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@#Introduction: Food security can be defined as the availability of and accessibility to food, acquired in an acceptable means at any given time and place in a way that could maintain health and wellbeing. One critical dimension of food security is continued access to adequate food. To measure this dimension, the Food and Agriculture Organization (FAO) developed the latest measurement tool, namely the Food Insecurity Experience Scale (FIES), the first instrument to measure people who experience food insecurity globally. This study aimed to validate the construct validity and reliability of the Malay version of FIES (M-FIES) for Malaysians. Methods: This cross-sectional study was conducted among 145 households in Kuantan, Pahang. Rasch analysis was used to analyse the construct validity of FIES. Results: FIES met the Rasch model assumptions with all items having an infit value of between 0.7- 1.3 and an outfit value of <2.0. The item and person reliability were 0.97 and 0.71, respectively; while the item and person separation were 5.59 and 1.58, respectively. The FIES item severity indicated that the items “few food”, “healthy”, “skipped”, “ate less”, and “runout” were disordered. Conclusion: The M-FIES is a valid and reliable measurement tool for the food insecurity situation among households based on its construct validity assessed using the Rasch model. Furthermore, the severity of item in M-FIES was different in terms of order from the original FIES, suggesting that the same items may be interpreted differently due to cultural or societal differences.
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@#Introduction: Food insecurity has a complex and multifaceted concept and definition, thus assessing it has been an ongoing challenge for researchers, health practitioners, and policy makers. Previous studies reported inconsistent findings on the prevalence and severity of food insecurity, depending on the measuring tools used. To overcome this limitation, this study aimed to translate and validate the Food Insecurity Experience Scale (FIES) for Malaysians, which has been used as a standard measurement by Food and Agriculture Organization (FAO). Methods: Two forward and backward translations involving experts in food insecurity studies and experts in language were done, as well as the pre-test and cognitive interview stipulated in World Health Organization (WHO) translation guidelines. Content and face validity were conducted as part of the validation process. Content Validity Index (CVI) was done to analyse content validity. Results: The harmonised Malay version of FIES was produced with 1.0 CVI, which was above the 0.8 criteria. Face validity showed good understandability and clarity of FIES. Conclusion: The translated Malay version of FIES had good acceptability, as well as good face validity when tested among the target audience. Thus, a full validation study of the Malay version FIES should be done before it is widely used to measure food insecurity in the population, specifically the Malaysian population.
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@#Introduction: Electronic cigarettes (ECs) are new devices that have been accepted widely by both smokers and non-smokers. However, the evidence on EC used in Malaysia is scarce. The objective of thisstudy was to determine the prevalence of EC use and the socio-demographic and smoking characteristicsassociated with current EC use among Malaysian current and ex-smokers. Methods: This was a sub-analysis of data from a cross-sectional, national-population- based EC study conducted from May to June in 2016 in Malaysia. A detailed description of the sampling methods can be found in the National E-cigarette Survey (NECS) 2016 report. Briefly, data were obtained from 1396 individuals who had ever been smokers, i.e., 957 (68.6%) current smokers and 439 (31.4%) ex-smokers. Results: Current EC use was found predominantly among current smokers (8.0%) as compared with ex-smokers (4.3%). Among current smokers, the main reasons given for smoking ECs were wanting to try it (44.7%), followed by intention to quit tobacco smoking (15.8%) and to reduce tobacco smoking (10.5%). Using multiple logistic regression analysis, we found that among current smokers, current EC users were more likely to be younger, i.e., 18-44 years (aOR= 4.83, 95% CI= 1.97-11.86, p=0.001), urban residents (aOR= 1.89, 95% CI= 1.15-3.11, p=0.012), single/ divorced/ widowed (aOR= 2.11, 95% CI= 1.24-3.61, p=0.006) and students (aOR= 2.25, 95% CI= 1.01-5.01, p=0.048). Among exsmokers, only younger respondents (18-44 years old) was reported as being more likely to be current EC users (aOR= 3.81, 95% CI= 1.14-12.76, p=0.030). Conclusion: This study showed that currently using and ever having used ECs were more prevalent among current smokers. The reasons given for initiating EC use among current smokers were mainly wanting to try it, followed by intention to quit and to reduce tobacco smoking. Current EC use appears to be common among current smokers who are younger, urban residents, single/divorced/widowed and students. Therefore, EC cessation intervention strategies and policies should target these high-prevalence groups
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@#Introduction: Electronic cigarettes (ECs) are new devices that have been accepted widely by both smokers and non-smokers. However, the evidence on EC used in Malaysia is scarce. The objective of thisstudy was to determine the prevalence of EC use and the socio-demographic and smoking characteristicsassociated with current EC use among Malaysian current and ex-smokers. Methods: This was a sub-analysis of data from a cross-sectional, national-population- based EC study conducted from May to June in 2016 in Malaysia. A detailed description of the sampling methods can be found in the National E-cigarette Survey (NECS) 2016 report. Briefly, data were obtained from 1396 individuals who had ever been smokers, i.e., 957 (68.6%) current smokers and 439 (31.4%) ex-smokers. Results: Current EC use was found predominantly among current smokers (8.0%) as compared with ex-smokers (4.3%). Among current smokers, the main reasons given for smoking ECs were wanting to try it (44.7%), followed by intention to quit tobacco smoking (15.8%) and to reduce tobacco smoking (10.5%). Using multiple logistic regression analysis, we found that among current smokers, current EC users were more likely to be younger, i.e., 18-44 years (aOR= 4.83, 95% CI= 1.97-11.86, p=0.001), urban residents (aOR= 1.89, 95% CI= 1.15-3.11, p=0.012), single/ divorced/ widowed (aOR= 2.11, 95% CI= 1.24-3.61, p=0.006) and students (aOR= 2.25, 95% CI= 1.01-5.01, p=0.048). Among exsmokers, only younger respondents (18-44 years old) was reported as being more likely to be current EC users (aOR= 3.81, 95% CI= 1.14-12.76, p=0.030). Conclusion: This study showed that currently using and ever having used ECs were more prevalent among current smokers. The reasons given for initiating EC use among current smokers were mainly wanting to try it, followed by intention to quit and to reduce tobacco smoking. Current EC use appears to be common among current smokers who are younger, urban residents, single/divorced/widowed and students. Therefore, EC cessation intervention strategies and policies should target these high-prevalence groups
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<p><b>INTRODUCTION</b>Diabetes mellitus (DM) is the most common cause of amputations in Malaysia. This study aimed to identify the predictive factors for major lower limb amputation among patients with type 2 DM (T2DM) who were admitted to a hospital, in order to reduce its likelihood.</p><p><b>METHODS</b>This cross-sectional study involved 218 patients with T2DM who were admitted to Hospital Tengku Ampuan Afzan, Kuantan, Malaysia, for diabetic foot problems from June 2011 to July 2012. A form was developed to document the patients' profiles, comorbidities, complications, investigations, treatment and clinical outcomes. The predictors for major lower limb amputations were determined using univariate and stepwise logistic regression analysis.</p><p><b>RESULTS</b>A total of 31 patients underwent major lower limb amputations (25 transtibial, 6 transfemoral). The following factors were found to be associated with the incidence of major lower limb amputations: T2DM duration ≥ 10 years, diabetic neuropathy, diabetic nephropathy, presentation with gangrene, diabetic foot conditions of Wagner grade 4 or 5, and necrotising fasciitis. Patients who underwent major amputations had significantly lower haemoglobin and albumin levels, and higher total white blood cell counts, erythrocyte sedimentation rates, and C-reactive protein, urea and creatinine levels. However, only T2DM duration ≥ 10 years, positive bacterial culture and albumin levels were significant on stepwise logistic regression analysis.</p><p><b>CONCLUSION</b>T2DM duration ≥ 10 years, positive bacterial culture and low albumin levels were found to be significant predictive factors for major lower limb amputation among patients with T2DM admitted for diabetic foot problems.</p>