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Introduction: Elderly is a vulnerable population that is prone for sarcopenia which is associated with the loss of muscle mass, strength and function which are one the diseases that affects elderly. Association between environmental factors with sarcopenia should be explored as it has the potential to influence the health and disability of a person. At present, limited research is conducted to investigate the association which could be attributed to the complex interaction between the human and environmental interactions. Hence this review is conducted to identify the environmental factors associated with sarcopenia. Methods: A systematic review was conducted using PubMed, SCOPUS, Web of Science and manual search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. We used articles that have been written in English and relevant articles were then screened, duplicates were removed, eligibility criteria were applied, and studies that met the criteria were reviewed. The keywords environmental factors, pollutants food environment, neighbourhood environment, locality and sarcopenia were included. Results: Initial search generated 934 publications and 12 articles were included after inclusion and exclusion criteria for this review. In this review, environmental factors associated with sarcopenia are divided into 3 themes that comprises of food environment (availability and physical access, economic access and food quality and safety), neighbourhood environment and pollutants. Conclusion: This systematic review revealed association between the food environment, neighbourhood environment and pollutants with sarcopenia. The findings are salient as it could aid the the policy makers to formulate the necessary strategy to reduce the morbidity and mortality associated with sarcopenia especially with the increase in ageing population globally. [ABSTRACT FROM AUTHOR]

This study aims to determine the prevalence of problematic smartphone use (PSU) among secondary school adolescents and to examine its relationship with psychological problems (depression, anxiety, and stress [Model 1], or the number of psychological problems [Model 2]). This cross-sectional study has utilised a self-administered questionnaire assessing the participants' sociodemographic and clinical characteristics, pattern and purpose of usage, presence of PSU (via the Malay-version smartphone addiction scale-short version [SAS-SV]), and presence of psychological problems (via the depression-anxiety-stress scale-21 [DASS-21]). Four hundred and fourteen students aged 15--16 from five national secondary schools in Seremban and smartphone users have been recruited via cluster sampling. Students in remedial or special education classes, previously diagnosed with depression, anxiety or stress and absent on the day of data collection were excluded. The prevalence of PSU, probable depression, anxiety and stress were 43.5%, 31.6%,48.3% and 26.8%, respectively. Most respondents reported mild to moderate severity for each psychological problem. However, three out of ten respondents had multiple psychological problems. In both multiple logistic regression models, Malay students had higher daily usage, and the higher monthly costs were significantly associated with PSU when other confounding factors were controlled. A higher number of psychological problems was associated with PSU (adjusted odds ratio: 1.28, 95% confidence interval: 1.06-1.54; p=0.011) but not purpose of usage or individual psychological problem. PSU and psychological problems were prevalent among secondary school adolescents. These findings highlight the complex relationship between PSU and psychological problems that warrant further detailed studies. [ABSTRACT FROM AUTHOR]

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Introduction: Community-based hypertension programs are available worldwide. This review aims to summarise the cost-effectiveness of these programs to prevent and control hypertension. Material and Methods: We searched through three databases of PubMed, Scopus and Web of Science in November 2020. Published articles from 2010 through 2020 were screened. The community-based prevention programs were categorised into four groups: self-monitoring, educational interventions directed to the patient, educational interventions directed to the health professional and health professional (nurse or pharmacist) led care. Results: Eleven articles were included in the final review. All 11 articles conducted the programs of education intervention directed towards patients, seven articles conducted programs that include both self-monitoring and health professional (nurse or pharmacist) led care and only two studies conducted programs of which the educational interventions directed to the health professional. Six studies reported as cost per mm Hg reduction in systolic and/or diastolic blood pressure (ranging $0.69-$235.7 per mm Hg reduction), two studies reported as cost per DALY averted (ranging $349-$582) and three studies reported as cost per QALY gained (ranging $1257 - $4219). Conclusion: All studies showed the programs to be cost-effective. This information could provide the evidence base to guide the initiation and development of hypertension programmes. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to determine the prevalence of mild cognitive impairment (MCI) and its associated factors among veterans who lived in the urban city of Kuala Lumpur, Malaysia. Methods: A cross-sectional study using a face-to-face interview was conducted to obtain information on sociodemographic, behavioral activities, and health-related conditions. All participants underwent cognitive tests using the Bahasa Malaysia version of the Montreal Cognitive Assessment (MoCA-BM). Results: A total of 406 male veterans with a mean age of 61.5 years old participated in the study. The prevalence of MCI was 21.4%. A logistic regression model revealed that low physical activity (adjusted odds ratio (aOR) 10.29), hypertension (aOR 2.22), lower education level (aOR 2.98), subjective memory difficulty (aOR 3.61), and subjective concentration difficulty (aOR 3.95) were associated with a higher likelihood of MCI. In addition, those aged 60 years and above, as well as those in the non-officer group, were associated with a higher risk for MCI with aOR 4.57 and 4.59 respectively. Conclusion: Inactivity and hypertension are preventable risk factors MCI. Therefore, military veterans must be encouraged to practice a physically active lifestyle after retirement to maintain a healthy cognitive level. [ABSTRACT FROM AUTHOR]

Background: Venous thromboembolism (VTE) remains one of the leading causes of maternal morbidity and mortality, with postpartum period carrying the greatest risk. Perinatal thromboprophylaxis is often administered based on risk-factor assessment. Low molecular weight heparin has a proven safety profile in the obstetrics population, however, its porcine-derived content may lead to reduced uptake amongst certain religious groups. We aimed to evaluate the safety of fondaparinux as an alternative postpartum thromboprophylaxis. Methods: We conducted a prospective, single arm, open label study from September 2017 until March 2018. Women who fulfilled the criteria for post natal thromboprophylaxis based on the 2015 RCOG guidelines were recruited. Each patient received subcutaneous injection of Fondaparinux, 2.5 mg daily for 10 days. A telephone interview was conducted on day 10 post delivery. Each woman was subsequently reviewed in the outpatient clinic 6 weeks postpartum. The primary outcome measure was occurrence of pulmonary embolism or deep vein thrombosis suggestive by clinical symptoms and assessment. Secondary outcome measures were allergic reaction and bleeding tendency such as secondary post-partum haemorrhage, spinal site bleeding and wound haematoma. Allergic reaction and bleeding tendency in neonates were also recorded. Results: Sixty women were included in the analysis. There were no VTE cases amongst our cohort. No major bleeding was recorded. Two patients (3.3%) had wound haematoma, one of which occurred 3 weeks post delivery. No adverse effect in neonates was noted. Conclusion: Fondaparinux is a safe alternative thromboprophylaxis for postpartum women. [ABSTRACT FROM AUTHOR]

Purpose: Handgrip strength (HGS) is indicative of overall physical health among older adults. A decrease in HGS may be associated with an increased risk of disease. The aim of this study is to determine the factors associated with HGS among older adults in Malaysia. Patients and Methods: One thousand two hundred four (1204) participants from urban and rural areas in Selangor state, Malaysia, were recruited. Sociodemographic and health-related conditions were gathered through a comprehensive face-to-face interview, followed by HGS assessments by a handgrip dynamometer. Subsequently, multiple linear regression was used to test the main association with the HGS. Results: A total of 691 participants (57.4%) were male, and 513 (42.6%) were female. Males had a mean HGS of 30.0 (SD 7.53) kg, and females had a mean HGS of 19.4 (SD 5.28) kg. Males' handgrip strength was significantly reduced with increasing age, physically inactive, and diabetes (all at the level p< 0.001) after adjusting for social-demographic characteristics and health-related variables. Meanwhile, for females, the HGS was significantly decreased with age (p< 0.001), physically inactive (p< 0.001) and hypertension (p=0.03). However, female HGS was positively related to BMI (p< 0.001). Conclusion: The study contributed to a better understanding of factors associated with HGS, and thus, the HGS is recommended as a section in the health evaluation among high-risk older adults as the strategy of disease control and prevention. [ABSTRACT FROM AUTHOR]

The high prevalence rate and ever-increasing incidence of tuberculosis (TB) worldwide remain a significant issue in healthcare. In Malaysia, the incidence and mortality rate of TB is increasing due to the delayed presentation of TB patients to healthcare facilities. However, there is a lack of local studies on the contributing factors of delayed presentation of TB patients in Malaysia. This study aims to establish a social epidemiology framework by analysing social factors including socio-epidemiological, socio-cultural, and health-seeking behaviours associated with the delay in seeking TB treatment among patients in Selangor, Malaysia. A sequential exploratory mixed-method study design that combines qualitative and quantitative research methods will be employed. This study will recruit adult patients who have been diagnosed with TB using chest X-ray and sputum smear microscopy. Four districts with the highest recorded cases in the state of Selangor will be selected as study locations. The qualitative study will involve a Focus Group Discussion (FGD) to explore six components, namely demographic, socio-cultural, health-seeking behaviours, social support and resources, previous knowledge and experience with illness, and treatment pathway. Meanwhile, the quantitative study will incorporate a structured survey that will be developed based on the themes identified in the qualitative phase and a review of several studies in the literature. Several quality control measures will be taken while ensuring that the survey questionnaires are anonymised and participants' confidentiality is maintained. The data obtained from both qualitative and quantitative approaches will be combined to provide a more robust assessment of the study. Given that this study will focus on districts with high recorded cases of TB in Selangor, the findings might assist to address TB-related issues such as the increasing incidence and mortality rates, which are mainly attributed to the delayed presentation of TB patients to healthcare facilities. [ABSTRACT FROM AUTHOR]

Introduction: Gardnerella vaginalis (GV)-associated bacterial vaginosis is recognised for its detrimental effects on pregnancy resulting in poor obstetric and neonatal outcomes. There is limited knowledge of the effects on placental histomorphology following GV infection in pregnancy. We investigated the effects of GV infection on the placenta, particularly with regards to the syncytiotrophoblasts and vascular development, and related these to neonatal outcomes.Methods: A prospective cohort study involving GV-positive pregnant women presented with abnormal vaginal discharge, with gestational age-matched healthy pregnant women controls. Placental sampling was performed upon delivery and examined histologically. Vascular endothelial growth factor-A (VEGF-A) and hypoxia-inducible factor-1α (HIF-1α) mRNA and protein expression were analysed by real-time PCR and immunohistochemistry respectively. The standard measures in neonatal outcomes were recorded.Results: Placentas from GV-positive mothers were found to have significant histological evidence of maternal and/or fetal inflammatory response compared with the controls (17/28: 60.7% vs 2/20: 10%) (p = 0.0011). There was an increase in the percentage of syncytial nuclear aggregates (SNAs) per villus (47.4 ± 11.09%) in placentas from GV-positive mothers (p < 0.0001). VEGF-A was significantly increased in specifically, the villous endothelial cells of placentas with GV infection, but no difference in the immunoexpression of HIF-1α in these cells between groups. However, these were not associated with adverse neonatal outcomes.Discussion: Increased placental VEGF-A expression associated with increased SNAs in pregnant women with GV infection of the genital tract may be an intrauterine response towards placental vascular remodeling, that may also serve as a protective role in moderating birth outcomes. [ABSTRACT FROM AUTHOR]

Background: Suicide remains an important cause of premature deaths and draws much media attention. However, unsafe reporting and portrayal of suicides by the media have been associated with increased risk of suicidal behavior. Current evidence suggests that media capacity-building could potentially prevent suicide. However, there are still knowledge gaps in terms of a lack of data on effective strategies for improving awareness and safe reporting of suicide-related media content. This study aims to investigate the effectiveness of a workshop conducted with members of the media community on the safe reporting of suicide-related content. Methods: An interventional single-arm pre and post pilot study was conducted on a sample of the Malaysian media community recruited through purposive and snowball sampling. The media safe reporting workshop was conducted by a suicide prevention expert with a media industry background. Thirty participants completed a self-reported evaluation questionnaire on their awareness and knowledge of reporting on suicide-related media content; before and after the interventional workshop. Results: There was a significant difference between the total scores before and after the intervention, with a large effect size. Post-intervention scores were significantly improved in 8 items, namely those related to the reporting of: (i) the content of any suicide note; (ii) headlines with methods of suicide; (iii) headlines with the location of suicide; (iv) cases of suspected suicide despite the unconfirmed cause of death; (v) suicide news to cater to readers' interests; (vi) cause of suicide; (vii) details of the location of suicide; and (viii) the negative impact to media community when reporting suicide stories. In particular, there was an improvement in the majority of items for people from the media community with no lived experience of suicidal behavior. Conclusion: The media safe reporting workshop is a potentially effective intervention for improving awareness and knowledge measures relating to safe reporting on suicide among the media community, with a more pronounced effect in those without lived experience of suicidal behavior. Limitations in the sample size, generalizability, short-term evaluation, and lack of a control group warrant future larger, longer-term controlled, and more representative studies. [ABSTRACT FROM AUTHOR]

Purpose: Older people often have chronic diseases which require a continuity of care over the long term. Countries undergoing population aging need to ensure that older people are receiving the care they need. This study assesses the prevalence of, reasons for, and factors associated with unmet healthcare needs among older people individuals in Malaysia. Patients and Methods: This cross-sectional study used data collected during 2018– 2020 from 1204 older adults aged 60 and older selected from Selangor state, Malaysia. A comprehensive face-to-face interview based on the Bahasa Malaysia version of the Japan Gerontological Evaluation Study (JAGES-BM) questionnaire was administered to gain information on unmet healthcare needs, socioeconomic factors, health-related factors, and measures of function (activities of daily living, depression, visual impairment, hearing impairment, memory impairment, and walking impairment). Multivariate logistic regression was used to analyze factors associated with their unmet healthcare needs. Results: Overall, the percentage of older people respondents with unmet healthcare needs is 6.6%. The most reported reasons for forgoing or delaying healthcare were lack of knowledge about healthcare and financial barriers to care. The inability to travel alone (adjusted odds ratio [aOR] 2.51), being overweight (aOR 1.88), and having self-reported depression (aOR 2.23) were each associated with a higher likelihood of having unmet healthcare needs in their daily life. Conclusion: The prevalence of unmet healthcare needs among older people in this part of Malaysia is lower than that reported in some other countries. However, it is possible to further reduce unmet healthcare needs by improving people's knowledge and attitudes about appropriate healthcare utilization, strengthening financial protection measures and providing support to people at high risk of having unmet healthcare needs. [ABSTRACT FROM AUTHOR]

Abstract Background Methadone Maintenance Therapy (MMT) is one of the popular choices for drug substitution therapy and is fairly new in Malaysia. Aside from its role in harm reduction against HIV infection, MMT programme may potentially enhances clients’ quality of life. This study aims to identify the impact of MMT programme on clients’ quality of life after 6 months in treatment and to explore factors that may be associated with changes in their quality of life. Methods In this retrospective report review, 122 subjects from 2 government MMT clinics were selected from the district of Tampin, Negeri Sembilan, Malaysia. The raw score from the WHO Quality of Life questionnaire (WHOQOL-BREF), at baseline and 6 months after therapy were collected and converted to 0–100 scale form to give quality of life scores for four domains; physical, psychological, social relationships and environment. Other variables of interest were socio-demography, age when joining MMT programme, age and duration of illicit drug use, HIV and Hepatitis C status, and the Opiate Treatment Index (OTI) score on drug use, sexual and social aspect at the baseline. Statistical analysis used the SPSS version 16. Results There was significant improvement in all four domains of quality of life, after 6 months of MMT. The largest improvement was for psychological domain (mean score difference 15.54 ± 20.81). Multivariable linear regression analysis showed that, for the physical domain, there was no significant predictor. For both the psychological and social domains, having tertiary education is a significant predictor for improvement in both aspects of quality of life. Negative HIV status is associated with improvement for the environment domain. Conclusions There was a significant short term improvement in the quality of life of MMT clients who stayed in the programme for at least 6 months in the district of Tampin, Negeri Sembilan, Malaysia.