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Background: COVID-19 pandemic still pose a substantial threat worldwide despite increasing vaccine availability. Patients with haematological malignancies have been shown to have increased risk of contracting COVID-19 and are more susceptible to develop severe illness from SARS-CoV- 2 infection. The immune response to vaccines is impaired in patients with haematological malignancy due to underlying disease or antineoplastic therapies. The monoclonal-antibody combination, Evusheld is composed of tixagevimab and cilgavimab, two neutralising antibodies against SARS-CoV- 2. It has been shown to be safe and have efficacy for the prevention of COVID-19. Our aim of study is to describe the incidence and outcome of breakthrough COVID-19 infection among patients who received Evusheld in our centre and analyse the factors that possibly increase the risk of breakthrough infection. Material(s) and Method(s): A retrospective review of all adult patients with haematological malignancy who received tixagevimab/ cilgavimab 150/150 mg injection in Hospital Pulau Pinang from 1 July 2022 to 31 August 2022 with a follow-up period to 30 November 2022 was conducted. Demographic data, clinical characteristics and outcome will be retrieved from patient's medical records. Data were analysed using Statistical Package for Social Sciences software (version 21.0). Result(s): A total of 96 patients (50 males and 46 females) received tixagevimab/cilgavimab injection during the study period with a median age of 61 years (range 19-82). Majority of them were diagnosed with multiple myeloma (42.7%), followed by lymphoma (33.3%) and leukaemia (24%). One third of them had history of therapy with monoclonal antibody and 20% had haematopoietic stem cell transplantation. No major adverse effects of tixagevimab/cilgavimab injection were noted among the study population. Of the 12 patients (12.5%) who had COVID-19 infection, all of them had mild infection;three were asymptomatic and six patients received Paxlovid antiviral therapy. The median time from tixagevimab/cilgavimab to the onset of COVID-19 infection was 35 days (range 5-97 days). The mean age of patients with breakthrough COVID-19 infection were older compared to those without breakthrough infection but was not statistically significant. The incidence of breakthrough COVID-19 infection was not affected by type of haematological malignancy, history of monoclonal antibody therapy or COVID-19 vaccination. Discussion and Conclusion(s): Our findings showed that tixagevimab/cilgavimab was safe and effective in preventing COVID-19- related morbidity and mortality among patients with haematological malignancy during the study period. However, the limitation is the lack of access to whole genome sequencing for detection of resistant variants for breakthrough infections.
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Penang is often known as a multilingual and multiethnic city in Malaysia. Its diversity of growing population based on its pre-colonial history and evidence of different ethnic groups living together has resulted in an emergence of a variety of languages today. Henceforth, this chapter embarks on an examination of languages that appear on public health signs in Penang. Conceptualising the study within the framework of language planning and policy, it dissects the languages observed on COVID-19 related signs that were designed by the multiple layers of agency in Penang. The findings are hierarchically organised as follows: (a) state government, (b) district government, (c) large enterprise, and (d) small enterprise. Although a trend of dynamism is reflected in the findings, they still mark social inequality for people's access to public advice related to the COVID-19 outbreak in Penang. The chapter concludes that the linguistic landscape of Penang is a mosaic closely connected to the social and political processes and urges for an increased use of community languages to safeguard vulnerable groups in Penang and across the globe. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
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Introduction: Vaccination against COVID-19 can help prevent serious complications and death. The World Health Organization (WHO) Strategic Advisory Groups of Experts (SAGE) collated few evidences that vaccine hesitancy was due to socio-psychological factors like decreased trust on the safety or the effectiveness of the vaccines. In Malaysia, the main challenge was to ensure the broadest possible acceptance of COVID-19 vaccinations. This study aimed to assess the association between complete vaccination status with health factors and perception towards COVID-19 vaccine uptake amongst people living in Seberang Perai, Penang. Method(s): A cross-sectional study among 410 adults aged >=18 years old was carried out using convenience sampling technique in September 2021. Validated items related to vaccine perceptions were adapted from previous literature. Baseline vaccination data were obtained from the vaccination centre at Hospital Seberang Jaya. Descriptive and inferential statistics were conducted using SPSS version 22.0. Result(s): The mean age of the respondents was 31 (standard deviation (SD) +/- 10) years. A total of 317 respondents were women. More than half of them, 219 (53.7%) were tertiary educated. Total of 147 respondents completed vaccination and there was a significant difference between gender and age, p<0.001 and p=0.013, respectively. There was also a significant difference between vaccination status and perceptions on COVID-19 vaccines to be safe and effective (OR: 4.8, 95% CI: 1.2, 18.2, p=0.013). Conclusion(s): There were no associations between vaccination and health status, while those perceived COVID-19 vaccine to be safe and effective were more likely to be vaccinated as compared to those who did not.
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Introduction: Some healthcare staff observed an increase in their blood pressures (BP) after the SARS-CoV-2 vaccination, thus Hospital Pulau Pinang (HPP) began collecting vital signs during the second dose of the vaccination. We aimed to compare the changes in BP after vaccination. Method(s): This was an observational study using secondary data collected as part of the SARSCoV- 2 vaccination in HPP. Changes in BP immediately after and 15-30 minutes post vaccination were compared with baseline using paired t-tests. Result(s): A total of 4906 staffs received 2 doses of the BNT162b2 mRNA COVID-19 vaccine. Most subjects did not report any adverse effects. Common adverse effects were redness, pain or swelling at the injection site, tiredness, fever, chills, headache and myalgia. Mean pre-vaccination systolic and diastolic BPs were 130.1 (SD 17.38) mmHg and 80.2 (SD 11.62) mmHg, respectively. BP was increased in more than half of the subjects immediately and 15-30 minutes post vaccination however, the mean increases were small. Among those with hypertension (n=244), only increases in diastolic blood pressure were significant. Overall, 58 (1.02%) were admitted into the observation room either due to hypertensive urgency or complaints of giddiness. Conclusion(s): Overall, the increases were relatively small and may not prevail over the benefits offered by vaccination. However, monitoring of BP may be warranted to prevent any unexpected serious events.
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Penang Hill, one of Malaysia's most well-known natural and cultural tourist sites, is a popular destination for both domestic and foreign visitors. The study's objective was to explore the perspectives of key stakeholders regarding ecotourism sustainability and stakeholder management. In-depth semi-structured interviews were conducted with three key stakeholders, and content analysis was done to explore the key findings. It was observed that PHC engages stakeholders through meetings, workshops, and seminars and tries to understand their interests for better management. Keen interests of stakeholders were observed towards activities that generate monetary rewards. It was also noted that all stakeholders showed great interest in the environmental conservation of the destination. The study concludes by stating that even though Penang Hill management is on the right path and trying hard to achieve ecotourism sustainability, stakeholders still need more support from the management authority to work towards the destination's sustainability, especially in this Covid-19 pandemic. The findings have ramifications for stakeholder management to implement long-term ecotourism in the destination © 2022, e-Review of Tourism Research.All Rights Reserved.
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This study is conducted to investigate the effectiveness and readiness of teaching and learning among students during the pandemic (COVID-19) towards the online learning among hospitality and tourism students. A quantitative method was employed and students from the Faculty of Hotel and Tourism Management Penang Campus were chosen as the target sample. The sample size for this study was 430 and a total of 360 questionnaires were successfully collected with the return rate of 83.72%. Descriptive analysis was used to interpret the demographic data, Pearson Correlation analysis was employed to examine the correlation among variables, and multiple regression analysis was used to measure the overall relationship between independent and dependent variables. From these analyses, the three (3) variables (social presence, cognitive presence, and teaching presence) were found to have positive relationships with a student's learning experience. Overall, this study is important to fellow academicians, academic researchers, and practitioners in improving their methods of teaching and learning, assisting the students, and strengthening their teaching techniques in online learning.
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PurposeThis research presents a comparative perception study towards rejuvenated, community-driven shophouses in George Town, Penang.Design/methodology/approachIt captures the opinions of two distinct age groups by utilizing a mixed-methods approach encompassing quantitative (main) and qualitative (supporting) research to obtain a dynamic understanding of perceptions between younger and older residents in the city and how these impact the long-term sustainability of heritage conservation efforts. The distribution of questionnaires to residents of Penang was the primary data collection method, with the structure of the questionnaires supported by recent academic literature and past perceptional research studies about built heritage.FindingsThe four main findings from the study are therefore as follows: 1. Both age groups have a similar, positive perception towards the tangible, physical elements of rejuvenated shophouses. 2. Intangible, functional factors play an equal or stronger role in influencing people and their attitude towards public participation and overall "Sense of Place”. 3. The pessimistic "Sense of Place” responses from the "Older” group reflect an equally pessimistic attitude towards intangible, functional factors surrounding rejuvenated shophouses. 4. Youth-led changes to George Town's heritage shophouses are degrading the "sense of place” connecting the older generation to the city.Originality/valueThe study can serve as a guide for the development of more inclusive and socially sustainable conservation and adaptive re-use policies for safeguarding the heritage identity and value of shophouses for current and future generations to experience in a post-COVID world.
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In the present paper, we show how uncertainty emanating from fluctuations in economic uncertainty, news-based uncertainty, and geopolitical risks affect the number of containers exported from Thailand via Penang Port, Malaysia. Our sample extends from January 2009 to May 2020 from three main entry points in the Northern Peninsular Malaysia–Thailand Border: Padang Besar, Surat Thani, and Bukit Kayu Hitam. Two modes of transportation of containers are mainly used for export purposes, namely, road and rai. This study examines the nonlinear effect of uncertainty on trade by employing a two-regime Markov regime-switching approach. The empirical results show that, overall, uncertainty significantly affects the movement of containers in the high-uncertainty regime. Therefore, small ports must continue to diversify their client base to cushion the impact of fluctuations in global trade due to uncertainty.
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Purpose - This research presents a comparative perception study towards rejuvenated, community-driven shophouses in George Town, Penang. Design/methodology/approach - It captures the opinions of two distinct age groups by utilizing a mixed-methods approach encompassing quantitative (main) and qualitative (supporting) research to obtain a dynamic understanding of perceptions between younger and older residents in the city and how these impact the long-term sustainability of heritage conservation efforts. The distribution of questionnaires to residents of Penang was the primary data collection method, with the structure of the questionnaires supported by recent academic literature and past perceptional research studies about built heritage. Findings - The four main findings from the study are therefore as follows: 1. Both age groups have a similar, positive perception towards the tangible, physical elements of rejuvenated shophouses. 2. Intangible, functional factors play an equal or stronger role in influencing people and their attitude towards public participation and overall "Sense of Place". 3. The pessimistic "Sense of Place" responses from the "Older" group reflect an equally pessimistic attitude towards intangible, functional factors surrounding rejuvenated shophouses. 4. Youth-led changes to George Town's heritage shophouses are degrading the "sense of place" connecting the older generation to the city. Originality/value - The study can serve as a guide for the development of more inclusive and socially sustainable conservation and adaptive re-use policies for safeguarding the heritage identity and value of shophouses for current and future generations to experience in a post-COVID world.
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Background: The integration of teleconsultation into health care systems as a complement to existing approaches to care is growing rapidly. There is, however, limited information on the extent of its implementation across low- and middle-income countries. Objective: The aim of this study was to determine the availability and the extent of teleconsultation in Malaysian primary care clinics. Methods: A cross-sectional study of public primary care clinics in Malaysia was conducted between November 2020 and December 2020. All clinics in Malaysia that see more than 300 daily patients were recruited. A web-based, self-administered questionnaire including questions on availability of the service, whether it uses video or telephone, and the types of services it provides was distributed to the medical officer in charge of each clinic. Results: In total, 97.6% (249/255) of the clinics responded. Out of these clinics, 45.8% (114/249) provided teleconsultation. A majority of the clinics providing consultation (69/114, 60.5%) provided only telephone consultation, while 24.6% (28/114) of the clinics offered video and telephone consultation, and 14.9% (17/114) offered only video consultation. Eighty percent (92/114) of the clinics were located in urban areas. A breakdown by state showed that 17.5% (20/114) and 16.7% (19/114) of the clinics were from two larger states;other states comprised less than 10% each (range 7-9/114). For the clinics providing video consultation, funding for the service came mostly (42/45, 93%) from the Ministry of Health. Conversely, nearly 1 out of 4 (23/97) clinics that provided telephone consultation funded the service either from donations or through self-funding. Most of the clinics provided teleconsultation for diabetes and hypertension. Less than 50% of the clinics with teleconsultation used it for follow up with allied health care providers or pharmacists (video consultation, 20/45;telephone consultation, 36/97). Conclusions: Our findings show that telephone consultation is more widely used than video consultation, despite a quarter of its funding being self-subsidized or obtained through donations. Also, teleconsultation was less utilized by allied health care providers and pharmacists. Plans for the expansion of teleconsultation in Malaysian primary health care should take into consideration these findings to ensure a better and more cost-effective implementation of the service.
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Systematic disinfection of the stethoscope diaphragm is required to ensure that it does not act as a vector for cross-transmission of health-related diseases. Thus, an antimicrobial latex film could be used as a cover to inhibit pathogenic bacteria from growing on its surface. The aim of this work is to determine the antimicrobial activity and mechanical properties of antimicrobial natural rubber (NR) latex films with different types of antimicrobial agents (mangosteen peel powder (MPP), zinc oxide nanoparticles (ZnO NP), and povidone-iodine (PVP-I)). The antimicrobial loading was varied from 0.5, to 1.0, and 2.0 phr to monitor the effective inhibition of Gram-negative bacteria and fungi growth. For MPP and PVP-I antimicrobial agents, a loading of 2.0 phr showed good antimicrobial efficacy with the largest zone of inhibition. Simultaneously, ZnO NP demonstrated excellent antimicrobial activity at low concentrations. The addition of antimicrobial agents shows a comparable effect on the mechanical properties of NR latex films. In comparison to control NR latex film (29.41 MPa, 48.49 N/mm), antimicrobial-filled films have significantly greater tensile and tear strengths (MPP (33.84 MPa, 65.21 N/mm), ZnO NP (31.79 MPa, 52.77 N/mm), and PVP-I (33.25 MPa, 50.75 N/mm). In conclusion, the addition of antimicrobial agents, particularly ZnO NP, can be a better choice for NR latex films because they will serve as both an activator and an antimicrobial. In a clinical context, with regard to frequently used medical equipment such as a stethoscope, such an approach offers significant promise to aid infection control.
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Así, la crisis que atravesamos hoy en día por el advenimiento de la pandemia por la Covid-19 en el 2020, nos ha llevado a replantear de manera significativa nuestros métodos y sistemas de enseñanza en el ámbito virtual. Entre los tres, hicimos una colaboración en la que se planteó un pequeño proyecto independiente;es decir, no estaba ligado a las instituciones donde laboramos, simplemente era una colaboración entre amigos docentes llevada al aula de nuestras respectivas instituciones, las cuales nos dieron facilidades para implementar este proyecto, y en el que nuestros alumnos participaron en un intercambio cultural por cuatro semanas, aprovechando las ventajas de un entorno virtual. La neutralidad del ambiente virtual La institución educativa donde trabaja mi amigo Carlos se ubica en Huatusco, Veracruz, en México, y pertenece a la educación media superior y técnica de la educación pública (institución 1, ver cuadro 1), con enfoque en las competencias laborales para responder a las demandas de desarrollo socioeconómico local y nacional. Quizás la mayor diferencia que puede observarse es que en la institución 2, en Penang, la instrucción se imparte completamente en inglés, mientras que en la institución 3, en San Luis Potosí, la instrucción se da en español y sólo se lleva el idioma inglés como parte del currículum.