS version 25. Results: All factors was rated to be positive with scores > 4.00, except for histology practical facilities that was perceived as an area for improvement (score 3 – 4.99). There was no significant difference of the scores between male and female respondents, and between preclinical and clinical ones. The scores were found to be consistent across gender and study phase. Conclusion: Anatomy education environment in UPM are positive and caters for the differences in gender and study phase. Nevertheless, the histology practical facilities may require further attention for improvement.
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@#Introduction: Chronic musculoskeletal pain is a common disabling condition among older adults with the majority, remain undertreated. This study aimed to determine the uptake of non-pharmacological treatment for chronic musculoskeletal pain among older adults and the associated factors. Methods: A stratified sampling proportionate to size with individual clinics as the strata were used to recruit 276 respondents from six public health clinics in Petaling district, one of the most aged districts in the state of Selangor, Malaysia. Based on the proportion calculated, eligible older adults were selected by systematic random sampling from the registration list. Data was collected using a pre-tested and validated questionnaire through a face-to-face interview with respondents. The questionnaire comprised of seven sections, namely, socio-demographic, comorbidity, depression, pain severity, treatment options, attitude towards chronic pain and chronic musculoskeletal pain. Inferential analysis was conducted using ChiSquare (X2) and Fisher’s Exact Tests. The P value of < 0.05 regarded as statistically significant. Results: A total of 242 (87.7%) of the respondents had chronic musculoskeletal pain, in which 235 (85.1%) were treated with non-pharmacological treatments. The commonly used non-pharmacological treatments were exercise (67.8%), biological-based therapies (40.9%) and massage (33.7%). The uptake of non-pharmacological treatment for chronic musculoskeletal pain among older adults was significantly associated with the presence of diabetes. Conclusion: The findings revealed the remarkably high uptake of non-pharmacological treatment among older adults who experienced chronic musculoskeletal pain which was significantly associated with diabetes and the presence of other diseases like high blood pressure, osteoarthritis, back pain and rheumatic arthritis.
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@#The American College of Obstetricians and Gynaecologists (ACOG), US Department of Health and Human Services (HHS), and American College of Sports Medicine (ACSM) recommend that all pregnancies with medical clearance should engage in moderate-intensity physical activity (PA) at least 150 minutes per week. However, most of them are physically inactive. Thus, this article aims to identify predictors of physical inactivity among antenatal women. Four databases were used to search relevant articles using PICO strategy systematically. The screening began with examining titles, abstracts, and keywords, followed by scrutinizing and assessing full articles. Finally, a total of five studies were included for the data extraction, and the predictors are sociodemographic (trimesters, parity, marital status, and pre-pregnancy PA status), socioeconomic (household income), lifestyle (smoking and eating unhealthy diet) and health-related factors (multiple pregnancies, received fertility treatment, being unwell, musculoskeletal pain, symptom of early pregnancy and uterine contraction). All these predictors provide crucial information for the success of future physical activity intervention.
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@#Postpartum depression is a depressive episode that can start at any point during the first year after childbirth. There are several tools that can be used for PPD screening. The need to define a predictive tool that is clinically useful and has acceptable sensitivity and sensitivity is important especially to be used in the primary care setting. This systematic review investigates the evidence of the sensitivity and specificity of screening tools used for PPD screening. The Standard for Reporting of Diagnostic Accuracies (STARD) guidelines were used to conduct the review as a basis for our methodology. PubMed, ScienceDirect and Springerlink databases between 2007 until 2017 were comprehensively searched EPDS and BDI instrument has sensitivity of more than 80% but findings for specificity was inconclusive. The heterogeneity across studies could be the result of methodological differences in validation of the instruments. In addition, these studies were conducted across continents and settings with different cultures, languages and resources. We have identified 5 different instruments used to screen for postpartum depression. The EPDS was the most validated instrument in the review and we found that EPDS and BDI have higher accuracy to screen postpartum depression because the sensitivity reported were more than 80%.
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Abstract@#Women with gestational diabetes mellitus (GDM) during their pregnancy have a greater risk of developing overt diabetes mellitus and dysglycemia (prediabetes, impaired glucose tolerance or impaired fasting glucose) later in future, compared to mothers with normal pregnancy. Postpartum screening is crucial for early identification of type 2 diabetes (T2DM) in women with GDM. Nevertheless, despite various strategies, its rate remains low. A systematic review using databases of PubMed/Medline, Science Direct and CINAHL from 2008 to 2018, was conducted to identify the factors influencing the attendance of postpartum diabetes screening. Open access English articles, focusing on observational studies were reviewed. Primary screening of titles and abstracts of 91 articles were done, secondary screening of 31 articles resulted in 6 articles, included in this manuscript. Various factors identified to be associated with the attendance to postpartum diabetes screening, which are age, education, ethnicity, some obstetric factors like multiparty, and history of insulin usage previously. Many women fail to be screened for diabetes during the postpartum period, and this delays T2DM diagnosis, which in turn gives rise to various complications. Further research that considers these factors is necessary for developing interventions to improve postpartum T2DM screening for mothers with GDM during their pregnancy
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Abstract@#Introduction: Mental problems have become increasingly important public health issue globally. This study aimed to determine the prevalence and factors associated with depression, anxiety, and stress among medical students in a public university in Malaysia. Methods: A total of 447 medical students were sampled by stratified proportionate to size sampling according to year of study. Validated self-administered questionnaire was used consisted of 5 sections namely, socio-demographic factors, social support received from family members and friends, presence of co-morbidity, previous history of resolved mental problem and Depression Anxiety Stress Scale DASS- 21. Data was analysed by using the statistical computer software ‘Statistical Package for Social Science (SPSS)’ version 22 involving three levels of analysis (descriptive, chi square and multiple logistic regression). Results: Only 31.1% of the respondents were found to be depressed with mainly within the moderately depressed category, 53.9% had anxiety and 26% were having stress. Perceived social support received from family members was a significant predicting factor for depression, anxiety and stress. Conclusion: High proportion of depression, anxiety and level of stress among medical students were found. The stressful medical program is putting medical students at risk of mental problems. Parents and family members should be encouraged to be more involved in any related programs to promote better mental health and well-being of medical students.
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Abstract@#Introduction: Malaysia is known for its shy and prudent community that indirectly causing the stigma and taboos related to later life sexuality. This study aimed to explore the sexual desire and satisfaction in later life among the Malay ethnic elderly in Malaysia who were living in the urban area, where discussions about sexual issues are perceived less sensitive and stigmatized. Methods: A total of 234 eligible elderly were approached but only 160 older people completed the questionnaire, sampled using multistage cluster sampling method. Face-to-face interviews were conducted using questionnaires consisted of sociodemographic characteristics, cognitive function, perceived health status, presence of chronic illnesses, smoking history, disability, perceived sexual problems, sexual desire and satisfaction. Multiple logistic regression was conducted to determine the associated factors for sexual desire and satisfaction, respectively. All tests significant level was set at 0.05. Results: Majority of the respondents were having sexual desire (53.8%) and not satisfied with their sexual life (51.3%), with elderly women (55.7%) experienced more sexual problems compared to men. The results showed male, being married, good perceived health and absence of arthritis were the significant contributing factors of better sexual desire. Having good health perception, being married and absence of sexual problems were significantly predicting better sexual satisfaction. Conclusion: The study emphasized the multifactorial aspects contributed towards the sexual dissatisfaction among the respondents despite having desire for sexual activity. Focus should be given to elderly women who tend to have multiple chronic diseases and more likely a widow due to their longer life expectancy.
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Abstract@#Introduction: The increasing prevalence of depression has been a major public health concern. Being a marginalized population put the inmates at risk of depression. The main objective of this study was to identify the determinants of depression among the inmates according to the biopsychosocial model. Methods: A cross sectional study involving 460 male inmates was conducted at a medium security prison in Seremban. Only Malaysian adult prisoners who have been convicted and had spent a minimum of three months in the prison were eligible for the study. They were selected using the probability proportional to size using stratified random sampling. Data was collected using validated and pre-tested questionnaire by face-to-face interviews, with depression was measured using the Center for Epidemiologic Studies Depression (CES-D) Scale. The data were analyzed using IBM SPSS version 22 with a p-value less than 0.05 was considered statistically significant. Results: The results showed prevalence of depression were 40.70% (95% CI: 36.21-45.19) with its development being predicted by presence of communicable disease (AOR=2.145, 95% CI: 1.123-4.095), history of childhood abuse (AOR=1.762, 95% CI: 1.045-2.972), sentences of more than 5 years (AOR=3.801, 95% CI: 1.529-9.450), being non-Muslims (AOR=2.261, 95% CI: 1.461-3.497) and perceived stress (AOR=4.007, 95% CI= 2.610-6.151). Conclusions: This study revealed an alarmingly high prevalence of depression among the male inmates, with stress being the strongest risk factor. Reintegration of the prisoners into the community should be considered as part of the rehabilitation program to ensure continuation of psychiatric care and reduce relapsing.