A Review of Lung Cancer Research in Malaysia.

Lung cancer is a major cause of mortality and morbidity in Malaysia and worldwide. This paper reviews all research and publications on lung cancer in Malaysia published between 2000-2015. 89 papers were identified, of which 64 papers were selected and reviewed on the basis of their relevance to the review. The epidemiology, risk factors, cell types, clinical presentation, diagnosis, treatment, outcomes, prevention, and the social impact of lung cancer in the country are reviewed and summarized. The clinical relevance of the studies done in the country are discussed along with recommendations for future research.

Detection of non-adherent behaviour in early psychosis.

OBJECTIVE: Adherence to antipsychotic treatment is an important aspect of the long-term management of schizophrenia. The evaluation of adherence is often difficult in the clinical setting. This study compared patient self-reporting and clinician judgment of adherence behaviour in patients with early and chronic schizophrenia. METHOD: Clinician-rated questionnaires and parallel patient self-rated questionnaires were administered to 229 patients with early schizophrenia (illness duration < 5 years) and 255 patients with chronic schizophrenia. Items in the questionnaires addressed two forms of adherence behaviour (forgetting to take medication and deciding to stop medication) as well as attitudes toward medication. RESULTS: Significant non-adherent behaviour was reported by patients, particularly in the early schizophrenia group. Non-adherent behaviour was related to feelings of embarrassment about taking medication. Both non-adherence and embarrassment were under-recognized by clinicians. Starting from a prior probability of 0.24, knowledge of the patients' attitudes increased the posterior probability to 0.33, whereas clinicians' detection of non-adherence (deciding to stop medication) improved the posterior probability to 0.65. When both clinicians' evaluations and patients' attitudes were known, the posterior probability improved to 0.68. CONCLUSION: Non-adherence is a widespread phenomenon in early schizophrenia. Increasing clinicians' sensitivity to patients' feelings of embarrassment may be an important factor in the detection of non-adherence. When taking a base rate of non-adherence into consideration, clinicians' evaluations appeared to be more effective in detecting non-adherence than simple information obtained from patients on their attitudes toward medication. Pragmatic real-life estimation of non-adherence has important implications for the possibility of intervention.

Karaoke therapy in the rehabilitation of mental patients.

OBJECTIVES: To study the efficacy of karaoke singing and its implications in the rehabilitation of mental patients in Hong Kong Chinese. METHODS: A double blind controlled trial was conducted over six weeks in a small sample of chronic schizophrenic patients matched in age, sex and duration of illness. The index group practised karaoke and the controlled group practised simple singing. Subjects were assessed in changes in mood and social interaction. RESULTS: No significant difference was detectable within the 2 groups. However, significant differences of anxiety and social interaction at the end of the third and sixth weeks respectively, were detectable between the 2 groups. CONCLUSION: Karaoke therapy may be more effective than simple singing in improving social interaction. There is preliminary evidence that it may be anxiety-provoking for unstable schizophrenic patients. More research is required for further elucidation of the characteristics of favourable candidates, optimal schedule and active components of the therapy.

A conceptual and quantitative analysis of 178 historical cases of dysmorphophobia.

The construction of the clinical category dysmorphophobia (now known as body dysmorphic disorder) resulted from the historical convergence of a neologism (coined by Enrico Morselli), a family of clinical concepts (already available during the late 19th century), and a specifiable behaviour (an 'attitude' towards part of the self and/or the body). The stability of such convergence has so far depended upon the epistemological capacity of the concepts involved and the social duration of the said attitude. This paper analyses the historical framework within which such convergence took place, and traces the history of dysmorphophobia in qualitative and quantitative terms. With regard to the latter, it compares cases reported before (139 subjects) and after (39 subjects) the publication of the DSM III criteria map. Patients in the former group were found to constitute a more heterogeneous group, and in the latter to have a better outcome. In the pre-DSM III group, differences were also found between delusional and non-delusional patients. The implications of these differences are discussed.

Skeletal 210Pb levels and lung cancer among radon-exposed tin miners in southern China.

A preliminary case-control study of 19 lung cancer cases older than 55 y and 141 age-matched controls was carried out among a group of underground miners in Southern China who were exposed to 222Rn and its decay products. 210Pb activity levels were measured in the skull to estimate radon exposure. Radon exposure was also estimated in working level months, based on work histories and available industrial hygiene data. There was a smooth gradient of lung cancer risk with categories of skeletal 210Pb level at time of last radon exposure; relative risks of 1.0, 2.9, 3.2, and 4.7 for categories < 51.8, 51.8-77.7, 77.8-107.3, and > or = 107.4 Bq (< 1,400, 1,400-2,099, 2,100-2,899, and > or = 2,900 pCi), respectively. Relative risks were unaffected by adjustment for exposure to arsenic in the mine or by adjustment for working level months. Risks also increased with cumulative working level month exposure, but the gradient of risk lessened after adjustment for exposure to arsenic. 210Pb, at the time of last radon exposure (p = 0.13) and at the current 210Pb level (p = 0.01), was not highly correlated with the working level month estimate. Data were sparse but smoking had minimal effect on risk gradient with level of skeletal 210Pb activity. This study suggests measured 210Pb level may be a more precise predictor of lung cancer risk than working level month.

Evaluation of the Chinese version of the Hospital Anxiety and Depression Scale. A cross-cultural perspective.

The authenticity of the Chinese translation of the Hospital Anxiety and Depression Scale (HAD) was tested in a sample of medical students. The Chinese version demonstrated good agreement with the English original. There was a large difference between the mean anxiety and depression subscores. Factor analysis consistently yielded three factors, suggesting the existence of a somatic factor. It is suggested that a common cut-off point for the subscales of the HAD scale is not advisable and a multidimensional model for mood disorders is more appropriate in a cross-cultural context.