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EXPOSURE TO SECOND-HAND SMOKE (SHS) AND ATTITUDE, PERCEPTION, AND ACCEPTANCE TOWARDS SMOKE-FREE POLICY IN OPEN-AIR EATERIES IN PENINSULAR MALAYSIA - A PROTOCOL 马来西亚半岛露天餐馆的二手烟暴露和对无烟政策的态度、认知和接受程度-一份议定书
Pub Date : 2019-10-02 DOI: 10.32827/ijphcs.6.5.154
K. Lim, C. Teh, H. L. Lim, C. Kee, J. H. Lim
Background: Second-hand-smoke (SHS) contributed significantly to the health problem in Malaysia.,and it is significantly high in open air eateries. However, no study been carried out to determine the objective measurement of SHS exposure, and, Attitude, perception and acceptance among Malaysian adult on smoke free policy in Malaysia. Thus, the present study proposes to fill the gap of the related issue. Materials and Methods: A cross-sectional study design will be used to measure nicotine vapour in selected open-air eateries and Survey of customers, workers and owners attitude, perception and their acceptance on smoke-Free policy in the open-air eatery premises. Nicotine vapour will be measured using NIOSH standard method 2551, whereas standard validated questionnaire will be used to measure attitude, perception and acceptance of premises owner, workers, and customers. Descriptive, Chi Square, independent T-Test and Multiple Linear regression will be used for data analysis using SPSS software. Expected Outcome: The findings from the present study are important to provide information on SHS exposure as well as the perception and acceptance of the customers, workers and owners of open-air eateries towards smoke-free policy in open-air eateries. Such information is particularly helpful in providing objective evidence to stakeholders and/or policy-makers on the formulation of suitable policies to address the problem of exposure to second-hand smoke among Malaysian population in public places since public acceptance and attitude are important pre-requisite elements in securing and enforcing effective smoke-free laws Keywords: Second-hand smoke, open-air eatery premises, attitude, perception, smoke-free policy
背景:二手烟(SHS)对马来西亚的健康问题有重大影响。在美国,露天餐馆的空气污染水平也相当高。然而,没有进行研究以确定SHS暴露的客观测量,以及马来西亚成年人对马来西亚无烟政策的态度,感知和接受程度。因此,本研究旨在填补相关问题的空白。材料与方法:采用横断面研究设计,测量选定露天饮食店的尼古丁蒸气,调查顾客、工人和业主对露天饮食店无烟政策的态度、看法和接受程度。尼古丁蒸汽将使用NIOSH标准方法2551进行测量,而标准验证问卷将用于测量场所所有者,工人和客户的态度,感知和接受程度。使用SPSS软件对数据进行描述性、卡方、独立t检验和多元线性回归分析。预期结果:本研究的结果对于提供有关二手烟暴露的信息,以及露天餐馆的顾客、工人和老板对露天餐馆无烟政策的看法和接受程度具有重要意义。这些信息特别有助于为利益相关者和/或政策制定者提供客观证据,以制定适当的政策来解决马来西亚人口在公共场所接触二手烟的问题,因为公众的接受和态度是确保和执行有效无烟法律的重要先决条件。关键词:二手烟,露天餐厅,态度,观念,无烟政策
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引用次数: 0
BILATERAL NEURORETINITIS SECONDARY TO DUAL INFECTION OF BARTONELLA HENSELAE AND LEPTOSPIRA 双侧神经视网膜炎继发于亨塞拉巴尔通体和钩端螺旋体双重感染
Pub Date : 2019-09-18 DOI: 10.32827/ijphcs.6.4.182
Muhamad Ruzaini Abd Hamid, Azreen Anuar, W. Hitam
Background: Bartonella henselae is the most common organism responsible for infective neuroretinitis. Conversely, ocular leptospirosis rarely manifests as neuroretinitis. There is no reported case of neuroretinitis caused by co-infection of both organisms to date. Case Report: A 33 year old lady presented with painless, progressive blurring of vision of both eyes for 2 weeks. Her ocular examination revealed reduced visual acuity to 6/36 with swollen optic disc and macular star exudates in both eyes. Optical coherence tomography showed subretinal fluid causing local neurosensory retinal detachment at posterior pole. Bartonella serology was positive for both IgM and IgG. In addition, Leptospira IgM was also positive. She was then started on oral Doxycycline 100mg BD for 14 days. After 8 weeks, her visual acuity improved to 6/9 and fundus examination showed resolution of optic disc swelling and macula oedema in both eyes. Conclusion: Bartonella henselae is a well-known causative organism for infective neuroretinitis. However, the other rare organisms such as Leptospira should be considered especially in tropical countries. Co-infection of both Bartonella henselae and Leptospira can manifest as neuroretinitis. Key words: Neuroretinitis, Bartonella henselae, Leptospira, dual infection
背景:亨selae巴尔通体是感染性神经视网膜炎最常见的病原体。相反,眼钩端螺旋体病很少表现为神经视网膜炎。到目前为止,还没有两种微生物共同感染引起神经视网膜炎的病例报道。病例报告:一名33岁女性,以无痛性、进行性双眼视力模糊2周为主诉。视力检查显示视力下降至6/36,视盘肿胀,双眼黄斑星状渗出物。光学相干断层扫描显示视网膜下积液导致视网膜后极局部神经感觉脱离。巴尔通体血清IgM和IgG均阳性。此外,钩端螺旋体IgM也呈阳性。随后开始口服强力霉素100mg BD,持续14天。8周后,视力改善至6/9,眼底检查显示双眼视盘肿胀和黄斑水肿消退。结论:亨塞巴尔通体是一种众所周知的感染性神经视网膜炎病原菌。然而,在热带国家尤其应考虑钩端螺旋体等其他罕见生物。亨selae巴尔通体和钩端螺旋体同时感染可表现为神经视网膜炎。关键词:神经视网膜炎;亨selae巴尔通体;钩端螺旋体
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引用次数: 0
EFFECTIVENESS OF HEALTH EDUCATION MODULE DELIVERED THROUGH WHATSAPP TO ENHANCE TREATMENT ADHERENCE AND SUCCESSFUL OUTCOME OF TUBERCULOSIS IN SEREMBAN DISTRICT, NEGERI SEMBILAN, MALAYSIA 通过whatsapp提供的健康教育模块的有效性,提高了马来西亚森美兰州seremban地区结核病的治疗依从性和成功结果
Pub Date : 2019-09-12 DOI: 10.32827/ijphcs.6.4.145
I. NoorHaslinda, M. H. Juni
Introduction: Health education and awareness program have shown to be the factor that promote adherence behaviour and successful outcome of tuberculosis (TB). Mobile health (mHealth) initiative that utilize WhatsApp may help in achieving health objectives. Aims: This study aimed to determine the effectiveness of Health Education Module named TB@Clicks delivered through WhatsApp to enhance treatment adherence and successful outcome among pulmonary tuberculosis (PTB) patients. Methodology: A randomized controlled trial was done among all newly diagnosed TB cases registered in Seremban District between 1st of July 2017 until 9th of April 2018. The patients who fulfils the eligibility criteria were systematically selected and randomly assigned to receive TB@Clicks module through WhatsApp or continue with the existing conventional health education. The respondents were followed-up until treatment was completed. The estimated total sample size was 110. Adherence rate and treatment outcome were gathered from the record book in Health Clinics. Multivariate statistical analysis was conducted to determine the effectiveness of intervention on both outcomes. Result: A total of 110 PTB patients were recruited and 93 patients retained in the study (84.5%). Among them, 50 (90.9%) was from intervention group and 43 (78.2%) was from control group. There were 81.8% of respondents who received intervention adhered to TB treatment and 85.5% has the successful treatment outcome as compared to only 69.1% adherence and 70.9% with treatment success in control group but both were not statistically significant (p=0.121 & p=0.065). In multivariate analyses performed using generalized linear mixed models, PTB patients who had received intervention was 4.1 (95% CI = 1.16-14.87) times as likely to had successful treatment outcome as patients who had not received intervention. Conclusion: The TB@Clicks intervention module delivered through WhatsApp was effectively enhanced the treatment success rate but no significant effects on the adherence rate among PTB patients. Keywords: Pulmonary tuberculosis, mHealth, medication adherence
健康教育和意识规划已被证明是促进结核病(TB)依从性行为和成功结果的因素。利用WhatsApp的移动健康(mHealth)倡议可能有助于实现健康目标。目的:本研究旨在确定通过WhatsApp提供的健康教育模块TB@Clicks的有效性,以提高肺结核(PTB)患者的治疗依从性和成功结果。方法:在2017年7月1日至2018年4月9日期间在Seremban地区登记的所有新诊断结核病病例中进行了一项随机对照试验。系统选择符合资格标准的患者,随机分配到通过WhatsApp接受TB@Clicks模块或继续进行现有的常规健康教育。对应答者进行随访,直到治疗完成。估计总样本量为110。依从率和治疗结果从卫生诊所的记录簿中收集。通过多变量统计分析来确定干预对两种结果的有效性。结果:共招募了110例PTB患者,其中93例(84.5%)保留在研究中。其中干预组50例(90.9%),对照组43例(78.2%)。接受干预的应答者中有81.8%的人坚持结核病治疗,85.5%的人治疗成功,而对照组只有69.1%的人坚持治疗,70.9%的人治疗成功,但两者均无统计学意义(p=0.121和p=0.065)。在使用广义线性混合模型进行的多变量分析中,接受干预的肺结核患者获得成功治疗结果的可能性是未接受干预患者的4.1倍(95% CI = 1.16-14.87)。结论:WhatsApp提供TB@Clicks干预模块可有效提高PTB患者的治疗成功率,但对依从性无显著影响。关键词:肺结核,移动医疗,药物依从性
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引用次数: 3
PREDICTORS OF OVERWEIGHT AND OBESITY AMONG SECONDARY SCHOOL STUDENTS IN PUCHONG SELANGOR, MALAYSIA 马来西亚蒲冲雪兰莪中学生超重和肥胖的预测因素
Pub Date : 2019-09-12 DOI: 10.32827/ijphcs.6.4.160
Queen Esehi Ojo, I. Suriani, B. Huda, Suhainizam
Background: Childhood obesity is gaining a dramatic increase in developing as well as in developed countries. Childhood overweight and obesity in which adolescents are included have be known to have negative impact on both physical and psychological health. Overweight and obese children are likely to stay obese into their adulthood and are more likely to develop non-communicable diseases . The objective of this study is to determine the occurrence and factors associated with overweight and obesity among secondary school students in Puchong Selangor Malaysia.  Materials and Method: A cross-sectional study design was employed. A self-constructed pretested questionnaire was used for the data collection. The questionnaire consists of six sections, which include: socio-demography characteristics, physical activity questionnaire, self-esteem scale, body parts satisfaction scale, body size perception scale and smoking status questionnaire. Weight and height were measured and converted to body mass index (BMI). The study analysis was done using SPSS version 22. Basic descriptive analyses were carried out for the mean, median, frequency and percentage. Chi square test was used to test association between the variables. Multiple logistic regressions were used to determine the predictors of overweight and obesity among the respondents. Result: The response rate was 100%. The respondents’ age was 13-17years and occurrence of overweight and obesity was 10% and 3.9% respectively. Out of the 281 students that participated in the study 164 were female (58.4%). Overweight and obesity was significantly associated with father’s education ( χ2 = 9.697, df= 2, p =0.006), mothers education ( χ2 = 7.448, df= 2, p = 0.023), body part satisfaction ( χ2 =14.837, df= 1, p = 0.001) and body image ( χ2 =6.745, df= 1, p = 0.009). Multiple logistic regression analysis showed that the predictors of obesity were age (AOR=2.049, 95% CL: 0.186, 0.835, p <0.007), body parts satisfaction (AOR=3.656, 95% CL: 1.729, 7.730, p <0.001) and body size perception (AOR=3.130, 95%:1.269, 7.718, p <0.014). Conclusion: The significant predictors of overweight and obesity among study population were age, body parts satisfaction and body size perception. Keywords: Overweight, obesity, association, predictors, secondary school, students.
背景:在发展中国家和发达国家,儿童肥胖正在急剧增加。众所周知,包括青少年在内的儿童超重和肥胖对身心健康都有负面影响。超重和肥胖儿童很可能在成年后继续肥胖,更有可能患上非传染性疾病。本研究的目的是确定超重和肥胖的中学生在马来西亚雪兰莪州的发生和相关因素。材料与方法:采用横断面研究设计。采用自编预测问卷进行数据收集。问卷由社会人口学特征、体育活动问卷、自尊量表、身体部位满意度量表、体型感知量表和吸烟状况问卷六个部分组成。测量体重和身高并转化为身体质量指数(BMI)。研究分析使用SPSS版本22完成。对平均值、中位数、频率和百分比进行了基本的描述性分析。采用卡方检验检验变量之间的相关性。采用多重逻辑回归来确定受访者中超重和肥胖的预测因素。结果:有效率为100%。调查对象年龄在13-17岁之间,超重和肥胖发生率分别为10%和3.9%。在参与研究的281名学生中,164名是女性(58.4%)。超重、肥胖与父亲受教育程度(χ2 = 9.697, df= 2, p =0.006)、母亲受教育程度(χ2 = 7.448, df= 2, p = 0.023)、身体部位满意度(χ2 =14.837, df= 1, p = 0.001)、身体形象(χ2 =6.745, df= 1, p = 0.009)显著相关。多元logistic回归分析显示,肥胖的预测因素为年龄(AOR=2.049, 95% CL: 0.186, 0.835, p <0.007)、身体部位满意度(AOR=3.656, 95% CL: 1.729, 7.730, p <0.001)和体型感知(AOR=3.130, 95%:1.269, 7.718, p <0.014)。结论:年龄、身体部位满意度和体型感知是研究人群超重和肥胖的重要预测因素。关键词:超重,肥胖,关联,预测因素,中学,学生。
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引用次数: 1
THE RELATIONSHIP BETWEEN A CHILD’S BMI WITH PARENTAL FEEDING STYLE AND MATERNAL PERCEPTION TOWARDS CHILDHOOD OBESITY 儿童体重指数与父母喂养方式和母亲对儿童肥胖认知的关系
Pub Date : 2019-09-09 DOI: 10.32827/ijphcs.6.4.133
Shivam Saw, Z. Latiff
Background: Prevalence of overweight and obesity are increasing among preschool children. The aim of this study was to evaluate the relationship between a child’s body mass index (BMI) with maternal perception towards the child’s weight and type of parental feeding style. Methodology: A cross-sectional study was conducted from June 2017 until November 2018 in kindergartens from Ipoh and Cheras. Self-administered validated questionnaires were distributed to parents. Data on child’s BMI, maternal perception to their child’s BMI, perception towards childhood obesity and parental feeding style were obtained and analysed using SPSS version 21. Results: A total of 483 children were recruited. The prevalence of overweight children was 6.8% (BMI ≥ 85 th to < 95 th percentile) whereas the prevalence of obesity was 8.1% (BMI ≥ 95 th percentile). When comparing the group of children with BMI ≥ 85 th percentile (n= 72) to those with BMI<85 th percentile (n= 411), we found that parents of overweight/obese children differed significantly in the accuracy of their judgment about their child’s weight.  Only 12.5% in the former group accurately perceived their child’s weight compared to 76.9% in the latter group (p<0.01). Majority of parents (34%) in our community had indulgent feeding style, followed by authoritarian (31%), authoritative (18%) and uninvolved (16%). There was however no statistical significance in terms of parental feeding style in both groups of children. Conclusion: A significant proportion of parents failed to recognise that their children were overweight. Public health programmes are thus required to raise parental awareness of childhood overweight and obesity. Keywords: childhood obesity, maternal perception, feeding style, BMI
背景:学龄前儿童超重和肥胖的患病率正在上升。本研究的目的是评估儿童的身体质量指数(BMI)与母亲对儿童体重的感知和父母喂养方式之间的关系。方法:从2017年6月到2018年11月,在怡保和齐拉斯的幼儿园进行了一项横断面研究。向家长分发了自我管理的有效问卷。获取儿童BMI、母亲对孩子BMI的感知、对儿童肥胖的感知和父母喂养方式的数据,并使用SPSS 21版进行分析。结果:共招募了483名儿童。超重儿童患病率为6.8% (BMI≥85 - < 95百分位数),肥胖患病率为8.1% (BMI≥95百分位数)。当比较BMI≥85百分位组(n= 72)和BMI<85百分位组(n= 411)时,我们发现超重/肥胖儿童的父母对孩子体重判断的准确性存在显著差异。前一组只有12.5%的母亲准确地感知到了孩子的体重,而后一组的这一比例为76.9% (p<0.01)。在我们的社区中,大多数父母的喂养方式是放纵型(34%),其次是权威型(31%)、权威型(18%)和不参与型(16%)。两组儿童的父母喂养方式差异无统计学意义。结论:很大比例的父母没有意识到他们的孩子超重。因此,需要制定公共卫生方案,提高父母对儿童超重和肥胖的认识。关键词:儿童肥胖;母亲感知;喂养方式
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引用次数: 2
ASSESSMENT OF PROBLEMATIC FACEBOOK USE AMONG UNDERGRADUATE STUDENTS IN UPM CORRELATED WITH DEPRESSION, ANXIETY AND STRESS 芬欧汇川大学大学生facebook问题使用评估与抑郁、焦虑和压力相关
Pub Date : 2019-09-09 DOI: 10.32827/ijphcs.6.4.113
Loh Jia Ling Nisha Syed Nasser, Hamed Sharifat Aida Abdul Rashid, Ezamin Abdul Rahim Suzana Ab Hamid, Salasiah Mustafa Ching Siew Mooi Beatrice Ng Andrew, S. Suppiah
Introduction: Facebook has emerged as one of the top social networking sites (SNSs) among university students but at the cost of leading to negative implications on psychosocial wellbeing. Psychological factors such as depression, anxiety and stress have been implicated in the development of addictions; however studies that evaluate this are scarce among the Malaysian population. Our objective was to identify problematic Facebook use among undergraduate students in Universiti Putra Malaysia (UPM) and to correlate the psychological factors that influence problematic Facebook use. Methods: A cross sectional study was conducted among 1060 students from various faculties in UPM. Validated Facebook Addiction Test (FAT) and DASS-21 questionnaires were used to collect data. Descriptive analysis was done for demographic data. Pearson correlation and regression analysis were used in the analytical part. Results: Problematic Facebook use was detected among 16.6% of the undergraduate students. Problematic Facebook use was significantly related to the level of depression, anxiety and stress (p<0.05). Multiple regression analysis indicated that younger age, male gender and depression were significant predictors of problematic Facebook use (p<0.05). Conclusion: Problematic Facebook use is significantly related to the level of depression, anxiety and stress.  Young male university students are more prone to problematic Facebook use than females. Depression plays an important role in the development of problematic Facebook usage, thus requires careful monitoring of young students for early detection and prevention. Keywords : Internet Addiction, Malaysia, social networking, student psychology, university
导读:Facebook已经成为大学生中最受欢迎的社交网站之一,但其代价是对大学生的心理健康产生了负面影响。抑郁、焦虑和压力等心理因素与成瘾的发展有关;然而,评估这一点的研究在马来西亚人口中很少。我们的目标是确定马来西亚博特拉大学(UPM)本科生中有问题的Facebook使用情况,并找出影响有问题的Facebook使用的心理因素之间的关联。方法:采用横断面调查方法,对北京师范大学各院系1060名学生进行调查。使用有效的Facebook成瘾测试(FAT)和DASS-21问卷收集数据。对人口统计数据进行描述性分析。分析部分采用Pearson相关分析和回归分析。结果:16.6%的大学生存在使用Facebook的问题。有问题的Facebook使用与抑郁、焦虑和压力水平显著相关(p<0.05)。多元回归分析显示,年龄、男性和抑郁是不良Facebook使用的显著预测因素(p<0.05)。结论:有问题的Facebook使用与抑郁、焦虑和压力水平显著相关。年轻的男性大学生比女性更容易有问题地使用Facebook。抑郁症在Facebook使用问题的发展中起着重要作用,因此需要对年轻学生进行仔细的监测,以便及早发现和预防。关键词:网瘾,马来西亚,社交网络,学生心理,大学
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引用次数: 6
TECHNICAL EFFICIENCY ASSESSMENT OF MATERNAL HEALTH SERVICES IN NEGERI SEMBILAN, MALAYSIA USING DATA ENVELOPMENT ANALYSIS 利用数据包络分析对马来西亚森美兰州孕产妇保健服务的技术效率进行评估
Pub Date : 2019-09-09 DOI: 10.32827/ijphcs.6.4.79
Arinah W.D.S., M. H. Juni, Lim Poh Ying, J. Ghani, Fakarudin Kamarudin
Introduction : Primary care is the first level of contact with the health system to promote health, prevent illness, care for common illnesses, and manage on-going health problems. Maternal health services were one of the important components of primary care delivered through health clinics and community clinics. It is crucial to ensure scarce resources in health clinic were utilized efficiently. Data envelop analysis is a technique which had advantage in assessment of efficiency of primary care because the technique can handle multiple inputs and outputs in efficiency score calculation.  Objectives: To assess technical efficiency of maternal health services and it determinants in primary care setting of health clinics in Negeri Sembilan using data envelopment analysis (DEA). Methodology: This e valuation research employing cross-sectional study design using primary data from health district offices and health clinics in Negeri Sembilan. Sources of data includes administrative records and expenditure records from district health offices, and maternal health services utilization obtained from clinic records. The study randomly selected 16 maternal health services of health clinics as DMUs. Data for 2016 and 2017 were used in the analysis. Analysis of DEA used two-stage DEA. In the first stage DEA to efficiency score, namely: overall technical efficiency (OTE), pure technical efficiency (PTE) and scale efficiency (SE) scores.  In the second stage, four environmental variables namely location of health clinic, distance of health clinic to the nearest health facility, years of service of nurses and comorbidity of patient regressed against PTE score using Tobit regression analysis. Results: In 2016, average pure technical efficiency (PTE) for maternal health services were 60.50% (SD 35.50). An increased in mean PTE in 2017 for maternal health services with the score of 67.30% (SD 34.30). Maternal health services in type 2 health clinic were efficient as compared with other types of health clinic in 2016. In 2017, maternal health services in health clinic type 6 were efficient. One determinant was found to significantly affect TE (comorbidity of patient). Conclusion: The findings from this study found that technical efficient maternal health services in Negeri Sembilan were in Health Clinic Type 5 (31.25%) and Health Clinic Type 6 (37.50%) in 2016 and 2017 respectively. Patients with more comorbidity significantly decrease technical efficiency of maternal health services. Keywords : technical efficiency, maternal health, primary care service, health clinic, data envelopment analysis.
初级保健是与卫生系统接触的第一级,以促进健康、预防疾病、治疗常见疾病和管理持续存在的卫生问题。产妇保健服务是通过保健诊所和社区诊所提供的初级保健的重要组成部分之一。确保卫生诊所稀缺资源的有效利用至关重要。数据包络分析是一种具有优势的初级保健效率评估技术,因为它可以处理多个输入和输出的效率评分计算。目的:利用数据包络分析(DEA)评估森美兰州卫生诊所初级保健环境中孕产妇保健服务的技术效率及其决定因素。方法:本评估研究采用横断面研究设计,使用来自森美兰州卫生区办事处和卫生诊所的原始数据。数据来源包括来自地区卫生办公室的行政记录和支出记录,以及来自诊所记录的孕产妇保健服务利用情况。本研究随机选取16家卫生诊所的产妇保健服务机构作为dmu。分析中使用了2016年和2017年的数据。DEA分析采用两阶段DEA。在第一阶段DEA对效率进行评分,即:总技术效率(OTE)、纯技术效率(PTE)和规模效率(SE)得分。第二阶段采用Tobit回归分析,将卫生所所在位置、卫生所与最近的卫生机构的距离、护士服务年限和患者合并症4个环境变量与PTE评分进行回归。结果:2016年孕产妇保健服务的平均纯技术效率(PTE)为60.50% (SD为35.50)。2017年孕产妇保健服务的平均PTE增加,得分为67.30% (SD 34.30)。2016年,二类卫生诊所的孕产妇保健服务效率高于其他类型卫生诊所。2017年,6类卫生诊所孕产妇保健服务高效。发现一个决定因素显著影响TE(患者的合并症)。结论:本研究发现,2016年和2017年森美兰州技术高效的孕产妇保健服务分别为5型诊所(31.25%)和6型诊所(37.50%)。合并症较多的患者显著降低了孕产妇保健服务的技术效率。关键词:技术效率,孕产妇保健,初级保健服务,卫生诊所,数据包络分析
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引用次数: 5
PREVALENCE OF FATTY LIVER CHANGES ON NON-CONTRAST ENHANCED COMPUTED TOMOGRAPHY AND ITS ASSOCIATED RISK FACTORS 非增强计算机断层扫描显示脂肪肝改变的患病率及其相关危险因素
Pub Date : 2019-09-08 DOI: 10.32827/ijphcs.6.4.68
H. Hassan, C. Koh, Laila Mastura Ahmad Apandi, S. Suppiah, Ezamin Abdul Bin Rahim
Background: The Fourth National Health and Morbidity Survey completed in 2011, revealed that 27.2% of Malaysian adults aged 18 years and above are obese, while 33.3% are pre-obese, with increasing prevalence of obese children. Together with observation of “ethnic lipodystrophy” in South Asians population and increasing prevalence of non-alcoholic fatty liver disease (NAFLD) in Asian population, further study of NAFLD in Malaysian population with their associated risk factors is necessary. Materials and Methods: A prospective cross-sectional study of patients who underwent CT Urography (CTU) examination, selected through simple random sampling. Presence of NAFLD was determined based on liver CT value of <40 HU and CT Liver-Spleen attenuation ratio. Association and correlation of NAFLD with Body Mass Index (BMI), abdominal wall subcutaneous fat thickness and biochemical markers were calculated. Result: Forty-six percent (46%) of study population had NAFLD, with male predominance. There were significant association of NAFLD with BMI, abdominal wall subcutaneous fat thickness and lower serum HDL level. Conclusion: Increasing prevalence of NAFLD with increasing BMI, thicker abdominal wall subcutaneous fat thickness and decreasing serum HDL level Keywords: non-alcoholic fatty liver disease, risk factors, non-contrast enhanced CT, subcutaneous wall thickness
背景:2011年完成的第四次全国健康和发病率调查显示,马来西亚18岁及以上的成年人中有27.2%肥胖,33.3%处于肥胖前期,肥胖儿童的患病率越来越高。随着南亚人群中“种族脂肪营养不良”的观察和亚洲人群中非酒精性脂肪性肝病(NAFLD)患病率的增加,进一步研究马来西亚人群中NAFLD及其相关危险因素是必要的。材料与方法:采用简单随机抽样的方法,对行CT尿路造影(CTU)检查的患者进行前瞻性横断面研究。根据肝脏CT <40 HU值及CT肝脾衰减比判断有无NAFLD。计算NAFLD与体重指数(BMI)、腹壁皮下脂肪厚度及生化指标的相关性。结果:46%的研究人群患有NAFLD,以男性为主。NAFLD与BMI、腹壁皮下脂肪厚度及血清高密度脂蛋白(HDL)水平有显著相关性。结论:NAFLD患病率随BMI升高、腹壁皮下脂肪厚度增厚、血清HDL水平降低而增加。关键词:非酒精性脂肪性肝病、危险因素、非增强CT、皮下壁厚度
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引用次数: 1
METHODOLOGICAL APPROACHES TO HEALTH SYSTEMS GOVERNANCE RESEARCH 卫生系统治理研究的方法学方法
Pub Date : 2019-09-08 DOI: 10.32827/ijphcs.6.4.35
A R Arifah, M. H. Juni
Background: Governance in health is a process whereby important decisions are made and determining who is accountable. Good health system governance (HSG) can ensure optimal functioning of the health system influenced by transparent rules and governed by effective oversight. Assessment of governance can influence the health outcome of the population when subsequent improvement is made for better policy input. The aim of this review is to understand the methodological research approaches used in the assessment of HSG. Methodology: A review was directed from a collection of articles obtained from Pubmed, ScienceDirect and CINAHL databases that summarises relevant prior publication on methodological approaches that have been used in HSG research describing study design, methods of data collection and analysis. Only original articles of the past ten years (2009 to 2019) published in English language is included. Data was extracted base on a pre-constructed matrix. Results and Discussion: Findings revealed different research methods for the qualitative, quantitative and mixed-methods design. Similarities between the three are in terms of how research questions direct the choice of study design and the use of a governance framework or recommendation of indictors to guide the study.  There were differences in terms of the nature of study, the methods used, and type of information gathered. Each study design has its own strengths and limitations. Lessons learned include research going beyond descriptions, tailoring approaches to fit study objectives, the importance of communicating findings and being clear in giving recommendations for policymaking. Conclusion: The qualitative design is contextual yet difficult to generalize, the quantitative design is generalizable yet very explicit to certain indicators specified while the mixed methods design is comprehensive but requires more resources to carry out. Keywords: health system governance, assessment, methodological approaches, research design
背景:卫生治理是一个作出重要决定和确定谁负责的过程。良好的卫生系统治理(HSG)可以确保卫生系统在透明规则的影响和有效监督下发挥最佳功能。在为更好的政策投入而进行后续改进时,对治理的评估可以影响人口的健康结果。本综述的目的是了解HSG评估中使用的方法学研究方法。方法学:从Pubmed、ScienceDirect和CINAHL数据库中获得的文章集合进行综述,总结了HSG研究中使用的相关方法学方法,描述了研究设计、数据收集和分析方法。仅收录近十年(2009年至2019年)以英文发表的原创文章。根据预先构建的矩阵提取数据。结果与讨论:研究结果揭示了定性、定量和混合方法设计的不同研究方法。三者之间的相似之处在于研究问题如何指导研究设计的选择,以及如何使用治理框架或指标建议来指导研究。在研究的性质、使用的方法和收集的信息类型方面存在差异。每个研究设计都有自己的优点和局限性。得到的教训包括超越描述的研究、定制适合研究目标的方法、交流研究结果的重要性以及为决策提供明确建议的重要性。结论:定性设计具有情境性,但难以概括;定量设计具有概括性,但对指定的某些指标非常明确;混合方法设计具有综合性,但需要更多的资源进行。关键词:卫生系统治理,评估,方法方法,研究设计
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引用次数: 0
MANAGEMENT OF NON-COMMUNICABLE DISEASE PREVENTION AT DISTRICT LEVEL IN MALAYSIA 马来西亚地区一级非传染性疾病预防的管理
Pub Date : 2019-09-08 DOI: 10.32827/ijphcs.6.4.53
R. Diana, M. Safrin, Nada, A. Rosliza
Background: The Non –Communicable Disease (NCD) unit in Malaysia has had much focus in recent years as its country undergoes a major epidemiologic transition with the rise in the four largest contributors of NCD deaths namely cardiovascular disease, cancer, diabetes and chronic respiratory disease. In line with reducing the burden of NCD both for the patient and healthcare, the district health office plays a vital role in managing disease prevention through adequate planning, focusing on the implementation of primary, secondary and tertiary prevention and monitoring the health of the population. Materials and Methods: A literature review was conducted through online database search such as Google Scholar and PubMed to identify articles that were related to the current management of non-communicable disease prevention. Initial keywords used were district health management, non-communicable disease, prevention and Malaysia. The reference list was also reviewed for related articles including some that were handpicked. Result: Healthcare system in Malaysia is performed as a top down exercise whereby most of the national planning is conducted at federal level by the Ministry of Health. However, at the ground level, the district health office needs to conduct situational analysis to identify the needs and challenges of the local community within their jurisdiction. The management of NCD prevention is focusing on the implementation of actions through primary, secondary and tertiary prevention levels that fall within the role of health professionals and health care providers in primary care, hospitals and community services environment. Conclusion: Community empowerment and health education are important components in primary prevention of NCD. Early diagnosis and prompt treatment for NCD provided at the district level will stop the progression of the disease, leading to a better prognosis. Tertiary prevention in the form of rehabilitation at district level reduces and limits the disability and impairment related to NCD. Keywords: Non-communicable disease, prevention, district level, NCD program, community empowerment
背景:近年来,马来西亚的非传染性疾病(NCD)部门备受关注,因为该国经历了重大的流行病学转变,导致非传染性疾病死亡的四大原因(心血管疾病、癌症、糖尿病和慢性呼吸道疾病)有所增加。为了减轻非传染性疾病对患者和医疗保健的负担,区卫生局通过适当的规划、注重实施初级、二级和三级预防以及监测人口健康,在管理疾病预防方面发挥了至关重要的作用。材料和方法:通过谷歌Scholar和PubMed等在线数据库检索进行文献综述,以确定与当前非传染性疾病预防管理相关的文章。最初使用的关键词是地区卫生管理、非传染性疾病、预防和马来西亚。参考文献列表也进行了相关文章的审查,其中包括一些精心挑选的文章。结果:马来西亚的医疗保健系统是自上而下的,大部分国家计划是由卫生部在联邦一级进行的。然而,在基层,地区卫生办公室需要进行情况分析,以确定其管辖范围内当地社区的需求和挑战。非传染性疾病预防管理的重点是通过初级、二级和三级预防层面实施行动,这些层面属于初级保健、医院和社区服务环境中的卫生专业人员和卫生保健提供者的职责范围。结论:社区赋权和健康教育是非传染性疾病一级预防的重要组成部分。在地区一级提供对非传染性疾病的早期诊断和及时治疗将阻止疾病的进展,导致更好的预后。以地区一级康复为形式的三级预防可减少和限制与非传染性疾病有关的残疾和损害。关键词:非传染性疾病,预防,区级,非传染性疾病规划,社区赋权
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引用次数: 1
期刊
International Journal of Public Health and Clinical Sciences
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